Page 276 - AIDSBK23C

Page 276

ATHLETICS AND HIV INFECTION

Exercise has benefits for persons with chronic illness, including HIV infection. Exercise
reduces fatigue, pain perception, depression and anxiety while increasing vigor. The wasting
effects of HIV/AIDS can be offset by exercise. In addition, high intensity exercise activates the
immune system. HIV infection and sports participation has raised issues regarding risks for
participants. Sports participation is not a risk for transmission. Recommendations for
prevention of transmission of blood-borne pathogens during sports have included education of
athletes about approaches to prevention of sexually transmitted diseases and the risks associated
with injectable drugs. When resources permit, hepatitis B vaccination should be made available.
Athletes should not be excluded from participation in sports solely because they are infected with
HIV or hepatitis virus.[1096,1097,1098]
Persons with early to moderately advanced HIV infection can engage in moderate sport
activities without risk to themselves or other participants. With the onset of AIDS, the ability to
exercise can be compromised by disease conditions, and intensive bouts of competitive exercise
should be avoided.[1099]
In the United States, the National Football League has also determined that a player with
HIV infection poses virtually no threat to others or himself by athletic participation. The long
latent period between initial HIV infection and the development of AIDS means that athletic
performance is unlikely to be affected for many years.[1100]
A complete set of guidelines regarding blood borne pathogens and sporting events have
been adopted by the American Medical Society for Sports Medicine (AMSSM) and the
American Academy of Sports Medicine (AASM).[1096,1101] The American Academy of
Pediatrics have adopted similar guidelines as follows:[1102]

• Athletes with human immunodeficiency virus, hepatitis B virus or hepatitis C virus infection
should be allowed to participate in all competitive sports.

• The infection status of patients should be kept confidential. Confidentiality about an athlete's
infection with a blood-borne pathogen is necessary to prevent exclusion of the athlete from
sports because of inappropriate fear among others in the program.

• Athletes should not be tested for blood-borne pathogens because they are sports participants.

• Physicians should counsel athletes who are infected with human immunodeficiency virus,
hepatitis B virus and hepatitis C virus that they have a very small risk of infecting other
athletes. These athletes can then consider choosing a sport with a low risk of virus
transmission. This will not only protect other participants from infection but also will protect
the infected athletes themselves by reducing their possible exposure to blood-borne
pathogens other than the one(s) with which they are infected. Wrestling and boxing, a sport
opposed by the AAP, probably have the greatest potential for contamination of injured skin
by blood.

• Athletic programs should inform athletes and their families that they have a very small risk
of infection, but that the infection status of other players will remain confidential.