HIV & Nutrition and Food Safety

Why maintaining good nutrition is important for people living with HIV:

Good nutrition can support overall health as well as help maintain the body’s immune system. It can also help those living with HIV maintain a healthy weight and properly absorb any HIV medication.

As you know, HIV attacks and destroys the immune system, which makes it harder for those living with HIV to fight off any infections. Daily use of HIV medication prevents HIV from destroying the immune system. In addition to a medication regimen, a healthy diet will also help to strengthen the immune system and keep people with HIV healthy.

What a healthy diet looks like:

Generally, the basics of a healthy, nutritious diet are the same for everyone, including people with HIV. Unless given special dietary instructions by a medical professional, the United States Department of Agriculture makes the following recommendations:

  • Choose a variety of foods from the five food groups: fruits, vegetables, grains, proteins, and dairy
  • Eat the right amount of food for your body to maintain a healthy weight
  • Stick to foods low in saturated fat (found in animal products such as fatty meats, whole milk, and butter), sodium (salt), and added sugars

How HIV can impact nutrition:

Thanks to HIV medications, people living with HIV are living longer and healthier lives. However, HIV and HIV medication can sometimes cause nutrition-related problems. Here are some examples of nutrition-related issues that have the ability to affect those with HIV:

  • HIV-related infections can make it hard to eat food or swallow
  • Changes in metabolism can cause weight loss or weight gain
  • Side effects from medication (like changes in appetite, nausea, or diarrhea) can make it hard to stick to an HIV regimen

If you have HIV and are experiencing what you think might be a nutrition-related problem, your health care provider can help resolve the issue. To avoid potential nutrition-related problems, make sure you’re also paying attention to food safety.

What food safety means:

Food and water can become contaminated with germs that cause illnesses. Food safety refers to the proper ways to handle, prepare, and store food to prevent these foodborne illnesses.

Why food safety is important for people living with HIV:

A weakened immune system makes it hard to fight off any infections, this includes foodborne illnesses. In people with HIV, foodborne illnesses are likely to be more serious as well as last longer than in HIV negative folks. Following food safety guidelines reduces the risk of foodborne illnesses.

How to prevent foodborne illness:

People living with HIV can reduce their risk of foodborne illnesses by avoiding certain foods and taking the time and care to prepare and store their food in a safe matter. Here are a few guidelines to follow:

Food and beverages to avoid:

  • Raw or undercooked eggs (example: in homemade mayonnaise or uncooked cookie dough or cake batter)
  • Raw or undercooked poultry, meat, and seafood
  • Unpasteurized milk, cheeses, or fruit juices
  • Raw seed sprouts (example: alfalfa sprouts or mung bean sprouts)

Four steps to food safety – clean, separate, cook, and chill:

  • Clean: Wash your hands, any cooking utensils, and your countertops when preparing food
  • Separate: Separate your food to prevent spreading any germs from one food to another. As an example, keep any raw meat, poultry, seafood, or eggs separate from any foods that are already cooked or otherwise ready to eat (fruits, vegetables, or bread).
  • Cook: Use a food thermometer to make sure that foods are cooked to the recommended safe temperatures
  • Chill: Refrigerate or freeze any meat, poultry, eggs, seafood, or other foods that are likely to spoil within 2 hours of either cooking or purchasing

Contaminated water (most typically due to human or animal waste) can also cause illness. To be safe, don’t drink any water directly from a lake or river, and don’t swallow any water while you’re swimming.

It’s also important to be careful about what you eat/drink if you’re traveling outside of the U.S., especially in developing countries. Before taking a trip abroad, check out this fact sheet for people living with HIV who are traveling outside the United States from the Centers for Disease Control and Prevention (CDC).

 

Resources:

USDA: Food Safety Guidelines
CDC: Traveling With HIV Guidlines
USDA: Choose My Plate
NIH: HIV and Nutrition

Drug Expert: HIV

Treatment with HIV medicines is called antiretroviral therapy (ART). ART can’t cure HIV, but taking HIV medicines help those living with HIV live longer, healthier lives. People on ART take a combination of HIV medicines (referred to as their HIV regimen) every day. A person’s initial HIV regimen generally includes three HIV medicines from at least two different drug classes. Today we’re going to discuss those drug classes, what they do, and what drugs belong to them.

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

NRTIs block reverse transcriptase, an enzyme HIV needs to make copies of itself.

Generic Name (other name, abbreviation) Brand Name
abacavir (abacavir sulfate, ABC) Ziagen
emtricitabine (FTC) Emtriva
lamivudine (3TC) Epivir
tenofovir disoproxil fumarate (tenofovir DF, TDF) Viread
zidovudine (azidothymidine, AZT, ZDV) Retrovir

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

NNRTIs bind to and later alter reverse transcriptase, an enzyme that HIV needs in order to make copies of itself.

Generic Name (other name, abbreviation) Brand Name
doravirine (DOR) Pifeltro
efavirenz (EFV) Sustiva
etravirine (ETR) Intelence
nevirapine (extended-release nevirapine, NVP) Viramune / Viramune XR (extended release)
rilpivirine (rilpivirine hydrochloride, RPV) Edurant

Protease Inhibitors (PIs)

PIs block HIV protease, an enzyme HIV needs to make copies of itself.

Generic Name (other name, abbreviation) Brand Name
atazanavir (atazanavir sulfate, ATV) Reyataz
darunavir (darunavir ethanolate, DRV) Prezista
fosamprenavir (fosamprenavir calcium, FOS-APV, FPV) Lexiva
ritonavir (RTV)** Norvir
saquinavir (saquinavir mesylate, SQV) Invirase
tipranavir (TPV) Aptivus

**Although ritonavir is a PI, it is generally used as a pharmacokinetic enhancer as recommended in the Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents and the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection.

Fusion Inhibitors

Fusion inhibitors block HIV from entering the CD4 cells of the immune system.

Generic Name (other name, abbreviation) Brand Name
enfuvirtide (T-20) Fuzeon

CCR5 Antagonists

CCR5 Antagonists block CCR5 coreceptors on the surface of certain immune cells.

Generic Name (other name, abbreviation) Brand
maraviroc (MVC) Selzentry

Integrase Inhibitors

Integrase inhibitors block HIV integrase, an enzyme HIV needs to make copies of itself.

Generic Name (other name, abbreviation) Brand
dolutegravir (DTG, dolutegravir sodium) Tivicay
raltegravir (raltegravir potassium, RAL) Isentress, Isentress HD

Pharmacokinetic Enhancers

Pharmacokinetic enhancers are used in HIV treatment to increase the effectiveness of an HIV medicine included in an HIV regimen.

Generic Name (other name, abbreviation) Brand
cobicistat (COBI) Tybost

Combination HIV Medicines

Combination HIV medicines contain two or more HIV medicines from one or more drug classes.

Generic Name (other name, abbreviation) Brand
abacavir and lamivudine (abacavir sulfate / lamivudine, ABC / 3TC) Epzicom
abacavir, dolutegravir, and lamivudine (abacavir sulfate / dolutegravir sodium / lamivudine, ABC / DTG / 3TC) Triumeq
abacavir, lamivudine, and zidovudine (abacavir sulfate / lamivudine / zidovudine, ABC / 3TC / ZDV) Trizivir
atazanavir and cobicistat (atazanavir sulfate / cobicistat, ATV / COBI) Evotaz
bictegravir, emtricitabine, and tenofovir alafenamide (bictegravir sodium / emtricitabine / tenofovir alafenamide fumarate, BIC / FTC / TAF) Biktarvy
darunavir and cobicistat (darunavir ethanolate / cobicistat, DRV / COBI) Prezcobix
darunavir, cobicistat, emtricitabine, and tenofovir alafenamide (darunavir ethanolate / cobicistat / emtricitabine / tenofovir AF, darunavir ethanolate / cobicistat / emtricitabine / tenofovir alafenamide, darunavir / cobicistat / emtricitabine / tenofovir AF, darunavir / cobicistat / emtricitabine / tenofovir alafenamide fumarate,  DRV / COBI / FTC / TAF) Symtuza
dolutegravir and rilpivirine (dolutegravir sodium / rilpivirine hydrochloride, DTG / RPV) Juluca
doravirine, lamivudine, and tenofovir disoproxil fumarate (doravirine / lamivudine / TDF, doravirine / lamivudine / tenofovir DF, DOR / 3TC / TDF) Delstrigo
efavirenz, emtricitabine, and tenofovir disoproxil fumarate (efavirenz / emtricitabine / tenofovir DF, EFV / FTC / TDF) Atripla
efavirenz, lamivudine, and tenofovir disoproxil fumarate (EFV / 3TC / TDF) Symfi
efavirenz, lamivudine, and tenofovir disoproxil fumarate (EFV / 3TC / TDF) Symfi Lo
elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide fumarate (elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide, EVG / COBI / FTC / TAF) Genvoya
elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate (QUAD, EVG / COBI / FTC / TDF) Stribild
emtricitabine, rilpivirine, and tenofovir alafenamide (emtricitabine / rilpivirine / tenofovir AF, emtricitabine / rilpivirine / tenofovir alafenamide fumarate, emtricitabine / rilpivirine hydrochloride / tenofovir AF, emtricitabine / rilpivirine hydrochloride / tenofovir alafenamide, emtricitabine / rilpivirine hydrochloride / tenofovir alafenamide fumarate, FTC / RPV / TAF) Odefsey
emtricitabine, rilpivirine, and tenofovir disoproxil fumarate (emtricitabine / rilpivirine hydrochloride / tenofovir disoproxil fumarate, emtricitabine / rilpivirine / tenofovir, FTC / RPV / TDF) Complera
emtricitabine and tenofovir alafenamide (emtricitabine / tenofovir AF, emtricitabine / tenofovir alafenamide fumarate, FTC / TAF) Descovy
emtricitabine and tenofovir disoproxil fumarate (emtricitabine / tenofovir DF, FTC / TDF) Truvada
lamivudine and tenofovir disoproxil fumarate (Temixys, 3TC / TDF) Cimduo
lamivudine and zidovudine (3TC / ZDV) Combivir
lopinavir and ritonavir (ritonavir-boosted lopinavir, LPV/r, LPV / RTV) Kaletra
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PrEP: The Basics

PrEP (short for Pre-Exposure Prophylaxis) is the use of anti-HIV medications to keep HIV negative people from becoming contracting HIV. PrEP is FDA approved and has been shown to be safe and effective when it comes to the prevention of HIV. Even though PrEP has been around in the United States since 2012, many people are still looking to learn more about how it works.

Daily PrEP lowers the risk of contracting HIV from sex by over 90% and by more than 70% among those who inject drugs. Your risk of getting HIV from sex can be lowered even more by combining PrEP with condoms and/or other prevention methods.

PrEP is not something that’s taken for life. It’s normally taken for anywhere from a few months to a few years, during periods of time when a person feels the most at risk of getting HIV. Examples of these time periods could be during specific relationships, dating new people, knowing you will be sexually active with new people whose status you don’t know, dealing with drug use problems, or while trying to conceive with an HIV-positive partner.

The CDC (Centers for Disease Control and Prevention) has a informative video with more information on how PrEP works, how to get it, and if it’s the right choice for you. You can find the video here: https://www.youtube.com/watch?v=TR8-3uAuZGo

 

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