Michael Stacey walked into a doctor’s office 15 years ago to find out why his psoriasis kept getting worse no matter what he did. A week later, he had his answer: Not only was he HIV-positive, he had AIDS.
“It was still very scary at that time, and there were still a lot of unknowns about the effectiveness of medications,” says Stacey, 50, of Madison, WI.
Stacey had no idea how long he had been positive, but it had probably been a while. That meant the virus, untreated, had had time to do some damage.
“The vast majority of people start therapy after many months to years of HIV infection,” says Steven Deeks, MD, professor of medicine at the University of California, San Francisco School of Medicine. “Even with the modern [drug] regimens, there’s pretty clear evidence that the immune system takes a hit.”
Although medications today work better than ever and are safe, Stacey and many other people with HIV, especially those who have had the virus for a long time, have a higher chance of getting other health problems, including cancer, heart disease, infections, and problems with thinking, attention, and memory.
People with the disease also have all the usual issues that come with aging, such as weaker bones, but at any earlier age, says Ryan P. Westergaard, MD, an infectious diseases expert at the University of Wisconsin School of Medicine and Public Health.
But it is possible to avoid or delay these health complications, even if you were diagnosed late.
Stacey started treatment -- 27 pills a day -- right away. Then he set about quitting smoking, eating healthier food, exercising, and, most important, always taking his medication (now just one pill a day).
“There’s no magic bullet, no specific treatment to reverse the harms of delayed diagnosis,” Westergaard says. “We need to do all the things we know how to do in preventive health care and be vigilant.”
Your best defense against complications from HIV is to get tested.
“The most important thing for everybody is to not have HIV that is untreated,” Westergaard says.
Hopefully, you’ll get diagnosed and treated early, but even if you don’t, you can still lower your chances for health problems in the future.
Experts recommend HIV testing for everyone ages 13 to 65.
Take Your Meds
Probably the most important thing you can do is to take your HIV drugs as directed. That means every single day -- no skipping. It will help you stave off health problems and make sure your medications keep working. When you miss doses, you give the virus a chance to change itself in a way that makes the drugs less effective.
Today’s HIV meds are easier to take than ever before, thanks to once-daily pills with fewer side effects.
Keep Regular Doctor Appointments
Stacey sees his HIV doctor and has blood tests every 6 months. He also goes once a year to his primary care doc.
Regular checkups can help you manage your blood pressure and cholesterol, both of which are key to avoid heart disease. These preventive steps are even more important for people with HIV, Westergaard says.
Your doctor can also make sure you get the vaccinations you need against viruses like the flu and hepatitis A, B, and C. These infections are a bigger threat for someone with HIV since the immune system is weaker.
Your dentist is also an important part of your HIV care -- she can help you avoid infections and keep you from losing teeth. Stacey lost all of his teeth because of HIV (he now wears dentures). Earlier dental care may have prevented that.
As soon as he was diagnosed, Stacey decided it was time to quit his 2-decade, two-pack-a-day cigarette habit. It took a while, but eventually, he did it -- and that’s a good thing. People with HIV are more likely to smoke and more likely to get the health problems it causes, like lung cancer, heart disease, and pneumonia.
“A cigarette is bad for everyone but particularly bad for someone with HIV,” Deeks says.
The same goes for recreational drugs like ecstasy.
Pay Attention to Diet and Exercise
If you have HIV, aim to get less fat, sugar, and salt and more fresh produce, whole grains, and lean meat. These good diet changes will also help you stay at a healthy body weight.
The other half of a healthy lifestyle is regular exercise. Do workouts that strengthen your muscles, such as lifting weights or doing pushups, situps, and other moves that use your own body weight. People with HIV can lose muscle mass, so these exercises are key. Add workouts to get your heart going, too -- walking, swimming, dancing, or even gardening can do the trick.
Practice Safe Sex
It’s important not only to protect your sex partners, but to make sure you don’t get any other sexually transmitted diseases that could harm your health.
For Stacey and many others, a diagnosis of HIV can take an emotional toll, which is why support is critical. When you have good ways to deal with stress, you can also help your physical health. For Stacey, balance comes through mindfulness and other relaxation techniques. For others, a support group of other people living with the disease might offer the most help.
Keeping HIV complications at bay takes effort, but it can be done. Deeks says today the disease is a “manageable medical problem” that’s easier to handle when you take good care of yourself.