Enjoying life

Am I eating enough?

You may experience periods of fatigue or constant tiredness. The cause could be psychological or physical. Stress and depression are common causes of fatigue, however, constant tiredness may be related to your HIV or other illnesses, diet, or lack of sleep or exercise. If you are feeling more than usually fatigued or the onset of tiredness is sudden or extreme, talk to your doctor.

If your eating habits have changed or you find you have little or no appetite, your doctor may recommend talking to a dietician. They can help you find easy ways to prepare and enjoy the right foods.

It’s important to be proactive. Keep doing things you enjoy — things which make you feel good about yourself. Take some time to really look after yourself.

Am I sleeping enough?

Sleep is fundamental to both physical and mental health. Not getting enough sleep can trigger emotional and mental health issues. Conversely, too much sleep can make you feel tired and reduce motivation to do things. Talk to your GP about different options to address sleeping issues. There are many possibilities aside from medication, including specific breathing and relaxation techniques.

Am I doing enough exercise?

Regular physical exercise will keep you fit and it can also help you manage stress, improve your mood, increase your energy levels, decrease symptoms of anxiety and mild depression, maintain your lean muscle mass and can help you sleep soundly at night. A daily walk in the fresh air can help you feel and sleep better. Exercising with someone else can make it more enjoyable as well as increasing your social contact. Exercise is good but enjoyable exercise is really good! And if you enjoy it, you’re more likely to keep doing it.

Work has the potential to affect your health and wellbeing in both positive and negative ways. Work can be boring, stressful or just an economic necessity. If you’re lucky, it can also be interesting, fulfilling, and a great reason to get up in the morning. If you have a choice whether to work or not (or whether to work full-time or part-time) it is a good idea to think about the role of work in your life before you make any decisions.

Your ability to work may be compromised by your health, and it can be difficult to balance the demands of work and family/personal life. Perhaps you are experiencing periods in which you are unwell or need regular time off for medical care. Taking antiretroviral treatments can also be an issue impacting work, particularly if you are experiencing side-effects (such as diarrhoea). Take some time to make sense of your options. You may want to talk it through with your partner, your doctor, a counsellor or peer support worker.

If you feel you need to have time off, think about how you will talk to your employer before you ask to see them. Remember, you do not have to tell them you have HIV. You may want to tell them or you may prefer to explain that you have a medical condition. You may find it easier just to discuss the symptoms you are managing.

It is useful to remember that the nature of the workforce is changing all the time. You may find there are opportunities for part-time work or work with flexible working hours.

Some women with HIV who are not working find it rewarding to get involved in activities such as volunteer work or study in order to keep busy and to develop or maintain skills and social networks.

Drinking too much alcohol and excessive use of recreational drugs increase emotional and mental health issues, as well as damaging your physical health and interfering with your HIV antiretroviral treatment. Think about your alcohol and drug use and whether they’re really helpful (beyond the moment).

A little alcohol can help you relax, feel good and increase your appetite. A glass of wine or beer or a single measure of spirits should do you no harm (unless you are pregnant). Heavy drinking increases your body’s requirements for certain nutrients, such as vitamin B6, and places a strain on your liver. A healthy liver is needed to process HIV antiretroviral treatments. Some women on treatments find they become increasingly likely to experience a ‘hung over’ feeling following even small amounts of alcohol.

Some recreational drugs also interact with HIV antiretroviral treatments so it’s important to talk honestly to your doctor about any drugs that you use, whether regularly or occasionally. Using recreational drugs while you are on antiretroviral treatment can be harmful because:

• each person’s body has a different reaction
• your immune system may be damaged through long-term use of some drugs
• some recreational drugs lower the levels of HIV treatments in your blood so less of the dose is absorbed
• some HIV treatments raise the blood levels of amphetamine-based drugs to possibly dangerous levels.

If you do inject recreational drugs, do not share needles or injecting equipment — even with other HIV-positive people. Use your own injecting equipment or use a new fit every time. This is important to reduce the risk of infection with HIV, hepatitis C or other blood borne viruses.

If you use drugs, you may want to reduce your use or stop altogether. You can seek advice and support through your doctor, community health service, or HIV support group.

Methadone and other opiate substitute therapies may interact with HIV antiretroviral treatment. Negative drug interactions can be managed by adjusting the dosage of methadone and/or HIV medications. Talk to your doctor as soon as possible so they can work out optimal therapy for you. Do not stop taking HIV treatment without talking to your doctor.

For information about interactions between HIV antiretroviral drugs and recreational drugs, see VAC’s Touchbase site. It lists more than 20 drug types and their interaction with HIV and HIV treatments (under the ‘Living with HIV’ section heading).