Feeling the Best You Can

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Today, more people on HIV treatment in the U.S. are living longer lives. With recent advances, there are several HIV meds that can be taken once a day,

so taking your meds may be getting easier.

However, being undetectable does not always equal a fulfilling, happy life. You might think that you're feeling and doing well, but it’s possible that you could feel even better. You may have become so used to the HIV drug side effects that you no longer recognize that they have an impact on how you feel, both physically and emotionally.

HIV meds have the potential to cause a range of side effects, including nausea and vomiting, nerve problems and weight loss in the face, arms, legs and buttocks (called lipoatrophy). These issues can limit your daily activities, restrict what you can eat, lower your energy level and keep you from feeling the best you can. Talk to your healthcare provider about any and all side effects you may have — even if you think they’re just “normal.” There may be things your healthcare provider can do to help you. You’ll never know unless you ask. There are HIV meds today that may cause fewer side effects and may have simplified dosing and lower pill counts.

Below is a review of some other issues that can keep people living with HIV from feeling the best they can.

There are many reasons you may feel tired, and it’s important that you talk to your healthcare provider to determine exactly what is making you tired. One way to help you feel less tired or weak may be by changing your HIV dosing regimen to include meds that don’t cause fatigue. Ask your healthcare provider if your current HIV dosing regimen includes meds that may cause you to feel this way. Click here to download a list of questions that will help you get the conversation started with your healthcare provider.

1. Don’t just accept it as normal. Fatigue affects many people living with HIV. Not only can fatigue have a dramatic effect on your quality of life, but it can also interfere with your ability to take your meds. That’s why it’s so important to find out the exact cause of your fatigue and work with your healthcare provider on a strategy to fight it.

2. Talk with your healthcare provider. The most important step is to talk openly with your healthcare provider. While many HIV meds may cause fatigue, there are other potential causes, including anxiety, depression, overuse of alcohol, tobacco or recreational drugs, as well as low testosterone levels.^1,2

Speak honestly about how you are feeling, and about your work schedule, exercise routine and social life. Your healthcare provider may also order a blood test to check your testosterone and red blood cell levels.

3. Plan your next step. Once you and your healthcare provider examine all possible causes of your fatigue, develop a strategy to improve it. Remember, you don’t have to be resigned to feeling fatigued all the time. There may be options available to help you fight back.

1. AIDS InfoNet. Fact Sheet Number 551: Fatigue. Available at:
http://www.aidsinfonet.org/factsheet_detail.php?fsnumber=551. Accessed September 27, 2007.
2. U.S. Department of Health and Human Services (DHHS). Health Resources and Services Administration. A Guide To Primary Care For People With HIV/AIDS, 2004 edition: Symptom Management — Fatigue. Available at: http://hab.hrsa.gov/tools/primarycareguide/PCGchap8.htm#PCGchap8e. Accessed September 27, 2007.

How you feel physically can directly impact how you feel emotionally, and vice versa. If your treatment is controlling your HIV, but the side effects are taking a physical toll, you may feel stress, mental tiredness, anxiety or low self-esteem because of it. These are all basic emotions that contribute to your overall health and happiness in life.

It is important to examine the connection between your physical and emotional health, and start a dialogue about it with your healthcare provider. Click here for a checklist that can help you do just that.

Complete this checklist and use it to start a discussion with your healthcare provider about how your health is affecting your emotional state.

Are you currently having any problems with:
Nausea or vomiting?
Diarrhea?
Heartburn?
Fatigue?
Weight loss?
Changes in your body shape?
Depression?
Decreased sex drive?

Have changes in your health or how you feel affected your ability to:
Do your job?
Spend time with friends?
Care for loved ones?
Perform household chores?
Exercise?
Have sex?

Before you were diagnosed HIV positive, which daily activity did you value the most?

Are you still able to do this activity? Yes No
If no, why not?

You might wonder, how is depression different from "feeling sad"? Depression is more intense than normal sadness and lasts longer. The signs can be different for each person, but may include feeling blue or having little interest in daily activities, feeling hopeless and difficulty concentrating or sleeping.³ Depression has various causes, including events in your daily life, chemical changes in the brain, and medication side effects.³ Depression can also be one of the reasons you feel fatigue.

No matter what may be causing your depression, your first and most important step is to talk to your healthcare provider. Left unchecked, depression may lead you to ignore personal and work-related responsibilities and push away people you care about. Depression may also cause you to miss doses of your HIV meds, which can lead to viral resistance (when the medicines no longer work against the virus).^1,2

If you think you may be suffering from depression, talk to your healthcare provider. If you have thoughts of harming yourself, seek immediate medical attention. Your healthcare provider can help determine if your dosing regimen may be a factor. Lab tests may help pinpoint an underlying cause for your depression, such as anemia or low testosterone. Your healthcare provider may also refer you to a mental health professional for psychotherapy and/or antidepressant medication.

Joining a support group can also be valuable for your emotional health. Click here to find one near you.

If you’re feeling sad about issues related to HIV drug side effects, be sure to also talk to your healthcare provider about addressing your physical concerns.

1. Eller LS, Corless I, Bunch EH, et al. J Adv Nurs. 2005;51(2):119-30.
2. Olatunji BO, Mimiaga MJ, O’Cleirigh C, et al. Top HIV Med. 2006;14(3):112-24.
3. AIDS InfoNet. Fact Sheet Number 558: Depression and HIV. Available at:
http://www.aidsinfonet.org/factsheet_detail.php?fsnumber=558. Accessed February 12, 2008.

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