No one needs a new excuse to put off exercise. Despite talk show gurus’ incessant chatter about the marvels of a good workout, most Americans avoid the gym or running shoes with languid artlessness.

Several small studies of people with HIV have found that regular exercise can help manage health-threatening stress, boost immune function and maintain body cell mass (important to avoid wasting). Not to mention improving mood. So HIV should not join “I don’t have time” or “I look hideous in a leotard” to exempt you from mounting the treadmill or plunging into the pool. The question is no longer Does exercise help? but How can I get myself to do it regularly?

Forget previous failures. You can start and stick with a fitness program if you follow “the four E’s.”

Exercise
First of all, get over old routines that have failed you or that your condition makes difficult. I’ve learned that lesson. I still haven’t started a regular exercise routine since my knees “forced” me to stop playing basketball last year: Sitting on an exercycle watching soap opera re-runs does not produce the same adrenaline rush as a competitive basketball game, but that excuse for doing nothing has worn out its welcome.

You don’t have to do what your friends do. If you never had good hand/eye coordination, don’t sign up for tennis. Clearly, trying to derive maximum physical benefits from an activity while you are learning it only proves frustrating and unfulfilling. It also will increase your chances of getting injured, another major contributor to the workout drop-out rate.

To prevent monotony, vary your workouts. Juggle a few different activities. (Variety provides better overall conditioning and helps cut down on injuries, because it keeps you from working the same muscles over and over again.)

Exertion
Identify a specific goal. “Getting into shape” is too vague. “Gaining weight” is, too. If you set specific, incremental goals -- gain five pounds in four weeks, go from 12 to 20 minutes on the StairMaster -- you’ll be able to sustain your motivation.

People often give up exercising when they expect visual results in days, or even weeks. The body needs time to get used to each level of exercise. Trying to do too much too fast can burn you out on any program -- physically and emotionally. So what if the textbook says you need to have your heart rate at a certain level for 30 minutes at least five times a week? Start at a level where there will be an achievement and success.

Make exercise a part of your daily routine, like brushing your teeth. Most people have a certain time of day when they are most productive. Identify it and exploit it.

Your exercise routine should help you develop flexibility, strength and endurance. Shawn Tucker, a licensed physical therapist in Chicago who specializes in HIV-related rehabilitation, says people with HIV should be sure to include weight training along with an aerobic exercise. “If you need to put on weight, you can’t add it without some form of resistance training work. Otherwise, you’ll eat a lot and may get heavier, but you’re not adding muscle mass.”

Environment
A pleasant and upbeat exercise environment can influence your motivation. Some are most comfortable in a congenial group atmosphere. Others like the solitude of jogging. Proximity and ease of transportation are key if you choose to exercise outside your home. Home exercise machines may mean freedom and convenience to one person, while another finds them incredibly boring and more useful as a clothes valet.

Support and encouragement from friends are important -- let them know you don’t appreciate even well-meaning ribbing. Work out with a partner. It may be easier to show up if someone else is relying on you. Or, if you can afford it, hire a personal trainer. A trainer can give you that initial push to get started.

Equipment
Style matters, even during exercise. Everything from footwear to headgear can affect your comfort, safety and enjoyment of an activity. So can the simplicity, durability and performance of the equipment you use. The computerized capabilities of the new stationary bicycles and treadmills, for example, aren’t just useless flash: They help keep you from getting bored.

Work up a sweat during exercise. The results will be flattering and life-enhancing.