By Alan Brand, 01 December 2015 (Article for World AIDS Day 2015)
People react in many different ways when they hear that they have HIV. You might carry on as if nothing has happened, you may search out lots of information, or you might find it difficult to accept the news.
You may blame yourself. But HIV does not infect people because they ‘deserve it’ – having HIV does not mean you are a wicked, immoral or stupid person.
Most people get HIV from a sexual partner. You might not have known about HIV at the time, or not thought you were at risk, or you might have decided not to worry about it for once. All these are very normal, human things to do.
You may blame someone else. If you think you know who passed HIV on to you, you may understandably feel angry with them.
But they may not realise that they have HIV. Very often, HIV is passed on by people who have only had it for a few months themselves, usually without knowing.
Or they may have known and not told you. Perhaps things would be better if they had done. But many people are afraid of telling others, because they feel ashamed, or are worried about being rejected. It’s not easy to tell. We’ll look at how to tell other people later.
Keeping an eye on your health
You can’t tell from someone’s physical appearance, if they have HIV or not. And you can’t always know how good their health is. But blood tests can show how HIV is affecting your health. Whether or not you are taking treatment, it’s important to have some tests done regularly.
One important test is called a CD4 count and is a measure of the strength of your immune system. A low CD4 count means that HIV is damaging your immune system. A higher CD4 count shows that your immune system is stronger. Another test is called a viral load. It’s a measure of the amount of HIV in a sample of blood. If you are taking treatment, the viral load test shows how well your treatment is working – the lower it is the better.
Have these tests done every 4 to 5 months. They will help you and your doctor make decisions about your health and treatment.
Quick guide to test results:
CD4 counts (An important monitor to determine when to embark on treatment as it measures the strength of your immune health)
· Between 500 and 1200 = usual for people who do not have HIV
· Above 350 = HIV treatment is not usually recommended
· Below 350 = HIV treatment is recommended
· Below 200 = There is a higher risk of illness and infections, so HIV treatment is recommended
Your doctor may give your CD4 results as a percentage
· Above 29% = similar to CD4 count of above 500
· Below 14% = similar to a CD4 count of below 200
Viral Load (An important monitor to determine how well your ARV treatment is working as it measures the amount of HIV in a sample of blood)
· Between 100,000 and 1 million = High
· Between 10,000 = for people with HIV not on treatment, this is low
· Below 50 = known as an “undetectable” viral load. The aim of HIV treatment is to have an undetectable viral load also known as viral suppression.
· CD4 and Viral load tests give essential information about the effects HIV is having on your immune health and hence your bodies response to infections and illness.
· The aim of HIV treatment is to have a very low (or undetectable) viral load and a high CD4
· When the CD4 count is low, the viral load is usually high. This situation is not good.
· When the CD4 count is high, the viral load is usually low. This is much better.
· If your CD4 count has dropped to 350 or below, it is recommended that you start ARV treatment.
· The result of treatment should be that the CD4 is going up, and the viral load is going right down to undetectable levels.
HIV treatment involves taking tablets (ARV’s) once or twice a day. ARV treatment stops the virus from reproducing and reduces the amount of HIV inside your body. If there is less HIV, there is less damage to your immune system, and you are less likely to get ill.
And if there is less HIV in your body fluids, you are less likely to pass on HIV (for example to a sexual partner, or to your unborn child during pregnancy).
The aim of HIV treatment is to have an ‘undetectable’ viral load – this means there is only a tiny amount of HIV in the body. ARV treatment is not a cure – they cannot totally wipe out HIV from your body.
HIV treatment helps you stay well by reducing the amount of HIV in the body. All ant-HIV drugs (ARV) try to prevent HIV infecting new cells. But different types of drugs do this in different ways. A combination of two to three different types of drugs provides a powerful attack on HIV. The aim of treatment is an “undetectable viral load” – very low levels of HIV in the blood.
Should I take HIV treatment?
Not everybody with HIV chooses to take anti-HIV drugs straightaway. Treatment will usually be recommended:
· if your CD4 count is below 350,
· if HIV is making you ill,
· if you have another health condition such as hepatitis or TB,
· if you are pregnant, or
· if you want to take it in order to reduce the risk of passing HIV on to a sexual partner.
N.B: By knowing your status early you will give yourself enough time to find out about your options and make the right decisions in time.
Taking drugs on time
HIV treatment only works well if it is taken exactly as prescribed.
This is often called ‘adherence’, and it means taking the drugs:
· at the right times,
· at the right dose, and
· following any advice about food and drink.
The nurses, pharmacists and doctors at your clinic can help you with this. You may need to develop a routine that helps you remember to take the drugs at the same time each day.
If you sometimes forget to take your pills, the drugs you are taking may stop working properly. If this happens you would need to change your treatment.
KEY POINTS ON ADHERANCE:
· It is essential to take all your doses of HIV treatment at the right times and in the right amounts.
· Taking anti-HIV (ARV’s) drugs regularly will mean that there is always enough of the drug in your body. This will keep HIV under control.
· Not taking ARV’s as prescribed can result in HIV becoming resistant to the drug treatment choice you are on and can result in HIV being harder to treat in the future.
Looking after your health
As for anyone else, taking care of your health involves more than popping pills.
It will also help if you can:
· Getting sufficient rest and sleep is important so that you can wind down and strengthen your immune system.
· Eating a balanced diet to maintain a healthy weight gives you energy and ensures that you get the nutrients your body needs.
· Get some exercise, which is good for the heart, lungs, circulation and mobility.
· Give up smoking, if you are a smoker.
· Talk to people and seek support (isolation and stress are bad for your health too).
As well as improving your physical health, all these things are good for your feelings and emotional wellbeing. For example, exercise can make you feel more relaxed and energised.
During difficult times, you may find that you use more alcohol or drugs. They may help you to forget, or to stop thinking about things. While they may offer temporary relief, relying on them is likely to make your feelings harder to deal with in the long run. Too much drink or drug use usually brings its own problems.
Seven ways to look after your health:
1. Eat a balanced healthy diet
2. Get some exercise
3. If you are a smoker consider giving up smoking
4. Get enough rest and sleep
5. Talk to people and get a support for example: join a support group.
6. Attending your clinic appointments and have regular blood tests.
7. Take anti-HIV (ARV) drugs, if your blood tests show that you need to.