According to the CDC, people living with HIV who are on effective HIV treatment are at no greater risk for serious complications from COVID-19 than people who are not living with HIV. People living with HIV should take special care to insure all vaccinations, including seasonal influenza and bacterial pneumonia, are current and access to medications remains uninterrupted among other things (link to CDC guidelines). Otherwise, based on the limited data available, people living with HIV on effective HIV treatment with healthy CD4 counts and people who are not living with HIV are in the same boat when it comes to COVID-19 infection.
When it comes to the potential impact on healthy behaviors and the isolation of quarantining, people living with HIV effectively treated by antiretroviral therapy (ART) medications do have additional factors to consider, according to Equitas Health’s Chief Medical Officer, Dr. Chad Braun.
“HIV meds, specifically protease inhibitors and some non-nucleoside reverse transcriptase inhibitors, can increase cholesterol and triglyceride levels, which increase the risk of heart disease. Several of my patients are experiencing weight gain, higher blood pressure, and higher cholesterol & triglyceride levels in the past 6-9 months.”
While it is important for everyone to eat healthy, stay socially connected, and be as active as possible right now, it is especially important for people living with HIV who are taking HIV medications.
You have seen the Facebook and social media posts, cataloging the excesses of quarantine diets: recycle bins full of wine bottles and Postmates deliveries of pizza and donuts. Left to our own defenses, we do not always make the best choices, and it is much easier to rip open that second bag of potato chips when no one else is watching, and sweatpants are your new wardrobe staple.
“Moderation is definitely the key here,” advises Braun. “Bake the cookies. Have one or two, and give the rest away.”
If you are struggling with the economic impact of COVID-19, your choices might be more limited than usual when planning family meals. Additional considerations might be necessary to make the healthiest choices available during this difficult time.
Whether you are fending for yourself in the kitchen for the first time or adjusting to economic uncertainty, healthy eating remains an important consideration for people living with HIV.
Dr. Braun suggests eating a heart healthy diet with lots of fruits and vegetables as an effective way to lower or stabilize cholesterol and triglycerides. And did we mention the Holidays are upon us?
Check out these links to recipes and shopping tips for heart healthy, budget-friendly meals:
Regular exercise has well established health benefits: better rest, stress reduction, weight loss, cardiovascular strength, lower blood pressure and lower cholesterol. All of these are particularly beneficial to people living with HIV and taking ART medications. Pre-COVID, fitness centers and gyms were an obvious choice for getting regular exercise. Whether they remain open or not, you might not feel safe there now.
“With winter weather upon us, we all have to get creative about how and where we can safely exercise,” says Dr. Braun. “If bundling up for a hike isn’t your idea of a good time, find ways to adapt your existing fitness routine at home. You can unroll a yoga mat just about anywhere. And, there are thousands of at-home workouts available for free online. Of course, you can always contact your provider if you have concerns about starting a new exercise routine.”
If you do choose to workout at the gym, be sure to wear a mask, practice social distancing, and sanitize your hands and all workout equipment before and after each use. Try to avoid peak hours and workout when you know your gym will be less crowded.
Or check out these links to at-home workouts, requiring little or no equipment:
Whether virtually or at a safe distance –remember that winter hike?– staying connected with friends and family is just as beneficial to your mental health as a heart healthy diet is to your physical health. Loneliness, isolation, and depression can also have serious physical effects on the body, including chronic pain, inflammation, weight loss or gain, and an increased risk of heart disease. There is one other health risk associated with depression that concerns Dr. Braun for people living with HIV: decreased medication adherence.
“Simply put, people suffering from depression are less likely to take their medications as prescribed. With HIV medications 100% adherence, or as close to it as possible, is critical to successfully suppressing the virus, which helps people living with HIV live long and healthy lives while remaining undetectable and untransmittable.”
It might be awhile before we are able to socialize in large and small groups at concerts, sporting events, parties, and evenings out at bars and restaurants. Adapting holiday celebrations will be a difficult and painful adjustment for many. It is also an opportunity to create new traditions and find meaningful ways to connect virtually.
Follow these links to find interesting ways to gather safely and virtually over the holidays and into the New Year:
If you have any suggestions for more links and resources for heart healthy recipes, at-home exercise and wellness routines, or ways to stay socially connected during quarantine, share them with us! Find us on Facebook, Twitter, and Instagram. Include #EHdoctorchad in your message or comments, so we can keep track of all your great ideas.