Examining High-Intensity Exercise on Cognitive and Vascular Outcomes in Older Adults Living With HIV—A Research Protocol: Design and Rationale From Two Harmonized Clinical Studies in the Deep South

Older people living with HIV (PLWH), particularly in the Deep South, have poorer health outcomes (cognitive impairment) than seronegative adults, which may be mitigated with regular physical activity and intense exercise. This population engages in low levels of physical activity. The current report describes the rationale and protocol for two harmonious studies "Examining the Effect of High-Intensity Exercise to Attenuate Cognitive Function Limitations and Train Exercise Habits in Older PLWH" (HEALTHCOG) and "A Pilot Trial of High-Intensity to Combat Vascular and Cognitive Dysfunction in Older Adults with HIV" (VASCOG) which are adopting and implementing the methods of a parent randomized clinical trial ("High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV" [HEALTH]) to compare 4 months of supervised high-intensity interval training (HIIT) or continuous moderate exercise (CME) on cognitive outcomes and underlying correlates. VASCOG and HEALTHCOG are poised to (a) compare cognitive changes after HIIT versus CME and the vascular impacts; (b) examine safety, feasibility, and acceptability of this approach in the Deep South; and (c) explore predictors of habitual physical activity and association of sustained physical activity with training. Results will have implications for prevention and treatment of cognitive impairment among older PLWH.