Exercising to live ‘better’ with HIV/AIDS

$3.9 million NIH grant supports research from Case Western Reserve, University of Colorado on benefits of working out for those living longer with HIV

World AIDS Day on Dec. 1 will be a somber remembrance of the thousands who died from HIV in the last 40-plus years, but also a celebration of those who have survived because of health and scientific medical advances.

For Allison Webel, PhD a nurse scientist and associate professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University, it’s also an annual reminder to focus on her ongoing research to help those survivors live not only longer, but healthier lives.

headshot of CWRU nursing faculty Allison Webel
Allison Webel

Webel and Kristine Erlandson, MD, an associate professor of Medicine-Infectious Disease at the University of Colorado School of Medicine, are co-primary investigators on a new five-year, $3.9 million project funded by the National Institute on Aging, a division of the National Institutes of Health, to examine the effectiveness of different kinds of exercise for people age 50 and older living with HIV.

“The focus this year is resilience, and as we celebrate how far we’ve come in surviving with HIV, now we’re doing more about figuring out how to this growing population live and age well,” said Webel, a national leader indeveloping HIV self-management interventions and identifying factors that lead to other chronic diseases for those aging with HIV. “We’re focused on increasing, not only the maximum lifespan, but their maximum healthspan.”

In this new research, that means looking more carefully into the benefits of two kinds of workouts for older people with HIV.

Webel and Erlandson will compare high-intensity interval training (HIIT) with continuous moderate intensity exercise (CME)-especially how each type of exercise reduces fatigue for older people living with HIV. The study will also compare HIIT vs CME on skeletal muscle and cellular energy production, called “peripheral blood mononuclear cell mitochondrial bioenergetics.”

They’ll also investigate whether a program known as mHealth coaching following either type of exercise can promote sticking with the workout regimen longer.

Webel will be working with partners at University Hospital’s Harrington Heart & Vascular Institute and Dahm’s Clinical Research Unit, and One to One Fitness, while Erlandson will work with similar collaborators in the Denver area.

Webel said previous studies have shown both aerobic and strength training improve all aspects of a person’s mental and social health, but that there is not enough research into the comparative benefits of HIIT and CME.

“Our findings in previous research suggest that an innovative approach to exercise is needed to improve physical function, reduce fatigue and to maintain a long-term exercise habit among older people with HIV,” Webel said.

“This is especially important because some of these people heard the wrong message in the early days. We know that today it is completely safe and healthy for people with HIV to exercise, even though the message early in the AIDS epidemic/pandemic was that they should not over-exert.”

Living with HIV/AIDS

Since the late 1980s, when researchers and physicians discovered a new virus, called the human immunodeficiency virus, or HIV, was causing waves of strange infections, the disease has gone from a death sentence to a manageable, treatable chronic disease, Webel said.

Today, an estimated 1.2 million people are living with HIV in the United States, and 50,000 Americans are infected with HIV every year.

While celebrated, it has also led to new challenges for treating the aging HIV patient-a population that now makes up nearly half of those 1.2 million, she said. Those living with HIV, even while receiving effective HIV medications, still have a higher rate of other diseases and death compared to the general population.

The reasons are often a combination of not only their increasing age, but the burden of other diseases and lifestyle factors.

Efforts by Webel and others, then, have focused on finding new strategies to improve the life of a particularly vulnerable population. Some of her previous work has looked at how diet and exercise combined can ease symptoms of HIV.

“We’re in a new era,” Webel said. “For younger people, having the virus isn’t as scary, and they may not need the same prompt to exercise and keep exercising. But the longer-term patients often do, and we’re trying to help them do that and do it well.”

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