STAYING HEALTHY WITH HIV/AIDS

TAKING CARE OF YOURSELF WHEN LIVING WITH HIV

Taking HIV treatment keeps your immune system healthy, but there are other things you can do to stay fitter and happier like eating healthily and exercising.
HIV does increase your chances of developing other health conditions like TB, but there are ways you can reduce this risk.
If you are young and HIV-positive or are growing older with HIV, you may have questions. Here we address the many ways you can take care of your health and wellbeing, whatever your situation.
Having HIV doesn’t have to stop you living a full and healthy life. With the right treatment and care, you can expect to live just as long as someone who doesn’t have HIV.
There’s a lot you can do to take care of yourself and feel fitter, healthier and happier.
If you have any questions, talk to your healthcare professional about nutrition, exercise, mental health or any of the other issues covered here.

Taking HIV treatment

Current treatment for HIV is not a cure for the virus, but it can keep HIV under control and this keeps your immune system strong.

In the past, older HIV drugs had serious side-effects, but treatment with modern HIV drugs is much better. If a side-effect doesn’t go away and is affecting your quality of life, you should be able to change to a different drug. Once you start HIV treatment, taking it every day is important to keep yourself well. Talk to your healthcare professional if you are having any problems taking treatment.

Eating healthily

People living with HIV should aim to eat a balanced diet, without too much fat, sugar or salt. For many people, eating well is a pleasure, and learning how to cook and prepare food for yourself, your family, or friends can be fun.

If you are underweight – perhaps because HIV was already making you ill by the time you were diagnosed – or overweight, or if you have any particular dietary problems or side-effects that make it hard to eat well, then you might benefit from talking to a healthcare professional about your diet.

To make it easier to understand what a balanced diet is made up of, it can help to think about the type of foods you eat. Your diet should be made up of:

plenty of fruit and vegetables to provide fiber, vitamins and minerals
plenty of starchy carbohydrates to give you energy – such as brown rice, potatoes, wholemeal pasta and bread
some protein such as lean meat, fish, eggs and beans
some dairy products, such as milk, yoghurt and cheese
small amounts of fats and sugars

Exercise and keeping fit

Being active is good for you in lots of ways – it can help to build your muscles, keep your bones strong, burn fat and keep your heart healthy. Some people who are living with HIV experience a loss of muscle mass and strength, so exercise can help prevent this.

You might get your exercise by taking part in a sport, or going to the gym, but everyday activities like dancing, playing in the park with your children, walking to work and gardening can all help get you moving.

If you want to do more exercise, feel fitter, have more stamina, more flexibility, or lose weight, there are three types of exercise to think about. These include:

Cardio or aerobic exercise – this increases your heart rate to help blood flow right around your body, delivering oxygen to your muscles and keeping your heart and lungs healthy. Try running, swimming, dancing or cycling
Resistance training – this increases the strength of your muscles by lifting weights for a period of time and then repeating. Even lifting a tin of beans will do!
Flexibility training – this stretches different parts of your body to strengthen your muscles and joints. Try stretching before and after any exercise you do, or focus on flexibility with an activity like yoga.

Particularly as we get older, regular exercise is important in reducing the risk of heart disease and diabetes, which can be more common in people living with HIV. Exercise is also great at reducing feelings of stress and symptoms of depression.

Staying happy and fulfilling your potential

Taking care of yourself is not just about your physical health, but looking after your mental and emotional health too.

Finding out you have HIV can be a shock, and it may take you some time to adjust. Support from your friends and family, or other people living with HIV, can really help when you are finding things difficult.
Once you begin coming to terms with HIV, it’s a good idea to think about the rest of your life. What are your goals? What’s important to you? Maybe you want to study, have a family, travel or change career – HIV shouldn’t stop you doing any of these things!

What else can I do to take care of myself?

Many of the things we do to look after ourselves are common sense. Try to get plenty of rest and sleep. If you smoke, try to stop – it isn’t always easy, but there is support available to help you. If you are concerned about your alcohol or drug use, talk to a healthcare professional for advice and support.
It’s also important to think about any other health conditions you have; particularly as we get older, we’re more likely to experience other health problems.

Looking after your mental health

Looking after your health is not just about looking after your physical health. Mental health is also important and mental health problems, particularly depression and anxiety, are very common, although people often find it harder to talk about them.3 Your healthcare professional should take them just as seriously as any physical health problems you experience, and offer advice and treatment if appropriate.
As well as medical help, support from friends and family can also be very helpful in coping with health conditions.

Preventing other health conditions

There are also actions we can take to avoid some infections, such as having vaccinations, or using an insecticide-treated bed net in areas where malaria is common. Worldwide, tuberculosis (TB) is the most common infection among people living with HIV. It can be very serious and if it is not treated, it can kill. The symptoms of TB include a persistent cough, fever, unintended weight loss and night sweats. Your healthcare professional should test you for TB and if you do have it, you should receive treatment which cures the infection. Hepatitis B and hepatitis C are also common among people living with HIV. Both are common among people who inject drugs. Hepatitis affects the liver and can be very serious if untreated. There is a vaccine against hepatitis B, and both hepatitis B and C can be treated. When someone living with HIV has a weakened immune system (shown by a low CD4 count), they are at risk of other illnesses. These are known as ‘opportunistic infections’ because they take the opportunity of the immune system being weak.

HOW CAN I LOOK AFTER MY MENTAL HEALTH WHEN LIVING WITH HIV?

It’s normal to feel emotional distress from time to time when living with HIV. Try to recognize when this might be happening so that you have the chance to address these feelings. Talking about the way you’re feeling is often the first step to getting better.

Try the following self-help tips.

Talk to family and friends

Sometimes it’s hardest to talk to those you love because you might be scared of their reaction or of upsetting them. However, they could be the greatest source of help and support because they already know you and can help you to feel less alone.

Access support groups

If the support of family and friends isn’t possible, you might prefer sharing your feelings with someone at a support group.
The fact that you don’t know these people personally may help you to talk honestly about your feelings and living with HIV. In return they can offer you practical and emotional wellbeing advice.

Share your feelings with your healthcare professional

Your healthcare professional isn’t just there to give you treatment and check your viral load. They also need to know if you’re experiencing other difficulties that could affect your overall health, such as mental health problems. They may suggest treatment that includes antidepressant drugs or talking therapies, such as counselling or cognitive behavior therapy (CBT).

Know what to look out for

Some people who experience mental health problems have trouble taking their HIV treatment properly and may miss doses, skip appointments or not eat a healthy and balanced diet. If this is happening to you, seek support and advice from your healthcare professional or pharmacist.

Exercise and staying healthy

Getting enough exercise, sleep and nutrition is important for a healthy mind and the benefits can be even more significant for anyone who is living with HIV. Many people find that changing to a healthier lifestyle helps with some of the symptoms and enables them to get some control back in their life. Drinking too much alcohol or being dependent on drugs could also have a big impact on your mental health and the success of your treatment.

Don’t be too hard on yourself

It’s natural to have negative feelings and feel fearful about what the future brings.
Often it’s about learning how to cope with feelings of uncertainty and, in many cases, this can be hard to do without the support of loved ones or a mental health professional.

Do things that relax and interest you

You may lack interest in activities that you used to enjoy, but keeping active is one of the best ways to break the cycle as it lifts your mood and energy levels, increases your appetite and improves your quality of sleep. Even small activities such as a walk around the park, 10 minutes of yoga or some gardening may help to relax and distract you from any negative thoughts.

BEING YOUNG AND HIV POSITIVE

Whether you have only recently found out you have HIV or you have grown up knowing you have HIV, being a young person living with HIV brings its own challenges.

Having relationships

Some people with HIV worry that they can never have a relationship, or that they will never be loved because they have HIV. None of these things are true - people living with HIV fall in love, have relationships, marry, have children… all the things that people who don’t have HIV do too. It’s also completely possible to do all of these things without passing HIV on to someone else.

When you start a new relationship, it can be really exciting and fun, and it can be intense, as you find out about each other.

Having a relationship with someone who doesn’t have HIV (sometimes called a mixed-status relationship) might raise some particular questions for you – when should you tell them that you have HIV? How will they react? How can you have sex without passing on HIV?

Deciding how and what to tell them will probably involve a lot of the same considerations as telling a friend. Think about how they might react and the questions they might have. It’s up to you to decide how much to tell them and when. You may feel like you want to avoid having a difficult conversation, but bear in mind that if you wait for a long time they may be upset that you didn’t tell them sooner.

GROWING OLDER AND AGEING WITH HIV

Now that effective treatment for HIV is available, it is considered to be a long-term condition and many people are living long and healthy lives with HIV.
In fact, a recent study suggested that over 4.2 million people living with HIV worldwide are aged over 50. Growing older with HIV also has an impact on your health, but there are many things you can do to look after yourself.

Taking HIV treatment long term

The introduction of combination antiretroviral treatment in the mid-1990s was revolutionary. People who would previously have died as a result of HIV saw their immune systems recover.

Since then, the drugs used to treat HIV have improved, and treatment keeps millions of people living with HIV well, and enables people to live long, healthy lives. In fact, some people are even living longer than the general population if they take their treatment correctly for their whole life.

However, many of the drugs used to treat HIV have not been around for very long. Whereas short-term side-effects are well researched and documented, longer-term side-effects are less well understood. Some HIV drugs affect the kidneys, liver, bones and heart in subtle ways. As part of your routine health monitoring, your healthcare professional will keep an eye on how well your body is working, so any problems can be identified and treated early.

Ageing and HIV

As we grow older, we are more likely to experience other health conditions. There are also issues that affect our health that are associated with ageing even in people who are otherwise completely healthy, such as gradual hearing loss, receding gums, and the menopause for women.

Growing older with HIV does appear to increase the risk of experiencing illness, when compared to people who do not have HIV, but the reasons for this are not well understood.

It could be that there are some long-term effects of having HIV, and/or long-term effects of taking HIV treatment. There is also the risk of long-term effects of smoking, (which is more common among people who have HIV) or being overweight.

To give yourself the best chance of a healthy older age, it’s a good idea to take action to improve your general health – stop smoking, maintain a healthy weight, eat healthily and take regular exercise.