January 2011 View PDF Ask a question En español
This publication provides a different way of thinking about health than what you may experience at a doctor’s office. The goal is to offer a framework for thinking about a big picture of well-being and provide a path for developing a long-term strategy to promote and maintain your overall health.
Long-term survivors of HIV are similar to people who live with other life-threatening conditions. They both have improved outcomes over time as they have proactively addressed their health on all fronts.
Of course, this isn’t the only aspect of being able to live a longer and healthier life with HIV infection. Sometimes it may be due to genetic factors or the type of HIV a person has. Sometimes, health outcomes might just come down to luck. However, in the biggest picture, people who proactively address their health on all fronts tend to do better than people who do not.
Building a strong foundation of health
Maintaining your general health includes addressing the mind, body, spiritual and social connections of who you are and how you live. By viewing health this way, the idea of a general health strategy being overwhelming begins to fade away.
People make choices daily about their health through both action and inaction. You probably already do things now that maintain your general health. Taking a moment to look at what they are, name them, refine them and explore ways to improve them is the very foundation of health.
No one strategy works best for everyone. Rather, the best answers are those that best fit your life. There are resources, tools and some basic principals to consider. A good strategy includes goals you can achieve, is tailored to your needs, fits into your life, and makes you feel better as you implement it.
This doesn’t mean that your strategy is failing if you come down with a cold or if you have a bad day. A general health strategy is not something one achieves or completes. It’s an ongoing process that needs to be revisited at times and altered as your life changes—as you change.
Preventive health guidelines
You probably see your doctor many times a year to monitor and treat your HIV. This helps you stay up to date with vaccinations, physical exams and age-appropriate screenings. How often your doctor recommends these exams and tests may differ from the guidelines below based on your health and family history. Discuss with your doctor which are right for you and how often they’re needed.
Typically a visit to your doctor will include:
- Height, weight, blood pressure and temperature measurements.
- A brief check-in, discussion and/or counseling about tobacco, alcohol, substance use, diet, exercise and sexual practices.
A more detailed or comprehensive physical exam is usually recommended:
- Every 5 years between 18–39 years of age,
- Every 2–3 years between 40–49 years of age, and
- Every 1–2 years for those 50 years of age and older.
The components of a comprehensive physical exam usually include:
- Height, weight and body mass index measurements
- Blood pressure reading
- Vision and hearing screening
- Skin survey
- Electrocardiogram if your blood pressure is elevated, heart-related symptoms are present and/or there’s a family history of heart disease.
- Spirometry test to measure how your lungs are working, if you have asthma or as a baseline test if you smoke.
- Showing or talking with you about:
- Monthly testicular self-exam (men)
- Monthly breast self-exam (women)
- Complete Blood Count (CBC)
- Blood chemistry panel
- Blood sugar
- Lipid panel—HDL, LDL and total cholesterol, triglycerides
- Urinalysis
- A vaccination review to schedule:
- Yearly flu vaccination.
- Pneumococcal pneumonia (A one-time re-vaccination after 5 years is recommended for people with HIV.)
- Hepatitis A and B
- Tetanus-Diptheria (booster every 10 years)
- Sexual infection screenings, such as chlamydia, gonorrhea, syphilis, trichomoniasis, herpes and HPV.
Biological health
Your basic biological health is something that a doctor can help you to understand and develop tailored strategies for promoting and improving. This includes physical exams, vaccinations, other preventive measures as needed and age-appropriate screening.
Nutrition
Your body needs nutrients in order to work properly. How often and what do you typically eat in a day? What does good nutrition mean to you, and what can you do to improve what you eat?
Having realistic goals about your nutrition that fit with your life is key to success. This often can mean small but steady improvements. For example, if a normal breakfast for you is a cup of coffee and a pastry on your way out the door, is it possible to add a glass of juice?
Consulting a nutritionist can help you plan for a better diet, but you can probably improve your general nutrition on your own as well. For some this means eating more, for others eating less, and for others it’s about eating different foods.
Relax!
The chemicals that your body produces when you experience stress can weaken your immune system. This can leave immune cells more prone to infection. It’s nearly impossible to completely avoid stress, but managing stress is important to our physical and mental health.
Can you identify the things that cause you stress that you could eliminate from your life? Are there ways you can reduce or manage it better? Some find that exercise decreases stress levels. Others get a massage, talk with friends, laugh, get out of the house, go to a movie, read a good book or find a support group or therapist. Try different methods until you find what works best for you.
Exercise
A few pounds of muscle mass (lean body mass) can make a difference in how well someone recovers from an infection. There are many reasons why exercise is good for us, from helping muscles and bones remain strong to improving the function of our heart and lungs.
Some people love to go to the gym and work out; others wouldn’t set foot in one. If you typically don’t exercise, consider taking a walk for 20 minutes each morning and/or at the end of the day. You may enjoy going for a hike, riding a bike or simply taking the stairs in your building. Ask yourself, “What can I do to improve the kind or quality of exercise I get each day?”
Sleep
When you sleep, your body has a chance to heal. Most people do well with about 8 hours of sleep each night. The amount of sleep you need may differ. Ask yourself, “Do I get enough sleep each night, and how can I improve upon it?”
When someone is depressed s/he may sleep more or even have trouble sleeping. When someone is fighting an infection or condition like anemia, his or her body usually demands more rest. It’s important to figure out why you sleep too much or too little.
This also could be due to drinking coffee or other caffeine drinks too late at night. Or, are you just too busy? Are you anxious about something? To improve your sleep, strive for small but steady improvements. If you sleep only 5 hours a night, can you make time for another 15 or 30 minutes?
Mental health
Health is more than just healthy bones, teeth and skin. It’s certainly about nutrition, exercise, rest and relaxation, but it’s also about how the physical, social, spiritual and mental health sides of us are connected. The paths to examining these issues and developing strategies that are right for each person will vary.
Addiction
Some people are genetically predisposed to alcoholism and other addictions, because of the way their bodies process (or don’t process) certain chemicals. Chemical changes in the brain can also leave people addicted to alcohol or drugs after using them for a time.
Addiction comes in many forms. Common ones are alcohol and drugs, but there’s also food, sex, the internet, video games, gambling, nicotine or shopping. Anyone with an addiction who speaks candidly about it can tell you how it interferes with their life, relationships and health.
In most cases, the first step is recognizing your addiction and then seeking support, guidance and expert advice on plotting a course of action. This can include therapy, medical interventions, 12-step programs, and inpatient or harm reduction programs.
Depression
The most common psychiatric diagnosis among people with HIV is depression, and it’s more common among women. It can be caused by chemical imbalances or by some HIV-related medicines. HIV itself can also contribute to it.
The key to treating depression is recognizing it in the first place and then identifying its possible causes. When someone is depressed, s/he may experience extreme fatigue, sleep disturbances, changes in appetite, and a general loss of interest and enjoyment in living.
Finding the strength to pay attention to sleep, nutrition and exercise is important to avoiding a cycle of worsening depression. Seeking ways to deal with it is critical. For some this might include taking medicine. For others it might simply involve spending time with people they love or doing things they enjoy.
Self-esteem, emotional health
A common theme that unites many long-term survivors is their philosophy of well-being. Often they believe that what they do today will make a difference for their tomorrows.
The road each of us must take to believe in ourselves and the value of our voices and choices is unique. For some, one way to improve self-esteem and emotional outlook might include seeking a therapist. For others it could include spiritual soul searching, or even going to the gym to improve body image.
Spiritual health
Defining what spirituality means to most people is nearly impossible. For those who embrace it, most would contend that it’s incomplete to discuss their health without discussing spirituality. Others, particularly those who have had negative feelings about spirituality and religion, may be offended by any discussion.
Each person’s path to exploring spiritual health is unique and very personal. For some, spirituality is the religion they were raised with; for others, it’s founded on a harmony with nature, a notion of a Higher Power, or a balance with the energies of the universe. What matters isn’t what your personal spiritual choices are, but that you’re living your life consistent with your beliefs.
Social health
Social health is not only having healthy personal relationships with others. It also includes one’s relationship to his or her communities.
While some people enjoy social activities, others do not. Social health doesn’t have to mean participating in large groups or social events. It does mean, however, developing meaningful relationships that include getting involved in some way in community. Social health is about giving and receiving support from community and loved ones.
Sometimes promoting your social health starts by simply thinking about your personal relationships, identifying which are meaningful and why. Are you happy with them? What can you do to develop new ones? Are you the kind of friend you want to be? How do people support you? Do you volunteer?
Final thoughts
Developing a strategy for good general health provides a way to deal proactively with HIV disease. There is a difference between medications, healing and health. Medicines treat certain conditions. But healing is a process, and your health is an experience. Medications have their place, but they’re merely one piece of a much larger puzzle that includes other things like supporting your mental, emotional, spiritual and social health.