The introduction of highly active antiretroviral therapy (HAART) has both extended life expectancy and reduced morbidity in people living with HIV/AIDS (PLWHA). These changes have resulted in the emergence of cardiovascular disease (CVD) and associated risk factors as a threat to the health of PLWHA. The major components of CVD risk associated with HIV infection include HIV, HAART, nonmodifiable factors such as genetics or environment, and modifiable risk factors such as inactivity and poor diet. Physical activity has been shown to be beneficial in reducing the risk of CVD through its effect on numerous modifiable risk factors, including functional aerobic impairment, dyslipidemia and insulin resistance, obesity, and atherosclerotic inflammation. A growing body of evidence indicates that exercise has similar benefits for these modifiable CVD risk factors that are exacerbated in PLWHA.