Managing your HIV
• 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.
• 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.
• 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
• 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
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.
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.
• 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
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.