To Stay Well, Get Moving!

For many gay men (and everyone else), cardio exercise is little more than a necessary jog toward that coveted six-pack. Even if the health benefits of raising our heart rate and keeping it there for a good workout may not be the main reason for hopping on a treadmill for 40 minutes or taking the bike for a 10-mile spin, those benefits are still the result -- whatever your motivation.

The benefits of intense cardio should, however, rank front-and-center for people living with HIV. The defined abs are great (and you'll get them, too), but the long-term health benefits of cardio exercise loom even larger and are greater if you're HIV-positive.

HIV and the side effects of HIV medications can have an impact in a number of ways, from anxiety and insomnia to changes in bone density and body-fat distribution. Putting your body to work with regular cardio exercise can help combat many of those. As long as you're managing the disease, your HIV status doesn't have to dictate whether you're a casual jogger or an Ironman.

The U.S. Department of Health & Human Services recommends 30 to 45 minutes of daily cardio exercise for those with HIV. Their definition includes "working around the house" as a form of exercise, so it's not clear how serious they take a legit cardio routine. (Despite what you might read, housework, gardening, washing the car are better than sitting on your butt, but are not cardio exercise.)

A research team at the University of Washington lays it out a bit more specifically: 20 to 40 minutes of aerobic exercise targeting a heart rate 50 to 90 percent of maximum three times a week. And don't use age as an excuse: That recommendation holds true for people over 50 living with HIV as well.

20 Years HIV+ & a Serious Marathoner

Safe cardio training can go far beyond that. In fact, with a little planning, there's nothing to stop people with HIV from tackling some of the toughest athletic goals.

AIDS Foundation of Chicago President and CEO David Ernesto Munar has been a distance runner since his days as a harrier on his high school cross-country team. For the last decade, he has participated in several marathons.

He's not alone. AIDS marathons have been popping up around the world for years. The National AIDS Marathon Training Program has a foothold in some of these cities, plus San Francisco and Washington DC. Nearing 20 years since his HIV diagnosis, Munar finds running gives him a deep sense of empowerment.

"I feel an agency over my body when I run," Munar said. "I'm controlling it. I may be sore, or I may have a great run, but I'm demonstrating an agency over my body that I feel HIV may rob me of somewhat. It's a confidence booster. You can't get rid of HIV, but in this moment you can be as strong or as fast as you want. For me it's very much like meditation."

The key to exercising so intently is managing the disease clinically. For many years, Munar rejected medications to control his viral load. In that compromised condition (not recommended!), he had to take extra precautions to keep himself healthy. He avoided running outdoors on cold or rainy days, which isn't an easy task in Chicago. When he broke his own rule, sinus infections and head colds often ensued.

Since he began taking ART medication, there's been a measurable shift in not just how he feels on a regular basis, but also where and when he's now able to exercise. "If you're dealing with your HIV clinically, and your viral load is suppressed, then you're going to be well-suited for even strenuous exercise," Munar said. "If your HIV is well-controlled, even strenuous exercise can be great for you."

Munar's own foundation is so committed to that philosophy that it has created a marathon-training program both as a fundraiser and to provide a welcoming, healthy space to connect with like-minded others. There are also "Team To End Aids" distance-training programs in Los Angeles and Houston. Even as far away as Africa, organizations like PositiveHeros use distance running to break down barriers.

You don't have to be a marathoner, however, for your body to get the benefits of cardio exercise -- and, additionally, as a great way to meet other healthy-minded pozzers.

Top Swimming Competitor Is HIV+

Jack Mackenroth is well known as a finalist on TV's "Project Runway," but he's also a master's-level swimmer who has been living with HIV for over two decades. He competes at the highest levels of his sport: He recently placed in the top six at the US nationals in three separate events.

Intense cardio exercise via swimming has resulted in both increased muscle mass and general cardiovascular fitness, Mackenroth said. Both have been proven helpful in managing HIV. Mackenroth is no stranger to long, exhausting workouts in the pool with Team New York. Because he controls his HIV medically, he added, he doesn't let his condition get in the way of his conditioning.

"In a way, it's quite the opposite of a hindrance," said Mackenroth, who is also the director of public relations and special events for World Health Clinicians. "I feel such pride of my achievements because I do it all while managing my HIV."

The mental aspect of cardio is a huge factor. Despite progress, HIV is still stigmatized in our culture. While it's no longer fatal, folks who contract the disease often deal with depression, anxiety and social rejection.

"For some people running is boring, for others it's cathartic," Munar said. "You can focus on a problem or focus on nothing, and your mind goes into the self-conscious. It's like meditating. It helps burn off the daily grind of stress that we carry, and not just what's related to HIV. Not everyone is going to find that mental health outlet in running, but they might find it in another exercise. It's about breaking your routine and breaking a sweat."

Despite his sport being largely individual, Mackenroth also extolled the virtues of long, solitary swims. It helps that he has found a lot of support with Team New York. Team New York has lot of HIV-positive swimmers," Mackenroth said. "It helps to have goals and a community that supports you."

However you may want to engage in cardio exercise, be it biking, running, swimming, jumping rope or on a Stairmaster, ACE Fitness has recommendations that take you from easing into a regular program to being aware of how exercise is making you feel. Whether you want to be a casual jogger or a weekend warrior, it's important to find a local sports organization to help map out a plan and meet new people. LGBT and HIV-oriented sports organizations exist in nearly every major city.

So just do it. Once you get started, you'll feel better -- in every way.

This story is part of our special report: "Keeping Fit with HIV". Want to read more? Here's the full list.