# The High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH) in Older Adults with HIV

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2023 · $783,778

## Abstract

PROJECT ABSTRACT
With advances in treatment and care,a longer life expectancy is changing the demographics of the HIV
epidemic, and nearly half of those living with HIV in the U.S. are now 50 years or older. People living with HIV,
even while receiving effective HIV medications, have excess morbidity and mortality compared to HIV-
uninfected populations. Increasing age, comorbid burden, and lifestyle factors, contribute to greater than
expected impairments in key components of daily function and a high burden of fatigue among older adults
living with HIV. Effective, scalable, non-pharmacological strategies are needed to improve the healthspan of
this vulnerable population.
 The overall goals of this proposal are to determine whether high-intensity interval training (HIIT) can
overcome 1) physical function impairments and increased fatigue and 2) impairments in mitochondrial
bioenergetics of older people with HIV (PWH) to a greater extent than continuous moderate-intensity exercise
(CME). We further seek to determine whether a biobehavioral coaching intervention following either HIIT or
CME can promote long-term adherence to physical activity, a crucial component of the sustainability of the
intervention. We have previously demonstrated greater than expected impairments in physical function and a
high prevalence of fatigue among older adults with HIV. We found that CME and resistance exercise improves
physical function in older PWH, with additional improvements from a higher-intensity aerobic and
resistance exercise program. Additionally, only our higher-intensity continuous aerobic exercise intervention
reduced fatigue among PWH. Lastly, less than half of our participants continued to exercise at least once
a week following the supervised intervention, which suggests that even when exercise is beneficial it can be
difficult for PWH to maintain. Together, our findings suggest that an innovative approach to exercise is
needed to improve physical function, reduce fatigue, and to maintain a long-term exercise habit among
older PWH.
 To address this critical need, our proposed study will leverage the resources of two diverse participant
populations at the University of Colorado and Case Western Reserve University to 1) Compare HIIT vs CME
on physical function and fatigue, 2) Compare HIIT vs CME on skeletal muscle and peripheral blood
mononuclear cell mitochondrial bioenergetics, and 3) Test a coaching intervention vs control on physical
activity adherence, assessing perceptions of these approaches using mixed methods. This study will generate
rigorous data on physical function and fatigue responses to exercise, the associated mitochondrial adaptations,
and investigate strategies to instill sustained, self-directed exercise behavior. Overall, our findings will inform
the development of scalable, effective exercise recommendations tailored to the unique needs of aging PWH.

## Key facts

- **NIH application ID:** 10599343
- **Project number:** 5R01AG066562-04
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Kristine Mace Erlandson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $783,778
- **Award type:** 5
- **Project period:** 2020-04-15 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10599343

## Citation

> US National Institutes of Health, RePORTER application 10599343, The High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH) in Older Adults with HIV (5R01AG066562-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10599343. Licensed CC0.

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