Journal of Physical Therapy and Health Promotion Mar. 2014, Vol. 2 Iss. 1, PP. 1-7 1 Long-Term Participation in a Community-Based Fitness Program for Hispanic Adults Living with HIV Influences Health-Related Outcomes Fitness in Hispanic Adults Living with HIV Alexis Ortiz *1 , Farah Ramirez-Marrero 2 , Martin Rosario 3 , Heidi L. Venegas-Rios 4 *1 School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA 2 Dept. Physical Education, University of Puerto Rico, Rio Piedras, Puerto Rico, USA 3 Dept of Anatomy & Neurobiology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico, USA 4 Division of Biostatistics, School of Public Health, University of Texas Health Sciences Center, Houston, Texas, USA * aortiz10@twu.edu Abstract- This study primarily evaluated the effects of a nine-month community-based exercise program on cardiometabolic risk factors and physical fitness for adults living with the human immunodeficiency virus (HIV). We evaluated several cardiometabolic measures (total cholesterol, triglycerides, and body composition), physical fitness variables (cardiorespiratory endurance, muscle strength and endurance, and flexibility), health status (Karnofsky) and immune profile (CD4) of adults living with HIV who participated in a community-based exercise program for a period of nine months. The exercise program adhered to guidelines from The American College of Sports Medicine and comprised of an aerobic, muscular strengthening/endurance, and neuromuscular training components. Participants were tested at baseline and every three months thereafter. Results showed positive changes in lipid profile (p < 0.040), body composition (p < 0.008), and muscle performance (p < 0.046) without affecting the immune system amongst the participants. In summary, it appears that adults living with HIV could benefit from participating in a community-based exercise programs without affecting their immune system. Keywords- HIV; Fitness; Exercise; Cardiometabolic; Community Health I. INTRODUCTION HIV infection is now considered a chronic disease [1], primarily as a result of highly active anti-retroviral therapies (HAART) [2]. However, multi-systemic chronic complications associated with HIV infection and HAART have emerged, causing reduced mobility, reduced participation in daily activities, and reduced health-related quality of life (HRQoL) [1, 3, 4]. Resistance and aerobic exercise programs have proven to be safe and beneficial for adults living with HIV at any stage of the disease [3-12], by increasing muscle strength and muscle mass [9, 11], improving body composition [1, 11], increasing energy levels [13], improving lipid profile [1, 14], and positively affecting psychosocial health [6, 13, 15]. Most of the evidence assessing the effectiveness of exercise in individuals diagnosed with HIV has been through aerobic conditioning programs [6, 7, 10, 12, 16, 17]. Impaired cardiorespiratory fitness has been determined to be one of the main causes for diminished physical capacity by affecting variables of cardiac output and decreasing lactate threshold [17]. Several authors have reported that participating in an aerobic training program performed in a cycle ergometer could improve oxygen consumption, lactate threshold, and quality of life when exercise was performed at moderate (80% of lactate threshold work rate) and high (50% lactate threshold work rate) intensities [6, 12]. However, most of the evidence arises from relatively short-term programs (3-4 months) and controlled research, but not from understudied community-based programs attending the underserved HIV-infected community [18] making the effects of long-term participation (>4 months) in such programs unknown. Therefore, if continuous participation in an exercise program follows a dose- response relationship, then, improvements in overall fitness status would be expected with long-term participation. The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act requires providing multi-disciplinary health services to communities in need by improving the availability, quality, and organization of these services to the HIV-infected community and their families [19]. Community-based centers are the main point of contact between health care providers and patients providing an integrated array of services [20]. However, participation in community-based research has been reported to range from 17% to 26% due to the high costs for case management and recruitment efforts [21]. Although, community-based research can provide a unique glance of health problems within the community and how these problems could be overcome with therapeutic interventions, it lacks the controlled and supportive rigorous research environment. Having a positive health impact on the community by providing health care modalities to these population could help improve prevention and management of cardiometabolic problems that lead to premature disability and death [22]. The Hispanic/Latino community which, given their 20% greater incidence rate of HIV than in non-Hispanic/Latino whites [18], is in greater need for these services. The purpose of this