Influence of Infection Duration on Physical, Psychological, and Quality of Life Responses to Combined Training in People With HIV in Brazil: A Nonrandomized Clinical Trial Protocol From the CALM-HIV Study

Abstract Antiretroviral therapy (ART) has increased life expectancy for people with HIV (PWH), but prolonged infection and ART exposure contribute to early-onset sarcopenia, frailty, and metabolic dysfunction. Combined aerobic and strength training may mitigate these complications, although responses may vary according to clinical history. This clinical trial will include PWH aged 50 years and older, stratified by time since HIV diagnosis and ART exposure. Participants will be allocated to a 12-week, supervised, combined training program (three sessions per week) or a control group. Outcomes include physical performance (strength, frailty, gait), body composition assessed by dual-energy x-ray absorptiometry, biochemical markers (lipid profile, CD4/CD8 ratio, inflammatory biomarkers), and psychosocial measures (quality of life, anxiety, depression, and cognitive function). Findings are expected to clarify differential responses across clinical subgroups and inform personalized exercise prescriptions for aging PWH.