Betsy Lincoln felt pregnant all the time. Loss of muscle tone in her face, arms, and legs made her look so bad, she didn’t want to leave her apartment. She had little strength or endurance. Lifting one of her children or climbing a flight of stairs exhausted her.
Lincoln (not her real name) is representative of many of the estimated 250,000 women in the United States infected with HIV (human immunodeficiency virus), or the deadly AIDS it causes. And that number is rising. In this country, most of the women are minorities and poor, with limited access to medical care. Recent research also suggests that they may be at increased risk for heart disease. Even the drugs they take to keep their infection under control can cause unwanted changes in body fat and loss of energy.
“Their waistlines are, on average, 20-25 percent above the normal range,” says Steven Grinspoon, associate professor of medicine at Harvard Medical School and Massachusetts General Hospital. “They can be socially stigmatized by their disease, and the side effects may make them less likely to take their prescribed HIV medications.”
“They wear their disease,” adds nurse practitioner and Ph.D. candidate Sara Dolan. “Because of changes in their body shape and image, they often avoid public places.”
With little time or money, going to the gym is out of the question, so Dolan, Grinspoon, and their Harvard-affiliated colleagues decided to bring the gym to them.
“These women face barriers to getting help they need and adhering to an exercise routine, including lack of child care and/or transportation,” Grinspoon points out. “The use of a home-based exercise program was selected to help break down these barriers and to improve chances that the exercises would be done as instructed.”
Physical therapists visited the women three times a week for 16 weeks. “This is the first time that the effects of supervised home exercise on HIV-infected women have been studied,” Dolan points out. “We found that such a program significantly increases their strength. We also saw improvements in heart/lung fitness, endurance, and body shape, particularly waist size.”