By Strength for Caring

Nutrition and HIV

Proper nutrition requires adequate intake of macronutrients ad micronutrients. Macronutrients contain calories that contain energy. These include proteins, carbohydrates, and fats.  These help to maintain body weight. Micronutrients include vitamins and minerals. They help maintain cell function.

People with HIV need to eat more than individuals who do not have HIV. Extra muscle weight helps to combat HIV. A proper diet for persons with HIV should consist of plenty of protein and starches, with moderate amounts of fat, unless otherwise specified by your loved one’s healthcare professional.

• Protein helps build and maintain muscle: Meats, fish, beans, nuts, and seeds are good sources of protein.
• Carbohydrates provide energy: Complex carbohydrates are found in grain, cereals, vegetables, and fruits. They are considered a “time-release” energy source and are full of fiber and nutrients. Simple carbohydrates, or sugars, provide a quick source of energy. Fresh or dried fruit, honey, jam, or syrups all contain simple sugars.
• Fat provides extra energy: Minimal amounts of fat are necessary, but too much fat can be detrimental to a healthy diet. Monounsaturated fats are found in nuts, seeds, canola and olive oils, and fish—all of these are appropriate sources of fat. Saturated fats in butter should be consumed in small amounts.

Increased water consumption is imperative for loved ones with HIV. Drinking plenty of water can reduce any side effects from medications. It can also help with dry mouth and constipation. Tea, coffee, colas, chocolate, and alcohol should be consumed in small amounts as they may cause dehydration.

In addition to a balanced diet, many health professionals recommend that individuals with HIV take a nutritional supplement and mineral supplement. Nutritional supplements help maintain body weight and provide the necessary additional vitamins and minerals for proper health. Be sure to ask your loved one’s health professional for information on health supplements.

Food Preparation and HIV

Food preparation safety is extremely important for loved ones with HIV. Infections can be carried by food or water. A kitchen where food is prepared for a person with HIV should always be kept very clean. Hand washing before preparing food is critical. Foods must be washed thoroughly and stored properly to maintain freshness. Eggs and meat need to be cooked thoroughly before serving. Leftovers must be refrigerated immediately and eaten within three days. In addition, tap water should be purified, or use bottled water instead, especially for drinking. A person with HIV should avoid raw eggs, including those in eggnog or milkshakes, eat raw meat or fish like sushi, oysters, or beef tartare.

Safe food handling techniques include:

• Avoid raw animal foods such as uncooked eggs, meat, and sushi.
• Cook meat and eggs thoroughly.
• Do not use cracked eggs.
• Thaw frozen foods in the refrigerator or microwave, not at room temperature.
• Wash fruits and vegetables thoroughly.
• Use only pasteurized dairy products.
• Keep hot foods hot (cooked to 165ºF to 212ºF and served at 140ºF to 165ºF.
• Keep cold foods cold (refrigerator temperature should be 35ºF or 40ºF; freezer temperature should be 0ºF).
• Do not allow foods to stand at temperatures between 45ºF and 140ºF for more than 2 hours.
• Refrigerate perishable foods immediately upon return from the store, Store foods that have been opened in airtight containers or a moisture/vapor-proof wrap.
• Don’t crowd or over-pack foods in the refrigerator.
• Avoid moldy or spoiled foods.
• Do not use foods after the recommended expiration date on the label.
• Always wash hands before handling food.
• Use different cutting boards for raw and uncooked foods.

Exercise and HIV

Strength training programs may be a good idea to increase lean body mass and help prevent wasting. Strength training programs can help people build and maintain muscles, as well as improve immune function. Strength training also increases appetite, metabolism, and bone density. Exercise helps a person with HIV perform physical tasks with greater ease.

Cardiovascular exercise is also important for loved ones with HIV. While any exercise program is vital for those with HIV, it is important to exercise moderately and take breaks as needed. Be sure to have your loved one rest when muscles become tired.

Fatigue and HIV

Too much bed rest and inactivity can cause even greater fatigue in those with HIV. However, a moderate exercise program may provide more energy and strength. Patients with decreased food intake or diarrhea and weight loss may experience even greater fatigue due to nutrient loss. Nutritional supplements, along with small healthy meals throughout the day, may help to decrease fatigue and increase energy levels in the person with HIV/AIDS.

There are several causes of fatigue in loved ones with HIV. Ask your healthcare professional for more information:

Causes of Fatigue may be:               

• Sleep disturbances                                           
• Nutritional problems                                       
• Too much inactivity                                          
• Anemia                                                
• Lung or breathing problems                              
• Hormone abnormalities                                    
• Depression                                                      

Pain and HIV

Pain is a common condition that affects many people with HIV. It can be caused by mouth infections such as oral thrush, nerve abnormalities (peripheral neuropathy) or other conditions associated with HIV. It may hurt your loved one to eat, and as a result, your loved one may have hunger pains from not eating. Those with HIV may have pain if they lie in one position too long. They may have pain from moving.

In many cases, pain can be controlled with proper treatment. Some studies show that as few as 15% of people with HIV receive proper treatment for pain. Some of the reasons include the person with HIV not knowing what is causing their pain so they are unable to communicate what is really happening. Also, the person with HIV may feel they are complaining about something that is not really important, so he or she will not tell anyone about the pain.

For individuals with HIV, especially those with advanced disease, proper control of pain is one of the most important determining factors of living happily and comfortably. When a person is in pain, nothing is pleasurable. When pain is managed properly, those with HIV are more self sufficient and able to enjoy life, family, friends, and leisure activities.

It is important for caregivers to help their loved one communicate any pain to their healthcare professional. The duration, severity, and possible cause of pain are important factors that should be discussed with a doctor or other healthcare professional.

Your Loved One’s Emotions

Coping with stress, anxiety, and feelings of depression through the course of HIV disease can be overwhelming for your loved one. As a person caring for someone with HIV, it is important to provide both social and emotional support. Try to keep your loved one involved in their care, and help your loved one stay involved in day-to-day activities. Some tips include:

• Don’t do everything for a person with HIV or make all of their decisions. This will help prevent your loved one from feeling helpless.
• Have your loved one help around the house if they are able to. Doing this may make them feel more useful.
• Get your loved one informed in the things that are happening around them. Include your loved one in normal talk about books, TV shows, or what is going on in the world. Or, simply join them while they watch TV or read together in the same room since this can be comforting.
• Be a good listener. Your loved one may want to talk about HIV. Having HIV can make a person angry, frustrated, scared, or lonely. Help your loved one work through their emotions.
• Help your loved one find a support group in his or her area that they can attend. A support group of other people with HIV can be a good place for your loved one to talk things out. If your loved one wants professional counseling, help them get that as well.
• Invite their friends over for a visit. Socializing can help them feel better.
• Show them you care by hugging them, kissing them, or holding their hand. Some people may not want to be physical, but if they do, reaching out to them by touching them can be a very powerful way of saying you care.
• Try to get out together to social events, for shopping, driving around, walking around the block, or just sitting on the porch for fresh air.
• Contact a healthcare professional for suggestions of other sources of emotional or psychological support for people with HIV, especially when psychological issues become overwhelming.Sometimes persons with HIV experience anxiety and depression that require more intensive therapy.
• Encourage your loved one to attend a church, synagogue, mosque or other spiritual place of their choice. Spirituality can be important in the healing process.

Alternative Therapies

Treatment that does not fit into standard Western medical practice is called “alternative” or “complementary.” This includes many different therapies such as:

• Chinese acupuncture and Native American healing
• Physical therapies, such as chiropractic, massage, and yoga
• Homeopathy or herbs
• Energy work, such as polarity therapy or Reiki
• Relaxation techniques including mediation and visualization

Many people living with HIV/AIDS choose to explore alternative options. They think alternative therapies can reduce stress and help with their wellness. Alternative therapies, particularly homeopathy and herbs, may not be monitored by the Food and Drug Administration (FDA), and may have dangerous side effects.

It is important to communicate any desires to use alternative or complementary treatment to your loved one’s doctor and healthcare professional team. There are some alternative therapies that should not be used with medicines the doctor may have prescribed. The more you and your loved one communicate all lifestyle and treatment desires with your loved one’s healthcare professionals, the better able your health professionals will be to ensure a safe and effective treatment plan.

Educational, Advocacy and Service Resources

AIDS Alliance for Children, Youth, and Families

AIDS Action

Elton John AIDS Foundation

Gay Mens Health Crisis

National Minority AIDS Council

National Association of People With AIDS

Project Inform

The Body

POZ magazine

AIDS Education Global Information System

Aids.org

Medscape HIV/AIDS

AIDS Treatment Data Network

AIDSMeds.com

National AIDS Treatment Advocacy Project

National Institute of Health AIDS Information

HIVInfo.US