Road To Wellness
Being HIV positive and living a healthy life
What is HIV & AIDS?
HIV stands for Human Immunodeficiency Virus. To understand what that means, let’s break it down:
- H – Human – This particular virus can only infect human beings.
- I – Immunodeficiency – HIV weakens your immune system by destroying important cells that fight disease and infection. A “deficient” immune system can’t protect you.
- V – Virus – A virus can only reproduce itself by taking over a cell in the body of its host.
AIDS stands for Acquired Immunodeficiency Syndrome. To understand what that means, let’s break it down:
- A – Acquired – AIDS is not something you inherit from your parents. You acquire AIDS after birth.
- I – Immuno – Your body’s immune system includes all the organs and cells that work to fight off infection or disease.
- D – Deficiency – You get AIDS when your immune system is “deficient,” or isn’t working the way it should.
- S – Syndrome – A syndrome is a collection of symptoms and signs of disease. AIDS is a syndrome, rather than a single disease, because it is a complex illness with a wide range of illnesses and complications.
At present there is no known cure for HIV, but the treatment of HIV has improved so dramatically that by complying with medical treatment, living a healthy lifestyle and caring for your emotions, people diagnosed HIV positive can live a normal, healthy and productive life.
Each person will respond differently to being diagnosed with HIV. Usually there is a strong emotional response; a combination of anger, fear, denial, shock, anxiety, rage, and even depression. It is important not to leave these emotions unattended. Caring for these feelings is just as important as caring for your body. Therefore it is essential to have a good support network. Ask your doctor or clinic if there are any support groups in your area.
The signs and symptoms of HIV and AIDS
The symptoms of HIV vary depending on what stage HIV you are in. Within 2-4 weeks after HIV infection, many, but not all, people experience flu-like symptoms, often described as the “worst flu ever.”
Some symptoms include:
- Fever (this is the most common symptom)
- Swollen glands
- Sore throat
- Muscle and joint aches and pains
Many of the above symptoms could also relate to other illnesses however, if you think you have recently been exposed to HIV – if you have had oral, vaginal or anal sex without a condom with a known HIV positive person, or a partner whose HIV status you do not know, or shared needles to inject drugs – get an HIV test.
What happens to your body when you contract HIV or AIDS?
HIV is spread through contact with certain body fluids from a person infected with HIV:
- Pre-seminal fluids
- Rectal fluids
- Vaginal fluids
Once you have contract HIV, you have it for life. HIV can hide for long periods of time in the cells of your body and attacks your T cells and CD4 cells. These cells are the fighter cells that your body needs to help fight infections and diseases. Over time, HIV can destroy so many of your CD4 cells that your body can’t fight infections and diseases anymore. When that happens, HIV infection can lead to AIDS, the final stage of HIV infection.
Additionally, if you have HIV and you are not taking HIV medication (antiretroviral therapy), eventually the virus will weaken your body’s immune system. The onset of symptoms signals the transition from the clinical latency stage to AIDS (Acquired Immunodeficiency Syndrome).
During this late stage of HIV infection, people may have the following symptoms:
- Rapid weight loss
- Recurring fever or profuse night sweats
- Extreme and unexplained tiredness
- Prolonged swelling of the lymph glands in the armpits, groin or neck
- Diarrhoea that lasts for more than a week
- Sores of the mouth, anus or genitals
- Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
- Memory loss, depression, and other neurologic disorders
Each of these symptoms can be related to other illnesses. So, as noted above, the only way to know for sure if you are infected with HIV is to get tested. Many of the severe symptoms and illnesses of HIV come from opportunistic infections (OIs) such as tuberculosis, pneumonia, and certain types of cancers, that occur because your body’s immune system has been damaged.
However, not everyone who has HIV progresses to AIDS. With proper antiretroviral therapy treatment, you can keep the level of HIV in your body low. These HIV medicines can control the virus so that you can live a longer, healthier life and reduce the risk of transmitting HIV to others.
HIV and Nutrition
The treatment of HIV and nutrition are intimately linked. Good nutrition enhances the effectiveness of antiretroviral treatment. Some research shows that treatment might be 3-5 times more beneficial for people who are well-nourished, than those who are malnourished.
HIV and AIDS are known to cause severe weight loss of both muscle and fat. Antiretroviral treatments prevent this loss and those who have lost weight will regain weight. So, the earlier a person starts to take the treatment, in conjunction with a good diet, the better. In addition, taking antiretroviral drugs without the right food or nutrition could even be very painful.
Studies have found that people with HIV tend to burn around 10% more calories while resting, compared to those who are uninfected. It is recommended that you eat five fist-size portions of carbohydrates a day, but if you have HIV it is advisable to increase this to six. However, it is important to eat the right carbohydrates, such as those found on the food list under the Healthy Eating section. The HIV infection may also affect the way the body processes and absorbs fat, so to help the body, stick to the fats on the recommended food list.
In general, people with HIV also have slightly higher protein needs. This protein is required to build up muscles and organs, repair and maintain all the cells in the body, and strengthen the immune system. If the meal does not have enough protein, the body will take protein from the muscles and convey it to where it is needed most. That is why weight loss through muscle waste is typically experienced. So, it is best to include protein in each meal. Even if you are having difficulty eating, especially due to loss of appetite, it is important that you do not stop eating. Try turning foods into smooth soups, mashes and purees which will be easier to eat.
Whilst there have been a number of studies into the effect of vitamin and mineral supplements, there are no conclusive results. Yet, there is a trend recommending the taking of a daily iron-free multivitamin. It would be best to consult with your doctor or health practitioner first, to see what would be best for you.
Everyone is likely to have a different response, both to the disease and its treatment. If you are not maintaining good body weight and are experiencing low energy, a dietician would be able to help you with your unique needs. This will take into account things like managing fat metabolism abnormalities and managing dietary complications related to antiretroviral treatment. It could also include managing symptoms that may affect food intake and the appropriate use of herbal and/or nutritional supplements.
Whilst food hygiene is important for everyone, it’s especially important for people who are HIV positive. This is because when certain disease-causing bacteria, viruses or parasites contaminate food, they can cause food-borne illness which the weakened immune system cannot fight off as it normally would. If there is any doubt about the freshness of the food, it should not be eaten. All cooking and eating utensils must be well cleaned and hands must be well washed before preparing or eating food.
Quick checklist to help you stay safe around food:
- Always wash your hands with soap and water before handling food, whether you’re preparing it or eating it.
- Wash your hands after blowing your nose, helping young children blow their nose, going to the toilet, or handling pets.
- Keep all pets away from your food.
- Wash all fruit and vegetables thoroughly.
- Use a separate chopping board to prepare raw meat.
- Wash your hands and all surfaces and utensils carefully after preparing raw meat.
- Keep raw and cooked food separate in your fridge. Put raw meat at the bottom of the fridge so that it can’t drip onto cooked food.
- Make sure you cook raw chicken thoroughly to kill any bacteria that could cause food poisoning.
- Heat leftover food until it’s piping hot.
- Only reheat food once.
- Allow food to defrost completely before cooking it, unless the instructions on the pack tell you to cook it from frozen.
- Check the ‘use by’ dates on food packs to make sure the food is safe to eat.
- Keep your fridge temperature at between 0?C and 5?C. It’s a good idea to use a fridge thermometer to be sure.
- Avoid nibbling on food that’s been sitting around at room temperature for a long time (at a buffet, for instance), as bacteria can grow quickly and could make you ill.
- Don’t wash raw chicken before you cook it. Any germs will be killed as it is cooked. Washing it can splash harmful bacteria around your kitchen.
- Avoid eating pâté of any type, unpasteurised milk, undercooked pre-prepared meals, mould-ripened cheeses -such as brie and blue-veined cheeses (such as Roquefort), raw or partially cooked eggs.
HIV and exercise
Physical and mental exercise can keep your mind and body strong, and is an essential component of keeping healthy when living with HIV. Regular physical exercise, such as walking, biking, running, swimming, or another activity you enjoy, keeps you physically fit and can keep both stress and depression in check.
Exercise will build muscle, keep bones strong, burn fat, keep the heart healthy, improve energy levels, help alleviate depression, and help the immune system work well. Exercise will also help manage some of the long-term side effects of HIV and the treatment such as elevated cholesterol, triglycerides, and blood glucose.
The Basics of Fitness
Before starting any exercise programme, talk to your doctor or clinic and get their advice. If you decide to work with an exercise coach you do need to tell your coach that you are HIV positive, so that he/she can adjust the training to your specific needs. It is advisable to get the assistance of a professional who will ensure that you use the correct technique and keep the right form when doing your exercise so as to prevent injury.
If you are feeling unwell do not start to exercise, and if you begin to feel unwell whilst you are exercising, stop. It is important to be in touch with your body and know the difference between not been well enough to exercise and experiencing a lack of motivation to exercise.
If you are already used to exercising, keep going! If you are not used to exercise, you need to start gently and slowly build up to the optimum level for each of the three different types of exercises: resistance, cardiovascular and flexibility. It’s important to be patient with your body during your workout.
Resistance exercise, such as weight training (with free weights or machines), is probably the most important part of your exercise routine. Lifting weights helps build your muscles and bone density, and counter the muscle wasting that is associated with the disease. The objective of the training would not be to increase strength or endurance but rather to simply build up the muscle fibre mass.
Start slowly and build up to an ideal of doing a full resistance training session three or four days per week. You should include 10 to 12 major muscles or muscle groups in your workouts.
Muscle groups that should be worked include the chest (major and minor pectorals), and the back (latissimus dorsi, the rhomboids, and the lower trapezius). It should also include the shoulders (deltoids and upper trapezius), the arms (biceps and triceps), and the legs (the quadriceps, hamstrings, gluteals, calves, and tibialis anterior). Finally it should include the abdominals and the erector spinae muscles of the neck and back.
If you are already doing cardio vascular training that’s good – keep going. If you are new to this, start slowly and build up. Whatever your fitness level, remember to never work out until exhaustion. If you start to hurt anywhere stop immediately and seek professional advice.
Cardio exercise includes running, swimming, dancing and cycling. The objective is to increase your heart rate and flow of blood round the body, to improve overall health. It helps to control blood pressure, blood sugar, blood lipids, and stress. Start cardio exercise once or twice a week, for five or ten minutes, building up to three times a week for 20 to 30 minutes.
This training ranges from basic stretches to a full yoga or Thai Chi workout. Joint pain and discomfort may make you feel like not stretching, however it is essential in helping you keep your muscle tone and flexibility so you can carry out daily activities. It may also help with pain and stress control. Do be careful never to stretch cold muscles. Although stretching may seem simple, there are special techniques to getting the full benefits from a stretching regime – so do get the advice of a professional.
The stretches could be integrated into your resistance and cardio vascular training, and you may also choose to do additional stretching in a specialised stretch class.
Caring for your emotions
Being HIV positive is a challenging situation, which often results in the experience of worry and anxiety. Managing these emotions is just as important as exercising and eating healthily. Modern medical science is increasingly becoming aware of the powerful effect of our mood, or attitude, on health.
There is a direct link between the experience of anger, fear, or sadness on the effective functioning of our immune system. The experience of ‘joy’ is therefore the healthiest experience we can have. Of course different people will experience joy in different ways. Knowing what makes you happy and how to become happy is a major step on your journey to wellness.
Two concepts apply here: one is the notion of a ‘baseline state’ and the other the ‘wellness threshold’. This relates to your general everyday mood – to your general attitude to life. See your baseline state as the average or general mood you experience on a daily basis. So, the closer your baseline state is to your ‘joy’ experience, the more effective your immune system becomes in ensuring you remain healthy.
Then there is also the wellness threshold. The further your baseline state is from your ‘joy’ experience, the less effectively your immune system will be in dealing with passing infections and physical challenges. The wellness threshold is a particular average mood of your baseline state, where the immune system can become dysfunctional, and then you become more vulnerable to disease.
It may be useful for you to focus on the practice of a simple relaxation exercise such as focussed breathing, meditation, yoga and even soothing affirmations. You may even want to call into the EAP programme for specialist support.
Finally, living with HIV can make you feel very isolated and alone, but you do not have to be alone, please speak with a Phela Wellness consultant, who will help you find the support and guidance that you need.
How can you reduce your risk of contracting or passing on HIV?
Anybody can get HIV, but you can take steps to protect yourself from HIV infection.
Know your status
- Get tested and know your partner’s HIV status. Talk to your partner about HIV testing and get tested before you have sex.
Get tested for other STDs
- If you have another STD (also known as sexually transmitted infections or STIs) you may be more likely to transmit both HIV and your other STD to someone else.
Have less risky sex.
- Oral sex is much less risky than anal or vaginal sex. Anal sex is the riskiest type of sex for the spread of HIV.
- Use a condom every time you have vaginal, anal, or oral sex. This is to stop the spread of HIV, but also to protect both you and your partner against other sexually transmitted diseases and other types of infections.
Limit your number of sexual partners.
- If you have more than one sexual partner, get tested for HIV regularly. Get tested and treated for sexually transmitted infections, and insist that your partners do, too.
- Having an STI can increase your risk of becoming infected with HIV.
Pre-Exposure Prophylaxis (PrEP)
- Talk to your health care provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention method that involves taking HIV medicine every day.
- PrEP is intended for people who don’t have HIV but who are at high risk of sexually transmitted HIV infection. PrEP should always be combined with other prevention methods, including condom use.
Don’t abuse drugs or alcohol
- Alcohol and drug overuse can contribute to feelings of depression.
- Avoid illegal drugs and take prescription drugs as directed by your doctor to help protect your immune system.
- Avoiding drug abuse can also help to prevent cognitive (thinking and reasoning) impairment, which is important in minimizing HIV-related dementia.
- If you inject drugs, don’t share your needles, syringes, or other drug equipment with your partner. But if you do, use only sterile drug injection equipment and water and never share your equipment with others.
- Giving up cigarettes is beneficial for anyone.
- Stopping all tobacco use will help you live healthier and feel better, as well as prevent a number of health problems and reduce your risk of serious events like heart attacks and strokes.
Prevent infections and illnesses.
- Since HIV makes your immune system less effective, you become more susceptible to every virus, bacteria and germ you’re exposed to.
- Wash your hands frequently, and stay away from sick people to stay as healthy as possible. Also stay up-to-date on all of your vaccinations to reduce your risk of preventable illnesses.
Protecting your partner from contracting HIV.
- Taking HIV medicines helps people with HIV live longer, healthier lives. ART can’t cure HIV infection but it can reduce the amount of HIV in the body.
- It’s crucial to take your HIV medication exactly as prescribed by your doctor. Be sure to take prescriptions at the same time every day, and always have your medication with you so that if you are away from home, you won’t have to miss a dose.
- Having less HIV in your body will reduce your risk of passing HIV to your partner during sex. For added protection, you can also talk to your partner about taking PrEP.
- To protect your partner, use condoms correctly every time you have sex. Even if you are taking HIV medicines, remember it’s still important to use condoms.
The Body – Complete HIV/AIDS resource:
Research for AVERT courtesy of Paediatric AIDS Treatment for Africa
AIDS info net:
WHO (April 2005), “Consultation on Nutrition and HIV/AIDS in Africa: Evidence, lessons and recommendations for action”