STI – Living with HIV

Living with HIV

Living with HIV is nothing like it was 20 or 30 years ago. Treatment today is generally simple, easy, and highly effective. On the down side there is currently no cure for HIV, once it is in your body we have not yet found a way to get rid of it. But HIV can be kept in an inactive state with medications called antiretrovirals. Unlike the drugs used in the 1980’s and 1990’s, antiretrovirals today are more refined and most have few if any side effects. Further, the days of taking a handful of pills are also gone. Today, many antiretrovirals are combined into single tablets allowing people to take only one or two pills once a day. For people who take their antiretrovirals as prescribed, HIV can be “locked down” and kept inactive. When this happens, the amount of virus in the blood becomes so low it can no longer be detected. This is what it means to have an undetectable viral load. Individuals who have HIV, but maintain an undetectable viral load, live essentially normal lives.

They have healthy immune systems that function normally. They are at no greater risk of getting sick than someone who does not have HIV.
Research now shows that HIV+ guys with an undetectable viral load do not pass on HIV to their sexual partners.
People with HIV who are on effective antiretroviral therapy live normal life spans. So, please do invest in your retirement plan.

Antiretroviral medications

Antiretroviral medications are taken in combinations, usually three antiretrovirals at once although recently sometimes only two. Today, many single pill combinations exist. These pills contain two or three antiretroviral medications combined into one tablet. Antiretroviral medications are very effective at shutting down the virus and keeping it inactive. If you are HIV+, there are a few things to know about antiretroviral therapy.

While starting HIV treatment is never an emergency, the sooner you start the better. Shutting down the virus quickly will reduce the extent to which it is able to spread and establish itself through out your body. This means: a) If you are at risk of HIV infection, you should test regularly so that if you do become infected you can act quickly to shut the virus down.
b) If you become infected, you should see a doctor experienced in treating HIV right away to start organizing your treatment plan.

Talk to your doctor and pharmacist to choose antiretroviral medications that are right for you. While modern antiretroviral medications are generally very well tolerated, anyone can have unanticipated side effects to any drug. If the medications you start make you feel unwell, talk to your doctor. Today, there are a number of different antiretroviral medications available to choose from. So find the ones that are best for you. Remember, you are going to take these medications every day for the foreseeable future, so you are going to want to take ones that are easy to tolerate.

It is essential that you take your medications every day exactly as prescribed. The key to living a long healthy life with HIV is maintaining a consistently undetectable viral load. If you stop taking your antiretrovirals, the HIV in your body will reactivate and be free to attack your immune system. If your HIV is active, you will also run the risk of transmitting it to your sexual partners.

Make sure you see your HIV doctor regularly, usually every 3 to 6 months. Your doctor will monitor your viral load and help you stay healthy.

A couple things to be aware of if you are HIV+

While people with HIV who take antiretroviral therapy and maintain an undetectable viral load live long, healthy lives, there are a couple health issues to be aware of.

Heart disease

People living with HIV are at a slightly higher risk of developing heart disease compared to people who do not have HIV. The reason for this is not entirely clear. Data consistently show that cigarette smoking is more common among people with HIV and we know this definitely leads to heart disease. But researchers also think HIV may affect the blood vessels feeding the heart and contribute to heart disease. If you have HIV, this is an opportunity to take care of your heart. If you smoke cigarettes, stop. There are medications and support programs to help you do this. Pay attention to your diet and watch your cholesterol. Also, have your blood pressure checked regularly. Lastly, get some exercise. Exercise is good for your heart, lungs, bones and muscles, and can simply make you feel well.

Anal cancer

Gay guys are at increased risk of anal cancer, and if you have HIV, you are at even higher risk. Like cervical cancer in women, anal cancer is caused by the human papilloma virus (HPV) that is introduced into the anus when we fuck. It takes years to develop anal cancer. Initially, the HPV virus will cause cells in the anal canal to become somewhat abnormal. Over time, the virus continues to affect the cells slowly making them more and more abnormal until eventually they develop into cancer. There are two things you can do to decrease your risk. First, get the HPV vaccine (Gardasil-9). The vaccine in free in Ontario for gay guys 25 years of age and under. If you are over 25 and have health insurance, your plan may very well pay for the vaccine. Second, talk to your doctor about anal cancer screening. This is not available everywhere, yet. However, if it is available, you can get an anal Pap test. This simply involves your doctor or a nurse inserting a swab in your anus and collecting cells from the anal canal. This is then sent to the lab to look for abnormal cells. If abnormal cells are found, you can be referred to a doctor or surgeon who will use a scope to look in your anus and check for cancer or pre-cancerous lesions. Pre-cancerous lesions can be removed before they develop into cancer. Anal cancer that is caught early has a very good outcome.