Response from Mr. Vergel
No problem. It is very good of you to post this question. I am glad you have the initiative to ask! There are no standards for exercise in HIV disease,so I will give you a few pointers that I have learned as a consumer and a trainer myself.
1- You cannot catch HIV by training someone who is HIV positive. Feel free to touch them. Do not be afraid of sweat. Just make sure that client has no open wounds anywhere, but this is standard practice anyway.
2- Ask your client if he/she has neuropathy (pain in the extremities) or myopathy (muscle weakness). If he/she does, you need to be extra careful since these are two huge issues that can cause them to get discouraged. Start then slow and with low weights.
3- Fatigue and diarrhea can also be very debilitating as side effects of HIV medications. Make sure the person stays hydrated and that you find out when in the day their energy is at the highest point.
4- AIDS is defined by T cells of 200 or below or the presence of an opportunistic infection. To be honest with you, I have seen people with 50 T cells having a lot better strength and energy than a person with 400 T cells, so T cells are not predictive of exercise performance (in my opinion)
5- Find out if their doctor put them on some sort of anabolic steroid, growth hormone or testosterone since these agents will tend to improve response to exercise dramatically.
6- Find out what their weight history has been and if they have experienced wasting syndrome or lipodystrophy (fat build up in the mid section, while they lose fat under the skin everywhere). Take body measurements if you can at baseline and every 3 months or so. Ask them if they got a BIA test for body composition at their doctor's office or local HIV agency.
7- You may want to ask them about their cholesterol, triglycerides and blood sugar since many of us have increased values due to HIV medications. Exercise should help bring these values down!
8- In my experience at the Body Positive Wellness Clinic in Houston, the fastest size and strength gains are in the legs. Many HIV positive people lose leg strength and size with the illness.
9- HIV positives may also have lower bone density and joint problem, so concentrate on low impact cardiovascular exercise (elliptical trainers are great)
10- Make them feel confortable. Tell them how much you know about HIV and how much you are willing to learn with them. People with HIV want to be treated like everyone else. Ah! one more thing, turn your cell phone off while you are training. I hate when I see trainers on the phone while training someone who just paid them $50 an hour for their time!
I hope this helps some. You can get a lot more information in medibolics.com if you wish.
Nelson
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