Taking that first step

It can be hard to get motivated. But you have no idea the benefits that await you—often within only days of becoming a little more active

If anyone knows how exercise over the course of a lifetime can be a bumpy ride of hills and valleys, it’s Alicia Diggs, 52, of North Carolina. Diagnosed with HIV in 2001, she recalls, “There was a time when I did not work out at all and I weighed almost 300 pounds.” Based in part on her family history, she knew that she was at severe risk for diabetes, heart disease and countless other ailments—and that she had to make a change.

So, first she stopped drinking soda. Then she started walking a lot in the park. Then she joined a gym and started taking different dance classes. And—not surprisingly—she lost weight and felt a whole lot better.

But then about a decade ago, in her words, “life situations happened”—her brother died, she hurt her knee and her father got sick—“and I started eating my emotions and stopped doing anything.” That brought her into the COVID pandemic, during which—once again feeling deeply compelled to get back in shape—she found something that not only motivated her to get back in shape, it was also among the most fun she’d ever had: She joined her local chapter of the 40+ Double Dutch Club, a nationwide network of mostly Black women who get together not only to jump rope as they did in their girlhood but also to stretch, hula hoop, dance to the classics of yesteryear—and, perhaps most crucially, just be there for each other. “It’s like a support system,” says Diggs. “A sisterhood.”

“I cried joyful tears” the first time she saw them in online videos, says Diggs—women in their 70s and even 80s jumping rope. Once she joined, other women in the group got wind via social media that she was living with HIV and involved in HIV activism—and completely supported her.

“They said, ‘Alicia, oh my gosh, you’re amazing!’” she says. “I’d been worried that they’d be uneducated about HIV and not want me to touch the rope, but nobody acted differently at all. It was like telling them I had diabetes or high blood pressure or anything else.”

The dangers of sitting and the gifts of moving

Diggs hit the ideal when it comes to exercise: Not only did she find something that made her move and was good for her health and longevity, she found something she absolutely loved—with people she loved. That’s crucial, say experts, because the most important thing about exercise isn’t how hard or long you go for in any one session but sticking with it over time, weaving it into the permanent fabric of your life.

“If you and your friends are going for a run or walk every weekend before brunch, then those are relationships you want to build on and maintain,” says Austin, Texas-based fitness trainer Tyriek Taylor, 35, who says that his workout routine helped him get through his 2019 HIV diagnosis.

There are repercussions to being sedentary and eating highly processed foods high in sugar, salt and white flour—leading to putting on weight. A mountain of research going back decades has shown how sitting all day on the job and couch-potato’ing in your off hours sets you up for a world of woes, especially as we age—everything from the bad-health trifecta of diabetes, high blood pressure and heart disease to a higher risk of numerous cancers to pain of all sorts, inflexibility, muscle and bone decay, lack of stamina when doing even the simplest tasks (like climbing a flight of stairs), depression, and accelerated cognitive decline.

A slightly smaller mountain of research suggests that all these things might happen harder and faster in folks with HIV, due to the virus’ tendency to accelerate aging, even when it’s well-controlled by meds. All the more reason why exercise is so crucial.

The benefits

But let’s stop focusing on the negative outcomes of not moving and look instead at the bounty of desirable outcomes when you do move. Research has shown that once you do, even before you start losing weight, you can lower your blood sugar in as soon as one hour, not to mention increase your energy, strength, stamina, and mood.

If you increase, intensify, or consistently stick with exercise—to the point that you’re doing something strenuous enough to raise your heart rate for at least 30 minutes most days of the week—and especially if you add some form of strength training to the mix, like squats and even chair push-ups—then the benefits really start to rack up. Not only will you lose weight and feel better, you’ll improve your blood sugar control, lower your blood pressure, develop stronger bones and muscles, reduce your risk of diabetes complications, and improve your mood, sleep quality, long-term mental cognition—and, likely, ultimately your longevity.

These rules apply to everyone, but they have special resonance for folks with HIV. A 2010 review of several studies found that people with HIV who did aerobic exercise, or a combination of aerobic and strength-training exercise, for at least 20 minutes at least three times a week for at least five weeks enjoyed “significant improvements” in the areas of heart and lung function, body composition (muscle to fat ratio), and mood (decreased depression).

And that’s just one piece of a large body of research finding similar results, including that regular exercise improved adherence to meds for folks with HIV, in part because exercise lifts a person’s mood (when you’re depressed, you’re less likely to take your meds).

About the only thing that exercise has been found not to improve in folks with HIV is their viral load. The only thing that can get a person with HIV to long-term undetectable status is sufficiently suppressive HIV medication.

This one’s for all the sitters out there

There are plenty of folks with HIV for whom moderate or intense exercise—such as biking, running, and/or some kind of cardio and strength training program at a gym—is a central part of our lives. This writer, in fact, is one of them: I’ve been a runner and gym goer since well before I was diagnosed with HIV in 2001; it’s so central to my wellness and happiness that sometimes I have to motivate myself not to work out and, instead, go for a relaxed walk or go see a friend.

For this story, POSITIVELY AWARE put out a query over several Facebook groups for folks with HIV asking about exercise habits—and plenty of people (mostly gay men as well as a few women) wrote back to describe intense routines they stick to religiously.

IN FLORIDA, Lepena Reid, 68, and diagnosed with HIV in the mid-1980s, said that her routine consisted of walking 30–60 minutes in her neighborhood or at the mall every day—plus strength training (which most people said they did on machines at a gym) a few days a week at the YWCA.

IN BRAZIL, L.F. (who withheld his full name), 58, and diagnosed with HIV in 2015, said that he joined a $30-a-month gym where he goes three to five times a week to do strength training. He goes early in the morning before putting in a full day taking care of his elderly father. Since he took up the gym again seriously several months ago, he says, “I’ve noticed I’m leaner, my legs are stronger, and I have some arms and chest now.”

But this story is more geared toward folks with HIV who barely get out of the chair or off the couch, who perhaps haven’t exercised in years or never have. And that focus starts with an acknowledgement that going from sedentary to active isn’t necessarily easy and eludes many people for a variety of reasons, from being stuck in a depressive rut to being too busy with work and/or caring for others to feeling set back from chronic pain or other ailments.

“I watched my mom do everything for us and nothing for herself,” says Taylor, “and I’ve seen a lot of moms like that, especially Black moms, bust their ass to raise their kids and die while doing it.” But the thing is, he says, “if you want to stay strong and live long enough to see your grandkids grow up, you have to take moments away from the people you care for to exercise.”

Taking the first step

What should the first step be? It doesn’t matter, say experts, as long as you take one—literally. If you have the time and money to access a trainer or some kind of gym or outdoor fitness group, like a walking group, that's great. (Start by calling or googling to see if your local HIV services group or other nonprofit, charity, or community center has offerings.)

It doesn’t even have to be structured. One of the easiest things to improve a lot of baseline health markers is simply to walk more, says Omar Kent, an independent trainer in New York City who has often worked with people with HIV. “You need three to five hours a week of activity that has nothing to do with the gym to maintain a certain quality of life,” he says. “So do things like get off the subway or train a few stops early and walk the rest of the way home.”

You could also take the stairs instead of the elevator or escalator on a regular basis, or even just walk a few flights of stairs every day for the sole purpose of exercise. If you sit most of the day—whether at a desk or on the couch—you could benefit simply by setting your phone or watch to go off every hour to get up and walk around for 10 minutes.

“I have a client who started working with me when he was 60 who couldn’t do much,” says Kent. “He was busy and we found a schedule where he could meet me at the gym two days a week. We worked on a lot of things over a period of time. And then he started telling me that he felt better just walking down the street. One day, he ran across the street just before the light changed and then realized that he wouldn’t have been able to do that a year before.”

Kent recalls another client who, because of her physical condition, was unable to raise her arms above her head; after some training, she was able to lift her luggage into an overhead compartment on a plane. “That’s really what people care about,” he says, “to participate in life without feeling like they’re limited.”

In this feature, you’ll find tips to get moving—or to take your exercise game from one level to the next. And read some of the capsule stories from folks with HIV. Then—take that first step! (Or that second or third step.) You may dread the thought of it, and you may feel discomfort at first as you push yourself out of your comfort zone. (It’s advisable to consult with your primary health provider before taking a new fitness step.)

As for Diggs, her joy at being part of the Double Dutch community was cut short in June when she was in a car accident, which caused some muscle damage (fortunately, she didn’t break anything). “I’m not able to jump right now,” she says—she misses her Double Dutch friends, three of whom dropped everything and drove long distances to be with her after the accident—“so I’ve been doing hula in the house a little bit. I also just joined Gold’s Gym, which has a trainer I talked to who is going to work with me. I have to be careful with some machines, but I can do stuff like the elliptical machine and free weights.”

Various events may have paused her exercise at certain points in her life, but she always returned to it—at the level and pace she could manage at that time. Why? “I’m completely afraid of being diagnosed with diabetes and heart disease—my family has a history of obesity,” she says. But her main reason is rooted not in fear but in a zest for living: “It gives me a better quality of life,” she says. “I have grandchildren—and I want to be around for them as long as I can.” 

A simple start

FEDERAL GUIDELINES for adults recommend at least 150 minutes of moderate-intensity physical activity a week. You might split that into 22 minutes a day or 30 minutes a day for 5 days. You can use any combination that fits your schedule. The Centers for Disease Control and Prevention offers suggestions and additional information: cdc.gov/healthy-weight-growth/physical-activity/getting-started.html

Need motivation? Follow these tips

Start with a teeny-tiny step. Almost literally. If you sit or lie down most of the day but are physically able to walk, even if you need a walker, then resolve that you are going to get up and walk around your house, or outside, for 10 minutes once a day for a week. (Text a friend about it so they can hold you accountable.) Then up it to twice a day for a week. Then to fifteen minutes three times a day for a week. And so on and so on.

Add joy to your movement. Would it be easier to get up and walk around, or to put in an hour at the gym, if you were listening to your all-time favorite music? If you were immersed in a podcast or a really good audiobook? If your walk had a happy destination like grabbing a coffee or watching dogs in a dog park? If you lost yourself in a cooking show on a TV screen in front of your treadmill? Then go for it! Anything that makes exercise the backdrop to something fun rather than a slog will help you sustain your routine. Machines have a place to plug in your headphones.

Don’t do it alone! There are so many ways you can tie exercise to connection, socializing, and fun. Call your local HIV services organization or poke around online (google your city or region plus terms like “free walking group,” “free exercise group,” or “free fitness options”) until you find a really cool group of people to be active with, like Alicia Diggs did with her Double Dutch “sisters.” Ask a neighbor or friend if they’ll take a daily or several-times-weekly walk with you or hit the gym with you. Or call or FaceTime a friend while you’re out walking. You can always do a YouTube class at home alone. (Google “Positive Fitness: An online fitness class for people living with HIV” for one option.)

Build fitness into your life. Especially if you’re busy, you don’t necessarily have to carve out special time to exercise, although many people swear that such dedicated time is crucial to their mental health. Walk to your errands instead of taking a car (if they’re within what is walking distance for you). Dance in the kitchen while making dinner. Walk while taking work calls. Or you could resolve to take the stairs anytime you’d ordinarily take the elevator or escalator. (The health benefits of stair-climbing can’t be overstated.)

Keep a movement journal. In addition to wearing an exercise-tracking device like a FitBit or setting your phone to track your movement, keeping a diary of your daily movement or exercise, as well as how it changes your body and mood, is a great way to stay motivated. It’ll make you more generally mindful of how much you are—or aren’t—moving, and what you’re getting from it. And it’s a great place to sketch out new fitness goals for yourself from week to week.