Health MOT

If you haven’t already, visit our Plan Ahead page. It has loads of great information to help you navigate your lifelong journey with HIV.

Use the Health MOT to create your personalised checklist of topics you may want to discuss with your HIV consultant or at your annual assessment with your GP. There are a number of assessments recommended by the British HIV Association (BHIVA) which you may want to consider as you plan for your lifelong journey with HIV. As you work through the MOT, tick the boxes that you would like to be reminded of – and print off a handy checklist at the end to take to your next appointment. Remember, you have the right to be involved in making decisions about your health.

Health MOT Summary

Thank you for taking the time to think about your lifelong journey with HIV. This is your life, your HIV and your journey – but even experienced drivers need a handbook!

See below for the topics you selected to talk through with your doctor:

HIV Health MOT
Summary

Managing your HIV
Checklist

My viral load

• You have probably come across the term “viral load” before. It indicates the amount of HIV in your body fluids and should be regularly measured at your HIV clinic.1

• As there is no cure for HIV, an “undetectable viral load” is the current goal of HIV treatment. It means you have fewer than 50 copies per millilitre in your blood, which means your antiretroviral medications are working effectively.1,2 Having an undetectable viral load in the laboratory doesn’t mean that the virus is gone from your body.1 An undetectable viral load means your immune system can recover, stay strong and reduces the risk of passing on the virus.1

• Use the links below for more information on viral load, and don’t forget to speak to your doctor about yours.
www.aidsmap.com/Viral-load/page/1044622/
www.tht.org.uk/myhiv/HIV-and-you/Simple-science/Whats-happening
www.labtestsonline.org.uk/understanding/analytes/viral-load/tab/test/

My HIV Treatment

• You might feel healthy right now, but HIV can damage the immune system and cause a range of illnesses.3 Guidelines now recommend that everyone who has HIV can start treatment when they feel that the time is right. Starting treatment also reduces your viral load, which decreases your risk of passing on HIV.

• As a patient, you have the right to treatment which meets your needs and preferences.4 All patients should be able to talk through their treatment options with their clinician in order to make treatment decisions together.

• Use the links below for more information on HIV treatment, and speak to your healthcare professional if you’re struggling to stick to your treatment or have any questions.

www.aidsmap.com/Why-taking-your-HIV-treatment-properly-is-so-important/page/1327020/

www.tht.org.uk/myhiv/HIV-and-you/Your-treatment

www.aidsmap.com/HIV-treatment/cat/1378/

My Mental Health

• Anyone can struggle with their mental health at any point, but people living with HIV are more likely to experience mental health problems than people who do not have HIV.5 The reasons for this are varied but include the complex and long-term nature of HIV, stress around diagnosis and the side effects of some HIV medications.6

• No matter what the reason is, it’s important to look after your mental health and get the support you need.

• Mental health conditions include depression, anxiety disorders, mood disorders, and personality disorders. For a description of specific mental health conditions and their symptoms visit www.mentalhealth.gov.

• If you are going through low points or are worried about your mental health, don’t hesitate to speak to your HIV consultant about how you are feeling. You are entitled to regular mental health screenings and you can get care and support from a specialist, if you need it.7

• Other ways of to help improve mental health may include:

  • o Joining a peer support group for people living with HIV or mental health conditions
  • o Exercising regularly to increase your energy levels and boost your mood
  • o Meditating to ease depression, anxiety and stress

Support groups

• From time to time we all need a little help and support. Living with an HIV diagnosis is not an easy task, and sometimes things can be overwhelming, particularly if you’re not able to turn to friends and family for support.

• Getting involved with a support group can be a great way to connect with people who face similar challenges — you may even help others on the way. A selection of local and national groups is listed below. You can also check with your local HIV clinic for nearby groups.

Click here to search for support groups across the UK and Ireland: http://patient.info/support/aids-and-hiv-1208

National UK:

London:

Bedfordshire:

Manchester:

Sussex:

Ireland:

Scotland:

If you prefer to speak to someone on the phone, you can always call the National Sexual Health Helpline on 0300 123 7123. It’s a confidential service where you can get advice about HIV and AIDS, sexual health, STDs, local services, clinics and support services. It’s free to call and is open from 9am-8pm Monday-Friday.

Your lifestyle
Checklist

Exercise

• Exercise can reduce the risk of cardiovascular problems by 35%, as well as helping to strengthen your mental health by decreasing your chances of getting depression by 30%.8

• However, sticking to an exercise regime isn’t always easy. You may enjoy exercise more if you invest a little bit of time into planning and thinking about your exercise plan. See the links below for information on apps, and tips and tricks that can help you get into an exercise regime and stick to it:

Importance of working out
http://www.aidsmap.com/Exercise/page/1188930/
Easy workouts for people with HIV
www.hivplusmag.com/wellness/fitness/2013/06/19/workout-especially-hiv-positive-people
How to make exercise a habit
www.jamesclear.com/exercise-habit
Tips on how to stick to your workout
www.menshealth.com/fitness/20-ways-stick-to-workout
Exercise apps to get you started and keep you going
http://time.com/3772922/workout-apps-gym/
For questions on how HIV can affect your exercise routine
www.hivplusmag.com/treatment/2015/03/04/how-get-or-stay-fit-when-you-have-health-issues

Diet

• Although having HIV doesn’t mean you have to follow a special diet, good nutrition can help to keep your body and immune system strong.

• If you are unsure about what a healthy diet looks like, follow the links below to find out more and gain some inspiration. You might find cooking to be a great way to relax and connect with a partner, your friends and family! Also consider talking to your HIV clinic, as they may be able to provide useful advice on your diet.

Healthy eating
www.aidsmap.com/Healthy-eating/page/2029215
Foods that strengthen your immune system
www.eatright.org/health/diseases-and-conditions/hiv-aids/nutrition-tips-to-keep-the-immune-system-strong-for-people-with-hiv-aids
Why not try one of these delicious recipes?
www.foodchain.org.uk/nutrition-and-hiv/recipes/

• A healthy diet doesn’t have to leave a big hole in your wallet. Visit foodchain.org.uk for more information, cooking classes and recipes for you to try out.

Smoking

• Anyone who has ever tried to stop smoking will know how hard it can be to actually quit. However, there are fantastic support groups and a vast amount of information out there to help you stay on track. From apps, emails, SMS, face-to-face sessions and quit kits, there are all kinds of things available to help you kick the habit. Visit www.nhs.uk/smokefree to see what could work for you. You should also make sure to bring it up the next time you visit your HIV clinic. That way you could leave your smoking days behind you sooner rather than later.

• Still not convinced? Check out these links to understand how smoking can affect your life with HIV:
www.aidsmap.com/Smoking/page/1045157/
www.tht.org.uk/myhiv/Staying-healthy/Alcohol-and-drugs/Smoking

• Enter your postcode to find your local stop smoking service on the link below:
nhs.uk/smokefree/help-and-advice/local-support-services-helplines

Drinking

• The government recommends that both men and women shouldn’t drink more than 14 units of alcohol each week. Calculate how many units of alcohol you drink here https://www.drinkaware.co.uk/understand-your-drinking/unit-calculator. As an added bonus, the calculator will also tell you how many calories your drinks contain, and how long you will have to exercise to burn them off again.

• For more detailed results and to find out if your drinking habit could affect your health, you can use this seven-day tracker https://www.drinkaware.co.uk/sevendaycalculator. If you would like to find out more information about responsible alcohol consumption and tips on how to cut back, visit https://www.drinkaware.co.uk/advice/are-you-drinking-too-much/do-you-need-to-cut-down/

• Don’t forget, there are lots of organisations out there who can give you advice and support, including Alcohol Concern, one of the UK’s largest alcohol charities, and Drinkline. Contact Alcohol Concern via their website www.alcoholconcern.org.uk, or phone Drinkline on 0300 123 1110.

Associated Conditions
Checklist

Researchers believe that HIV can speed up the ageing process.3,9 This means that young people with HIV can have ‘older’ immune systems, leading to early development of diseases that would normally affect older people. These may include heart disease, some cancers, osteoporosis and disorders of the liver, kidneys and brain.10-16

Your healthcare professional will be aware of this, and should be testing you regularly for any associated conditions. Find out more on these tests and how HIV affects your health in the long term by clicking through the links below.

Make sure to also stop by our health page to read more about conditions that are associated with HIV.

My Bones

• If you are over 40 years old, your healthcare professional can measure your bone mineral density (BMD) and do a test called FRAX (Fracture Risk Assessment Tool) http://www.shef.ac.uk/FRAX/, which can tell you how high your chance is of breaking a bone. If you don’t have your BMD score you can still calculate your FRAX score here www.shef.ac.uk/FRAX/tool.aspx?country=1. Please note that the FRAX score can underestimate absolute fracture risk in people living with HIV, so often clinicians will tick the “secondary causes of osteoporosis” box in the assessment.

• Information on bone mineral changes http://i-base.info/guides/side/bone-mineral-changes

My Heart

• Ever wondered what your heart age was? If you’re over 30, you can use this calculator https://www.nhs.uk/tools/pages/heartage.aspx to find out. It will also show you how your heart age may change with lower cholesterol levels.

• QRISK2 is a common test your doctor may use to work out your risk of having a heart attack or stroke over the next ten years. It is based on a few medical questions that a healthcare professional will answer about you. These include questions on your blood pressure, cholesterol, body mass index, and other areas that affect your risk. https://qrisk.org/three/

• Find out more about potential heart problems http://www.tht.org.uk/myhiv/Staying-healthy/Living-with-HIV-long-term/Heart-problems

• Keep your heart healthy http://www.foodchain.org.uk/nutrition-amp-hiv/other-conditions-associated-with-hiv/heart-health/

My Kidneys

• For more information about how HIV can affect your kidneys
http://www.tht.org.uk/myhiv/Staying-healthy/Living-with-HIV-long-term/Kidney problems

• Kidney tests your doctor might run: The most common kidney tests you may hear about are eGFR and creatine clearance tests, which work out how well your kidneys are working to filter waste products in your blood. A urine test is also often used to check for waste products and proteins in a similar way. The tests need to be carried out by a healthcare professional.17 As you age, these become more important as kidney disease is most common in older age http://www.nhs.uk/Conditions/Kidney-disease-chronic/Pages/Diagnosis.aspx

• More info on the tests available to check your kidneys are working fine http://www.aidsmap.com/Renal-function-tests/page/1733221/

Managing your HIV

My viral load

Indicates the amount of HIV in my body fluids and should be regularly measured at my HIV clinic.

My HIV Treatment

As a patient, you have a right to treatment which meets your needs and preferences.

My Mental Health

If you are going through low points or are worried about your mental health, don’t hesitate to speak to your HIV consultant about how you are feeling.

Support groups

Getting involved with a support group can be a great way to connect with people who face similar challenges.

Your lifestyle

Exercise

Exercise can reduce the risk of cardiovascular problems by 35%, as well as helping to strengthen your mental health by decreasing your chances of getting depression by 30%.8

Diet

Although having HIV doesn’t mean you have to follow a special diet, good nutrition can help to keep your body and immune system strong.

Smoking

Anyone who has ever tried to stop smoking will know how hard it can be. However, there are fantastic support groups and a vast amount of information out there to help you stay on track.

Drinking

The government recommends that both men and women shouldn’t drink more than 14 units of alcohol each week.

Associated Conditions

My Bones

If you are over 40 years old, your healthcare professional can measure your bone mineral density (BMD) and do a test called FRAX (Fracture Risk Assessment Tool).

My Heart

QRISK2 is a common test your doctor may use to work out your risk of having a heart attack or stroke over the next ten years.

My Kidneys

The most common kidney tests you may hear about are eGFR and creatine clearance tests, which work out how well your kidneys are working to filter waste products in your blood.

HIV and Cancer

There are some links between certain cancers and HIV which you can discuss with your healthcare professional.

You can print this page and take it with you to your next appointment to act as a reminder for your discussions.
Go To Summary
References

1. Aidsmap. Viral load factsheet. Available at:http://www.aidsmap.com/Viral-load/page/1044622/ Last accessed: March 2019.

2. Aidsmap. HIV lifecycle. Available at:http://www.aidsmap.com/pdf/HIV-lifecycle/page/1044602/design/fe30aa65-dc0f-4526-bbe9-fb7f285158a3. Last accessed: March 2019.

3. Deeks SG. Immune Dysfunction, Inflammation, and Accelerated Aging in Patients on Antiretroviral Therapy. Top HIV Med. 2009 Sep-Oct;17(4):118-23.

4. The NHS Constitution for England. Available from:www.gov.uk/government/publications/the-nhs-constitution-for-england. Last accessed: March 2019.

5. BHIVA. Standard of Care for People Living with HIV 2018. Available at:https://www.bhiva.org/file/KrfaFqLZRlBhg/BHIVA-Standards-of-Care-2018.pdf. Last accessed: March 2019.

6. World Health Organization. HIV/AIDS and mental health:
Report by the secretariat. 2009. 124: 4.3 Available from:https://apps.who.int/iris/bitstream/handle/10665/2107/B124_6-en.pdf?sequence=1&isAllowed=y. Last accessed: March 2019.

7. MEDFASH. Psychological support for adults living with HIV. Available at:http://www.medfash.org.uk/uploads/files/p18i3s4vo5pr911ria701j8mv7i2.pdf. Last accessed: March 2019.

8. Benefits of exercise. NHS Choices. Available at:http://www.nhs.uk/Livewell/fitness/Pages/whybeactive.aspx. Last accessed: March 2019.

9. Effros RB et al. Workshop on HIV Infection and Aging: What Is Known and Future Research Directions. Clin Infect Dis. 2008 August 15; 47(4): 542–553.

10. Aidsmap. Chronic kidney disease and HIV factsheet. Available at:http://www.aidsmap.com/Chronic-kidney-disease-and-HIV/page/1045114/. Last accessed: March 2019.

11. Aidsmap. The heart factsheet. Available at:http://www.aidsmap.com/The-heart/page/1045105/. Last accessed: March 2019.

12. Aidsmap. Cognitive Impairment and HIV factsheet. Available at:http://www.aidsmap.com/Cognitive-impairment-and-HIV/page/3135688/. Last accessed: March 2019.

13. Güerri-Fernández R et al. HIV infection, bone metabolism and fractures. Arq Bras Endocrinol Metabol.2014; 58(5):478-83.

14. Aidsmap. The liver factsheet. Available at http://www.aidsmap.com/The-liver/page/1045123/. Last accessed: March 2019.

15. Aidsmap. HIV, mental health & emotional wellbeing booklet. Available at: http://www.aidsmap.com/HIV-mental-health-emotional-wellbeing/page/1321435/. Last accessed: March 2019.

16. Silverberg MJ et al. Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study. Ann Intern Med. 2015 Oct 6;163(7):507-18.

17. NHS Choices. Chronic Kidney Disease. Available at:http://www.nhs.uk/conditions/Kidney-disease-chronic/Pages/Introduction.aspx. Last accessed: March 2019.