Exercise to Mitigate the Effects of Aging With HIV: A Narrative Review With Exercise Recommendations for Practice

ABSTRACT: Although antiretroviral therapy (ART) has extended the lifespan of people living with HIV (PWH), many experience complex age-related comorbidities and functional decline. Nurses are increasingly caring for PWH navigating cardiometabolic disease, neurocognitive changes, frailty, and mental health challenges. This narrative review provides a multidimensional overview of aging with HIV and highlights the role of exercise as an accessible, evidence-based strategy to support healthy aging. Chronic immune activation and long-term ART use contribute to inflammation, mitochondrial dysfunction, cardiometabolic risk, and neurocognitive impairment. Evidence demonstrates that aerobic and resistance training can improve immune markers, cardiometabolic health, cognitive function, mood, and quality of life without adversely affecting HIV progression. Practical, adaptable exercise protocols suitable for clinical, home-based, and community-based settings are provided to support integration into routine HIV care. Regular exercise represents a safe and scalable strategy nurses can incorporate into comprehensive, patient-centered care for aging PWH.