Chronotropic Incompetence among People with HIV Improves with Exercise Training in the Exercise for Healthy Aging Study.

BACKGROUND: People with HIV (PWH) have lower exercise capacity compared to peers without HIV, which may be explained by chronotropic incompetence (CI), the inability to increase heart rate during exercise. METHODS: The Exercise for Healthy Aging Study included adults ages 50-75 with and without HIV. Participants completed 12 weeks of moderate intensity exercise, before randomization to moderate or high intensity for 12 additional weeks. We compared adjusted heart rate reserve (AHRR; CI <80%) on cardiopulmonary exercise testing by HIV serostatus and change from baseline to 12 and 24 weeks using mixed effects models. RESULTS: Among 32 PWH and 37 controls (median age 56, 7% female, mean BMI 28 kg/m2), 28% of PWH compared to 11% of controls had CI at baseline (p = 0.067). AHRR was lower among PWH (91 vs 101%; difference 10%, 95% CI 1.9-18.9; p = 0.02). At week 12, AHRR normalized among PWH (+8%, 95% CI 4-11; p < 0.001) and was sustained at week 24 (+5, 95%CI 1-9; p = 0.008) compared to no change among controls (95%CI -4 to 4; p = 0.95; pinteraction = 0.004). After 24 weeks of exercise, only 15% PWH and 10% of controls had CI (p = 0.70). CONCLUSIONS: Chronotropic incompetence contributes to reduced exercise capacity among PWH and improves with exercise training.

Qualitative Description of Exercise Perceptions and Experiences Among People With Human Immunodeficiency Virus in the High-Intensity Exercise to Attenuate Limitations and Train Habits Study.

BACKGROUND: The benefits of physical activity (PA), specifically exercise, among older adults in general are well known. Yet globally, there is concern regarding limited engagement in PA, increased obesity, and frailty among older people with human immunodeficiency virus related to low levels of PA. METHODS: We conducted in-depth interviews among 30 older, sedentary people with human immunodeficiency virus participating in the ongoing High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH study, NCT04550676) between February 2021 and August 2022. A semistructured interview guide, informed by two minds theory, which frames behavior change as an intention-behavior gap between 2 neurocognitive systems, was used to elicit data from participants. Interviews explored general exercise perceptions, self-efficacy for exercise, mobile health intervention tailoring, outcome expectations, and PA goals. Thirty interviews from 33 participants were recorded and transcribed verbatim, and deductive and inductive thematic analysis were used using Dedoose. RESULTS: Physical activity was defined as maintaining daily living activities and addressing health goals. Previous experiences with PA varied among participants and were influenced by chronic illnesses, including human immunodeficiency virus; motivation; work commitments; interest; and social support. Reported barriers to PA included antiretroviral adverse effects, comorbidities, aging, and the COVID-19 pandemic. Changes in health status, body changes, and relationships were identified as benefits of PA. Conversations with healthcare providers supporting exercise goals were perceived to be important but rarely received by the participants. CONCLUSION: Understanding how older people with human immunodeficiency virus perceive PA is crucial to developing tailored strategies and structuring service delivery within the healthcare setting to promote a physically active life.

Factors Related to the Need for Informal Care Among Community-Dwelling Older Adults in Chile.

PURPOSE: To identify factors contributing to the need for informal care among community-dwelling older adults with functional impairment in Chile. METHOD: A secondary data analysis was conducted using cross-sectional data from 540 Chilean older adults aged ≥60 years (mean age = 72.2 years, SD = 6.22 years). RESULTS: Informal care need was reported by 24.3% (n = 131) of participants. Among the variables that most influenced the need for informal care among older adults were hospitalization in the past 1 year, functionality, comorbidities, and multidimensional frailty (all p < 0.05). CONCLUSION: This study identified factors that clinicians and nurses should be aware of when caring for this population to prevent or manage the need for informal care. [Journal of Gerontological Nursing, 50(2), 43-52.].

The use of non-invasive imaging modalities for the assessment of skeletal muscle quantity and quality in people with HIV: A narrative review.

BACKGROUND: People with HIV (PWH) are prone to mobility impairments and physical dysfunction, with the loss of skeletal muscle quantity and quality being a major contributor to the dysfunction. Assessment of skeletal muscle is an important component of care for this patient population for early intervention and treatment. The use of non-invasive imaging techniques to evaluate skeletal muscle, such as dual X-ray absorptiometry, computer tomography and magnetic resonance imaging, has increased in popularity in recent years. PURPOSE: This narrative review synthesizes the use of these techniques and summarizes the associations between outcomes from these imaging modalities and physical function in PWH.

Blunted Muscle Mitochondrial Responses to Exercise Training in Older Adults With HIV.

BACKGROUND: Muscle mitochondrial dysfunction associated with HIV and antiretroviral therapy (ART) may improve with exercise. METHODS: Muscle specimens obtained before and after 24 weeks of exercise in older people with HIV (PWH; n = 18; ART >2 years) and uninfected controls (n = 21) were analyzed for citrate synthase (CS) activity and complexes (C) I-V, manganese superoxide dismutase (MnSOD), peroxisome proliferator-activated receptor-γ coactivator-1 (PGC1α), and voltage-dependent anion channel 1 (VDAC1) content. RESULTS: Only controls had increased CS, MnSOD, PGC1α, and CIV (P ≤ .01; P < .01 vs PWH) after training. CONCLUSIONS: The blunted mitochondrial adaptations to training in PWH suggests the need for different types of exercise-induced stimulation. CLINICAL TRIALS REGISTRATION: NCT02404792.

The Impact of Moderate or High-Intensity Combined Exercise on Systemic Inflammation Among Older Persons With and Without HIV.

BACKGROUND: We investigated whether higher-intensity exercise provided greater decrease in markers of inflammation, and whether responses differed by HIV serostatus. METHODS: People with HIV (PWH; n = 32) and controls (n = 37) aged 50-75 years completed 12 weeks moderate-intensity exercise, then were randomized to moderate- or high-intensity exercise for 12 additional weeks (n = 27 and 29, respectively). Inflammation biomarkers were measured at 0, 12, 24 weeks. Mixed and multiple regression models were adjusted for baseline inflammation, age, and body mass index. RESULTS: Baseline tumor necrosis factor-α (TNF-α), soluble TNF receptor 2 (sTNFR2), and soluble CD14 (sCD14) were significantly higher among PWH than controls (P < .04). From week 0-12, changes in interleukin-6 (IL-6), TNF-α, and sTNFR1 were not significantly different by HIV serostatus. We found no significant interaction between HIV serostatus/exercise intensity on week 12-24 changes in IL-6, TNF-α, and sTNFR1. Among high-intensity exercisers, PWH and controls had significant increases in sCD14 (P ≤ .003), controls significant increases in IL-10 (P = .01), and PWH nonsignificant decrease in highly sensitive C-reactive protein (P = .07). Other markers were not significantly different by serostatus or intensity. CONCLUSIONS: Moderate and high-intensity exercise elicited similar effects on inflammation among PWH and controls, with additional beneficial effects seen among high-intensity exercisers. Increase in sCD14 and attenuated IL-10 increase (PWH only) merit further study. CLINICAL TRIALS REGISTRATION: NCT02404792.

Associations between demographics and quality of life in children in the first year of cancer treatment.

Symptom distress and decreased quality of life (QOL) among children with cancer are well documented. Research is emerging on the child's voice in QOL-symptom reports, but existing QOL questionnaires are burdensome and objective biologic markers are lacking. We examined children's symptoms and QOL from parent and child perspectives and compared the results to one biologic marker (body posture). A cross-sectional secondary analysis of prospective data from children receiving creative arts therapy explored potential associations among demographics with and between QOL measures (PedsQL, Faces Scale, posture). Children (n = 98) ranged in age from 3 to 17 years (M = 7.8) and were in the first year of cancer treatment. No significant associations were found among the child's sex, race/ethnicity, socioeconomic status (SES), or distance from hospital, and total PedsQL. Older age was associated with worse total PedsQL, pain, nausea, worry, and posture (all P < 0.05). Greater worry (ß = 0.51) and worse posture (ß = 0.41) were the QOL variables most strongly correlated with older age. Poorer posture was associated with worse child PedsQL (total score, nausea, treatment anxiety, cognitive) and parent PedsQL (pain, nausea). Worse scores on the Faces Scale, PedsQL, and posture were all correlated (r = 0.21-0.39, all P < 0.05). Interventions to improve QOL could target nausea, worry, and older patients. Accuracy and interpretation of symptom distress in children are problematic. The Faces Scale and posture may be suitable, readily obtained measures of QOL in pediatric oncology that hold promise.

Ibuprofen taken before exercise blunts the IL-6 response in older adults but does not alter bone alkaline phosphatase or c-telopeptide.

INTRODUCTION: Non-steroidal anti-inflammatory drugs (NSAIDs) taken before exercise have been shown to impair bone formation. NSAIDs also suppress inflammatory cytokines, such as interleukin-6 (IL-6), that can have pro-resorptive effects. It is unclear how taking NSAIDs timed around exercise influences inflammatory and bone biomarkers following an acute exercise bout in older adults. PURPOSE: To determine if timing of ibuprofen use relative to a single exercise bout has acute effects on serum IL-6, bone-specific alkaline phosphatase (BAP, marker of bone formation), and c-telopeptide of type I collagen (CTX, marker of bone resorption). METHODS: As part of a 36-week exercise intervention, participants aged 60 to 75 years were randomized to 3 groups: placebo before and after exercise (PP), ibuprofen before and placebo after exercise (IP), or placebo before and ibuprofen after exercise (PI). Acute responses were studied in a subset of participants (12 PP, 17 IP, 13 PI). Blood was sampled before and immediately, 30 min, and 60 min after exercise for IL-6, BAP, and CTX. RESULTS: The exercise-induced increase in IL-6 was blunted in response to IP when compared to PI 60-min after exercise (p < 0.001). There were no significant differences in the change in BAP or CTX between groups at any time points CONCLUSION: Ibuprofen taken before exercise dampened the inflammatory response to exercise but had no effects on bone biomarkers in older adults. It may be necessary to monitor changes for a longer time interval after an acute exercise bout to determine whether bone turnover is altered by ibuprofen or other NSAIDs. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00462722; Posted 04/19/2007.

Effects of Physical Activity Programs on Health Outcomes of Family Caregivers of Older Adults with Chronic Diseases: A Systematic Review.

This systematic review was conducted to analyze and capture the most recent trends in physical activity interventions for family caregivers of older adults with chronic disease as found in randomized clinical trials over the last 10 years (2010-2020). We used PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library. We synthesized participants' demographics, physical activity interventions and family caregivers' health outcomes. The Cochrane Collaboration Risk of Bias Tool was used to assess risk of bias of the included studies. Sixteen studies were included and most studies (n = 11) had a moderate risk of bias. Physical activity programs with mixed modes (e.g., aerobic and resistance exercise), mixed delivery methods (e.g., in-person and telephone) and mixed settings (e.g., supervised gym-based sessions and unsupervised home-based sessions) were used most frequently. Physical activity interventions significantly improved psychological health but had inconsistent effects on physical health. This review provides current trends and research findings that suggest types of physical activity interventions and components that improve family caregivers' health and wellness.

A supervised exercise intervention fails to improve depressive symptoms and quality of life among sedentary older adults with HIV infection.

Older people living with HIV (PLWH) experience multimorbidity that can negatively impact quality of life (QoL). Exercise can improve physical function, but effects on QoL are not well understood. 32 PLWH and 37 controls aged 50-75 completed 12-weeks of moderate-intensity exercise, then were randomized to moderate or high-intensity for 12 additional weeks. Depressive symptoms (CES-D scores) were significantly greater and QOL (SF-36 mental and physical summary scores) significantly lower among PLWH at baseline (all p < 0.05). PLWH had significantly greater worsening in CES-D scores compared to controls (3.4 [0.7, 6.0]; p = 0.01) between 13and 24 weeks. Mental QoL changed minimally, with no significant difference in changes by serostatus between weeks 0 and 12 or weeks 13 and 24 (p ≤ 0.22). Changes in physical function summary scores were similar by serostatus between 0 and 12 weeks (1.5 [-1.6, 4.6], p = 0.35), but declined significantly more among PLWH between 13 and 24 weeks (-4.1 [-7.2,-1], p = 0.01). Exercise intensity had no significant effect on changes in CES-D or SF-36 summary scores; high-intensity exercise was associated with greater improvements in vitality/fatigue (4.1 [0.8, 7.3], p = 0.02), compared to moderate-intensity. Exercise initiation failed to improve depressive symptoms or QoL among PLWH. Additional interventions may be needed to maximize these patient-reported outcomes among older PLWH initiating an exercise program.

Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: A pooled analysis of four clinical trials.

OBJECTIVE: Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex-specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass and fat-free mass in older women and men enrolled in four similar clinical trials. DESIGN: Pooled analyses of data from four double-blinded, randomized controlled trials. PARTICIPANTS: Women (n = 295) and men (n = 290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months. MEASUREMENTS: Twelve-month changes in BMD, fat mass, fat-free mass and serum DHEA sulphate (DHEAS), (17)estradiol, testosterone and insulin-like growth factor-1 (IGF-1). RESULTS: Women on DHEA had increases (mean ± SD; all P < 0.001 vs placebo) in DHEAS (231 ± 164 µg/dL), testosterone (18.6 ± 20.9 µg/dL), (17)estradiol (8.7 ± 11.0 pg/mL) and IGF-1 (25.1 ± 52.3 ng/mL), and men had increases in DHEAS (269.0 ± 177 µg/dL; P < 0.01), (17)estradiol (4.8 ± 12.2 pg/m; P < 0.01) and IGF-1 (6.3 ± 41.4 ng/mL; P < 0.05). Women on DHEA had increases in lumbar spine (1.0% ± 3.4%) and trochanter (0.5% ± 3.8%) BMD and maintained total hip BMD (0.0% ± 2.8%); men had no BMD benefit and a decrease in fat mass (-0.4 ± 2.6 kg; all P < 0.01 vs placebo). CONCLUSIONS: Dehydroepiandrosterone therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are (a) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and (b) whether DHEA has a more favourable benefit-to-risk profile for women than oestrogen therapy.

Turning disability into ability: barriers and facilitators to initiating and maintaining exercise among older men living with HIV.

Physical activity reduces the risk for comorbidities, but little is known about barriers to exercise among older adults living with HIV. Three focus groups were conducted among 19 adults living with HIV, aged ≥ 50 years, who were enrolled in or recently completed a supervised exercise intervention. Sessions were recorded, transcribed, and coded first using inductive methods. All participants were male, and the majority were white, non-Hispanic; 53% were receiving disability benefits. All had suppressed HIV infection on antiretroviral therapy, with almost 20 years since HIV diagnosis. Participants noted a lack of self-efficacy, motivation, and physical limitations that contributed to a sense of "disability" as barriers to exercise prior to the intervention. Through social support and improvements in self-efficacy, participants were motivated to start and continue exercising. Perceived sense of disability may impede (or interfere with) exercise initiation and maintenance; self-efficacy and social support may facilitate exercise maintenance in older adults living with HIV.

Evaluation of the effects of a clinically implemented exercise program on physical fitness, fatigue, and depression in cancer survivors.

PURPOSE: Despite national recommendations, exercise programs are still not clinically implemented as standard of care for cancer survivors. This investigation examined the effects of a clinically implemented and personalized exercise program on physical fitness, fatigue, and depression in a diverse population of cancer survivors. The association of various participant characteristics on program performance was also examined. METHODS: Data were collected from 170 cancer survivors who had participated in a clinical exercise program. Any cancer type was included and survivors were either undergoing medical treatment or had completed treatment (< 6 months prior to program initiation). Baseline and post program measures of estimated VO2peak, grip strength, fatigue, and depression were compared in survivors who completed the program follow-up. Multiple regressions were performed to investigate the association of age, gender, body mass index (BMI), and medical treatment status on baseline and change scores in outcome measures, as well as program adherence. RESULTS: All measures improved in participants who completed the program (p < 0.01). Age, gender, and BMI were associated with baseline measures of estimated VO2peak and grip strength (p < 0.01), and age was inversely associated with baseline fatigue (p = 0.02). Only BMI was inversely associated with change in estimated VO2peak (p < 0.01). No participant characteristics or baseline measures were predictive of program adherence (p > 0.05). CONCLUSION: This investigation provides evidence that a personalized, clinical exercise program can be effective at improving physical fitness, fatigue, and depression in a diverse population of cancer survivors.

Bidirectional Relationships Between Fatigue and Everyday Experiences in Persons Living With HIV.

Fatigue symptoms are very common among persons living with HIV (PLWH). Fatigue is related to functional and psychological problems and to treatment nonadherence. Using secondary data from ecological momentary assessment, we examined fatigue as a predictor of PLWH everyday experiences. In bidirectional analyses based on the shape shifters model, we also examined these experiences as predictors of fatigue. Data were examined from 67 PLWH who completed daily surveys on a handheld computer. Brief validated scales were used to assess participants' control beliefs, mood, stress, coping, social support, experience of stigma, and motivation. At the beginning and end of the study, fatigue was measured with two CES-D items that have been used in past HIV symptom research. Multilevel models and logistic regression were used to test reciprocal predictive relationships between variables. Moderate to severe fatigue affected 45% of PLWH in the study. Initial fatigue predicted PLWH subsequent overall level of control beliefs, mood, stress, coping, and social support, all p < .05. These state variables remained relatively constant over time, regardless of participants' initial fatigue. In tests for reciprocal relationships with 33 PLWH, average daily stress, OR = 4.74, and stigma, OR = 4.86, also predicted later fatigue. Fatigue predicted several daily survey variables including stress and social support. Stress and support in turn predicted fatigue at a later time, suggesting a self-perpetuating cycle but also a possible avenue for intervention. Future studies should examine daily variation in fatigue among PLWH and its relation to other everyday experiences and behaviors. © 2016 Wiley Periodicals, Inc.

Cancer-Related Fatigue, Version 2.2015.

Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.

Functional impairment, disability, and frailty in adults aging with HIV-infection.

The integration of antiretroviral therapy (i.e., ART) into HIV care has dramatically extended the life expectancy of those living with HIV. However, in comparison to similar HIV-uninfected populations, HIV-infected persons experience an excess of morbidity and mortality with an early onset of aging complications including neurocognitive decline, osteoporosis, impaired physical function, frailty, and falls. Recent consensus guidelines encourage clinicians and researchers to consider functional impairment of HIV-infected adults as a measure to understand the impact of aging across a range of abilities. Despite the importance of assessing function in persons aging with HIV infection, a lack of consistent terminology and standardization of assessment tools has limited the application of functional assessments in clinical or research settings. Herein, we distinguish between different approaches used to assess function, describe what is known about function in the aging HIV population, and consider directions for future research.

Association of functional impairment with inflammation and immune activation in HIV type 1-infected adults receiving effective antiretroviral therapy.

BACKGROUND: The relationships of inflammation, immune activation, and immunosenescence markers with functional impairment in aging human immunodeficiency virus type 1 (HIV-1)-infected persons are unknown. METHODS: HIV-infected persons who were aged 45-65 years, had a plasma HIV-1 RNA load of <48 copies/mL, and were receiving antiretroviral therapy underwent standardized functional testing. In a nested case-control analysis, low-functioning cases were matched (1:1-2) by age, sex, and HIV-1 diagnosis date to high-functioning controls. Markers of inflammation, T-cell activation, microbial translocation, immunosenescence, and immune recovery were used to estimate functional status in conditional logistic regression. Primary analyses were adjusted for CD4(+) T-cell count, smoking, and hepatitis. RESULTS: Thirty-one low-functioning cases were compared to 49 high-functioning controls. After statistical adjustment, lower proportions of CD4(+) T cells and higher proportion of CD8(+) T cells, higher CD38/HLA-DR expression on CD8(+) T cells, and higher interleukin-6 were associated with a significantly greater odds of low functional status (odds ratio, ≥ 1.1 for all analyses; P ≤ .03). Other inflammatory, senescence, and microbial translocation markers were not significantly different (P ≥ .11 for all analyses) between low-functioning and high-functioning groups. CONCLUSIONS: Functional impairment during successful antiretroviral therapy was associated with higher CD8(+) T-cell activation and interleukin 6 levels. Interventions to decrease immune activation and inflammation should be evaluated for their effects on physical function and frailty.

Creative Arts Therapy Among Children With Cancer: Symptom Assessment Reveals Reduced Anxiety.

BACKGROUND: Symptom distress is related to decreased quality of life (QOL) among children with cancer, with high levels of pain, nausea, and anxiety reported. Creative arts therapy (CAT) has been related to improved QOL and symptoms in pediatric oncology, but the quality of evidence is mixed. OBJECTIVE: This article aims to examine the QOL symptom subscales in relation to CAT over time in children during the first year of cancer treatment. METHODS: A secondary analysis of prospective data was performed with linear mixed modeling on 267 observations with predictors of 2 groups: No CAT (n = 18) vs CAT (n = 65). The covariate of time (6 months) was used to explore the CAT relationship with the Pediatric Quality of Life Inventory (PedsQL) symptom subscales (pain and hurt, nausea, procedural anxiety, treatment anxiety, worry, cognitive problems, perceived physical appearance, and communication). RESULTS: Children (n = 83) were between 3 and 17 years old (M = 6), 51.2% female, and 32% minority. All tumor types were represented: liquid (37.3%), solid (24.1%), and central nervous system (38.6%). Reduced child report of procedural anxiety was significantly related to receiving CAT with a medium magnitude of association (adjusted effect size = 0.58, P = .01). CONCLUSION: Creative arts interventions were associated with a longitudinal improvement in anxiety in children with cancer. Further work is needed to target interventions to the appropriate specific burdensome symptoms. IMPLICATION FOR PRACTICE: Pediatric oncology nurses can advocate for CAT as an effective intervention to ameliorate the burdensome procedural anxiety experienced by patients.

Telenovela (Spanish Soap Opera) Interventions on Latino Health: A Scoping Review.

Introduction: The use of telenovelas shows promise as a mode of education that could enhance Latino people's ability to prevent or manage different health conditions. This scoping review examined the available evidence about telenovela interventions on Latino health. Methods: A scoping review was conducted by searching five peer-reviewed databases for articles published on any date in English or Spanish. The methods of this review were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews recommendations. Results: A total of 431 articles were identified, and 22 articles published between 1999 and 2022 were included in the final scoping review. Nineteen telenovela interventions were described in the literature. Most studies included telenovela interventions without other elements (n = 15; 68%), and 91% were conducted in the U.S. (n = 20). Studies were qualitative (n = 8; 36%), quantitative (n = 8; 36%), and mixed methods (n = 6; 27%), and most telenovela interventions were developed and/or tested in Spanish (n = 10; 53%). The most common topics for the telenovela interventions were substance use/risky sexual health behaviors, cardiovascular disease, and mental health. Conclusions: This scoping review may serve to continue empirical and theoretical work on telenovela-style entertainment interventions on Latino health and future implementation in real-life settings.

Skeletal muscle DNA methylation: Effects of exercise and HIV.

Aging, human immunodeficiency virus (HIV) infection, and antiretroviral therapy modify the epigenetic profile and function of cells and tissues, including skeletal muscle (SkM). In some cells, accelerated epigenetic aging begins very soon after the initial HIV infection, potentially setting the stage for the early onset of frailty. Exercise imparts epigenetic modifications in SkM that may underpin some health benefits, including delayed frailty, in people living with HIV (PWH). In this first report of exercise-related changes in SkM DNA methylation among PWH, we investigated the impact of 24 weeks of aerobic and resistance exercise training on SkM (vastus lateralis) DNA methylation profiles and epigenetic age acceleration (EAA) in older, virally suppressed PWH (n = 12) and uninfected controls (n = 18), and associations of EAA with physical function at baseline. We identified 983 differentially methylated positions (DMPs) in PWH and controls at baseline and 237 DMPs after training. The influence of HIV serostatus on SkM methylation was more pronounced than that of exercise training. There was little overlap in the genes associated with the probes most significantly differentiated by exercise training within each group. Baseline EAA (mean ± SD) was similar between PWH (-0.4 ± 2.5 years) and controls (0.2 ± 2.6 years), and the exercise effect was not significant (p = 0.79). EAA and physical function at baseline were not significantly correlated (all p ≥ 0.10). This preliminary investigation suggests HIV-specific epigenetic adaptations in SkM with exercise training but confirmation in a larger study that includes transcriptomic analysis is warranted.