HIV/AIDS remains a global health burden affecting 39 million people worldwide, including 466,978 cases in Indonesia. Beyond the medical challenge, people living with HIV/ AIDS (PLWHA) frequently experience anxiety due to stigma and uncertainty about the future. This study aims to analyse the effectiveness of integrated breathing exercises combining diaphragmatic and pursed-lip breathing in reducing anxiety among PLWHA. A quasi-experimental two-group pre-post design was conducted. A total of 46 PLWHA were allocated. Anxiety was measured using the Hamilton Anxiety Rating Scale (HARS). The Wilcoxon signed-rank test noted a significant difference in the intervention group (p = 0.001), while no significant change occurred in the control group (p = 1.000). The Mann-Whitney U test noted a significant difference between groups post-intervention (p = 0.000). Both groups presented an equal median of 2 and an IQR of 2. The intervention group demonstrated a min of 1 and max of 3 with Δt = 3, while the control group showed min of 1, max of 5 and Δt = 4. These findings demonstrate that integrated breathing exercises are more effective than standard hospital care. This study highlights the need to validate and establish standardized breathing exercises in nursing practice for improving the psychological well-being of PLWHA. © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.