HIV

Understanding HIV

HIV stands for human immunodeficiency virus. It is the virus that causes HIV infection. If HIV is not treated, it can gradually weaken a person’s immune system, making them more vulnerable to infections and illnesses.

There are several stages of HIV infection:

1. Acute HIV infection – this happens within weeks after someone is infected. The virus multiplies rapidly. Some people have flu‐like symptoms (fever, sore throat, rash). The viral load (amount of virus in the blood) is very high, which increases transmission risk.
2. Chronic HIV infection (also called clinical latency or asymptomatic phase) – HIV is still active but reproduces at lower levels. Many people do not show symptoms for years. Without treatment, this stage can last around 10 years or longer before progressing.
3. Acquired immunodeficiency syndrome (AIDS) – this is the most advanced stage. The immune system is significantly damaged. The body cannot fight off certain infections or cancers. AIDS is diagnosed when the CD4 cell count falls below a certain point or when certain opportunistic illnesses occur.

There is no cure for HIV at present, but with proper medical care, especially early use of antiretroviral therapy (ART), people living with HIV can live long, healthy lives. ART helps the immune system recover, suppresses the virus, and lowers the risk of HIV transmission.

HIV Prevention

Preventing HIV means reducing the chance of being infected or preventing someone who has HIV from passing it on. Some prevention methods are behavioral, others medical.

Key prevention strategies include:

• Use of condoms correctly and every time you have sex. Condoms are highly effective for reducing transmission during vaginal or anal sex.
• Pre‐Exposure Prophylaxis (PrEP) – a medicine taken by HIV‐negative individuals who are at risk, to reduce the chance of becoming infected.
• Post‐Exposure Prophylaxis (PEP) – taking HIV medicine after a possible exposure to the virus, ideally within 72 hours, to help prevent infection.
• Treatment as Prevention (TasP) – if someone has HIV and takes ART consistently so that their viral load becomes undetectable, the chance of transmitting HIV through sex is essentially zero. This idea is sometimes summarized as undetectable = untransmittable (U=U).
• Preventing perinatal transmission (from parent to child during pregnancy, birth, or breastfeeding), by ensuring that pregnant people are tested and treated early.
• Safe practices in injecting drugs – using sterile equipment, not sharing needles.

Also, education, awareness, reducing stigma, safer sexual behaviors, and regular testing are part of a comprehensive prevention approach.

Testing and Monitoring HIV

Testing is the first step. After diagnosis, monitoring helps track how HIV is affecting the body and how well treatment is working.

Testing

• HIV testing is recommended for anyone who might have been exposed, including people with risk factors (e.g. unprotected sex, sharing injection equipment, having a partner with HIV).
• Testing should be done before pregnancy or as early as possible during pregnancy. If someone’s HIV status is unknown during pregnancy or the child‐bearing period, testing is especially important.

Monitoring

After a positive test, certain lab tests and measures are important:

• Viral load (amount of HIV in the blood) – this shows how actively HIV is reproducing. Regular monitoring ensures that ART is effective.
• CD4 cell count – measures immune system strength. A low CD4 count indicates higher risk of certain infections.
• Drug resistance testing – to see if the virus is resistant to certain medications, especially before starting or changing treatment. (Wikipedia)

How often tests are done depends on individual health status, how long a person has been on treatment, whether they are pregnant, and other risk factors. After viral suppression is achieved, fewer tests may be needed.

HIV Treatment

ART (antiretroviral therapy) is the core of HIV treatment. Its goals are to reduce viral load, preserve or restore immune function, prevent HIV‐related illness, reduce risk of transmission, and help people live long and healthy lives.

What Treatment Involves

• ART is made up of combinations of HIV medicines. These may be one or more pills or sometimes injections. They are taken daily or, in some cases, every few weeks/months depending on the drug formulation.
• Treatment should be started as soon as possible after diagnosis. Early treatment helps to protect the immune system and reduce the risk of complications.
• Adherence (taking the medicines exactly as prescribed) is crucial to get viral suppression, avoid drug resistance, and reduce transmission risk.

Treatment Outcomes

• When ART works well, the viral load may become undetectable. That means that common tests cannot detect HIV in the blood. This leads to a much lower risk of passing HIV to others. (The Well Projecct)
• People on ART who maintain viral suppression can have immune recovery, fewer HIV‐related illnesses, and life expectancy close to that of people without HIV.

Side Effects and Drug Resistance

• HIV medicines can have side effects. Some are mild, others more serious. Doctors choose drug combinations that balance effectiveness and tolerability. Monitoring is needed to notice side effects.
• If medicines are not taken properly, or if someone already has resistant HIV, treatment may fail, meaning the virus starts replicating despite treatment. In those cases, treatment must be changed based on resistance testing.

Recently Diagnosed with HIV

Being newly diagnosed with HIV can be overwhelming. It is normal to feel many different emotions. With information, support, and care, many people adjust and live full lives.

What to Do First

• Find a healthcare provider who has experience with HIV treatment. This could be a clinic, specialist, or an HIV care centre.
• Learn about HIV, how ART works, what your lab tests mean, and what to expect in terms of side effects. Knowledge helps with making decisions.
• Begin ART as early as possible, ideally right after diagnosis, unless there is a medical reason to wait. Early treatment has been shown to improve long‐term health.

Emotional, Psychological, and Social Support

• It is common to experience fear, sadness, shock, guilt, or anger. It is okay to take time to deal with the diagnosis.
• Support networks help. This may include mental health professionals, peer support groups, community organizations. Talking with others who have had similar experiences can reduce isolation.
• Decide when and how to share your status with others. You do not have to tell everyone right away. Disclosure is personal, and doing so may involve weighing benefits and risks.

Managing Practical Matters

• Understand your medical rights, how to access treatment (including cost, insurance, government programs if available).
• Keep track of doctor visits, lab tests, and medication schedules.
• Plan for any side effects, possible interactions with other medicines, etc.

Living with HIV

HIV is now treated as a chronic condition. People living with HIV can lead healthy, productive lives. But it involves ongoing medical care, attention to mental health, lifestyle, and support. (CDC)

Healthy Living

• Maintain regular medical care and follow up with your healthcare provider.
• Take ART exactly as prescribed.
• Prevent and treat other infections. Stay up to date on vaccinations.
• Take care of mental health. Many people with HIV experience stress, anxiety, depression, or stigma. Getting counseling or finding support can make a big difference.

Relationships, Stigma, and Disclosure

• Living with HIV involves decisions about if, when, and whom to tell about your status. Trust and safety matter.
• Stigma can come from many places: family, community, employer, sometimes even healthcare settings. Seek out supportive environments. Connecting with supportive groups helps.

Other Aspects

• Monitor your overall health: heart health, kidney health, bone health, liver health, etc., since HIV and some HIV medicines can affect these.
• Healthy lifestyle: good nutrition, regular physical activity, avoiding smoking, limiting alcohol.

HIV and Pregnancy

HIV during pregnancy requires special care to protect both parent and child. Prevention of perinatal transmission (from parent to baby) is a core goal.

What is Recommended

• HIV testing should be done before pregnancy or as early as possible in each pregnancy. If someone becomes pregnant and their HIV status is unknown, getting tested early is essential.
• If HIV is diagnosed, start or continue ART immediately during pregnancy. Taking HIV medicines throughout pregnancy, during labor and delivery, and during breastfeeding can reduce the risk of the baby getting HIV to less than one percent.
• Delivery choices: if the viral load is very low (undetectable) and treatment has been working well, vaginal birth is usually safe. If viral load is high (or ART has not yet controlled the virus), cesarean section may be recommended to reduce transmission risk.
• After birth, babies exposed to HIV should receive HIV medicines as soon as possible (within hours of delivery) to reduce the chance of infection.
• Also important is safe breastfeeding advice depending on local guidance, access to clean water, and risk vs benefit in each setting. In many places, people living with HIV can breastfeed safely if ART is well managed and viral load is suppressed.

Nutrition and Pregnancy

• Micronutrient deficiencies are common in pregnant people with HIV, and they can affect pregnancy outcomes (low birth weight, preterm birth, etc.). Supplementing key vitamins like B group, C, E, along with iron and folic acid during pregnancy, can help.
• Eating a varied and balanced diet supports health of both parent and baby, helps ART work well, and supports recovery post‐delivery.

Aging with HIV

More people with HIV are living longer thanks to effective treatment. Aging with HIV brings some additional issues.

Key considerations

• As people age, they become more likely to develop chronic health conditions such as cardiovascular disease, diabetes, bone disorders, kidney disease. HIV infection and some HIV medications can increase risk of some of these conditions.
• Monitoring for these comorbidities (other diseases) becomes more important. Regular screening, preventive care, and managing risk factors (e.g. diet, exercise, quitting smoking) are very helpful.

Supporting Healthy Aging

• Maintain viral suppression through ART, stay in care, manage HIV effectively.
• Healthy lifestyle is more important as you age: balanced diet, physical activity, maintaining a healthy weight.
• Mental health and social support matter a lot. Loneliness, stigma, and mental health challenges may worsen with age.
• Bone health, muscle strength, mobility issues may require special attention.

Eating Well with HIV

Good nutrition plays a crucial role in supporting health for people living with HIV. It helps the immune system, supports effectiveness of ART, and improves overall quality of life.

Why nutrition matters

• Nutrients help the body recover and maintain tissues, fight off infections, and cope with side effects of medications.
• Poor nutrition can make people more susceptible to infections, weaken the immune system, and make ART less effective.
• HIV and some HIV medicines may cause symptoms like nausea, loss of appetite, changes in weight, diarrhea, or difficulties absorbing some nutrients. These effects can affect nutrition.

What is a healthy eating style

• Eat a variety of foods from all major food groups: fruits, vegetables, whole grains, lean proteins, dairy (or alternatives).
• Choose foods lower in saturated fats, added sugars, and sodium.
• Ensure enough calories to maintain a healthy weight. If weight is lost unintentionally or someone is underweight, eating more (in a healthy way) may be needed.

Dealing with nutritional issues

• If certain foods cause discomfort, try smaller, more frequent meals.
• Stay hydrated.
• If side effects of medicines affect eating (nausea, diarrhoea), talk with your healthcare provider about options to ease these.
• Consider nutritional supplements only under medical advice (especially if there is a documented deficiency).

Food safety

• Because HIV lowers immune defenses, foodborne illnesses can be more serious. So taking food safety seriously matters.
• Wash hands and cooking surfaces well. Keep raw and cooked foods separate.
• Cook food to safe temperatures.
• Store foods safely, refrigerate per guidelines.
• Drink clean, safe water. Avoid raw or undercooked meats, unpasteurized dairy, raw eggs, or other risky items depending on your setting.