High-Intensity Exercise to Combat Vascular and Cognitive Dysfunction in Adults With HIV

Inclusion Criteria: * Age 50 years and older * Sedentary lifestyle, defined as \< 150 min/wk moderate physical activity as assessed by CHAMPS questionnaire * Neurocognitive Impairment (as assessed using the BRACE+ * Prescribed HIV ART for ≥ 12 months, with no current use of older drugs with established mitochondrial toxicity * Able to speak, read, and write in English * Willingness to participate in all study procedures Exclusion Criteria: * Diagnosis of mitochondrial disease * Active substance abuse or factors preventing compliance or safety * Uncontrolled hypertension, defined as resting BP \> 150/90 mmHG * Chronic kidney disease * Severe cardiac disease, including NYHA Class III or IV congestive heart failure, clinically significant aortic stenosis, history of cardiac arrest, use of a cardiac defibrillator, or uncontrolled angina * Acute myocardial infarction identified by medical history and ECG * Pulmonary disease requiring the use of supplemental oxygen * Poorly controlled diabetes * Neuropsychologically Intact * Orthopedic problems that limit ability to perform exercise * Simultaneous participation in another intervention trial