PURPOSE: The objective of this systematic review was to examine the effectiveness and safety of aerobic exercise interventions on immunological/virological, cardiopulmonary, and psychological outcomes in adults living with HIV/AIDS. METHODS: Ten randomized trials of HIV-positive adults performing aerobic exercise three times per week for at least 4 wk were identified by searching 13 electronic databases, abstracts from conferences, reference lists, and personal contact with authors from 1980 to November 2002. At least two independent reviewers assessed articles for inclusion, extracted data, and assessed methodological quality. Random effects models were used for meta-analysis. RESULTS: Main results indicated that aerobic exercise was associated with small nonsignificant changes in CD4 count (weighted mean difference 14 cells/mm3, 95% CI -26 to 54), viral load (weighted mean difference 0.40 log10copies, 95% CI -0.28 to 1.07), and VO2max (weighted mean difference 1.84 mL/kg/min, 95% CI -0.53 to 4.20). Individual studies suggested that aerobic exercise may improve psychological well-being for adults living with HIV/AIDS. These findings are limited to those participants who continued to exercise and for whom there was adequate follow-up. CONCLUSION: In conclusion, performing constant or interval aerobic exercise, or a combination of constant aerobic exercise and progressive resistive exercise for at least 20 min, at least three times per week for 4 wk may be beneficial and appears to be safe for adults living with HIV/AIDS. However, these findings should be interpreted cautiously due to small sample sizes and large dropout rates within the included studies. Future research would benefit from increased attention to participant follow-up and intention-to-treat analysis.

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