HIV/AIDS
The human immunodeficiency virus, abbreviated as HIV, is a primarily sexually transmitted disease which severely affects the functioning of the immune system, lowering the body’s natural resistance toward other viruses and disease causing organisms. The acquired immunodeficiency disease (AIDS) stems directly from HIV, and, in serious cases, can be life threatening, if not quickly diagnosed and treated. According to the latest statistics from the U.S. Department of Health and Human Services, more than 1.2 million Americans are living with HIV (young gay and bisexual men are the population most affected by the condition) while 1 out of every 8 people with the condition are unaware they have it.
The symptoms of both conditions run a wide gamut, depending on what stage the infection is in. In the primary stage people infected with the virus experience symptoms usually associated with the flu, generally a few months after contracting the virus: Headache, fatigue, fever, joint and muscle pain, and sore throat are all commonly reported. As a result of these overlapping symptoms many people, assuming they are simply sick with the flu, do not get tested for HIV. This is quite serious as, even in this early stage of the infection, the viral load is quite high in the bloodstream, leading to a rapid spread of the infection throughout the body. Over time, as the virus continues to circulate through the body and adversely impact the immune system, the above mentioned symptoms will reemerge more intensely along with: swelling of the lymph nodes, significant weight loss, diarrhea, shingles, and oral yeast infections. If the virus is left untreated, it will evolve into AIDS within the span of a decade. This occurs when a person’s CD4 white blood cells – systematically eliminated by HIV – fall below a count of 200. By this time the body’s immunity will be seriously diminished and prey to what would otherwise be fairly innocuous lesser conditions. Symptoms stemming from the combination of these infections can include chronic fatigue and diarrhea, recurring fever and night sweats, continued weight loss, and outbreaks of skin rashes.
While HIV is primarily transmitted sexually – through the semen and vaginal fluid of an infected partner via intercourse or oral sex – it can also enter the body in several other ways. It can manifest through receiving a blood transfusion from an infected donor, sharing a contaminated drug or tattoo needle, and it can even be transmitted to babies by an infected mother during pregnancy, the act of birth, and breast feeding. Though HIV/AIDS first appeared predominantly in the gay community, it has spread to demographics of all genders, race, and sexual orientation. Among the biggest risk factors are engaging in unsafe sex with multiple partners, using and sharing needles to take intravenous drugs, and having a preexisting sexually transmitted infection, which can cause sores through which HIV can enter the body. Some of the infections/conditions that can develop as a result of HIV/AIDS are tuberculosis, meningitis, kidney disease, lymphoma, and cytomegalovirus.
If You Have Been Diagnosed with HIV/AIDS
Once you have seen your physician – who can use a number of diagnostic procedures include a mouth culture test, CD4 count, as well as testing for complications such as TB and hepatitis – and have been diagnosed with HIV/AIDS, there are a number of treatment options available. While there is as of yet no cure for HIV/AIDS, you can utilize a combination of pharmaceutical drugs to alleviate the effects of the virus. These drugs include non-nucleoside reverse transcriptase inhibitors, nucleoside or nucleotide reverse transcriptase inhibitors, and Integrase inhibitors. These treatments, however, can produce some noticeable side effects such as elevated cholesterol levels, nausea and vomiting, heart disease, weakened bone density, and high blood sugar levels. To supplement the treatment regimen proscribed by your doctor, you can also implement the following lifestyle changes: adopting a healthy diet (rich in fruits, vegetables, whole grains and lean protein), avoiding raw eggs, seafood, and dairy products (which can stimulate foodborne illnesses exacerbated by HIV), and a regular vaccination schedule to reduce the chance of infections.
A Whole Health Perspective
Looking at HIV/AIDS through a Whole Health model, we explore the individual’s unique presentation from the 5 Aspects of Whole Health™ perspective.
1. Physically – Once infected by the HIV virus, the body’s immune system becomes compromised. The immune system is the “defense” system of the body, organizing and mounting a defense to eradicate foreign invaders which could harm the body. The immune system is primarily comprised of the lymph tissue, bone marrow tissue, the spleen, the thymus gland, and specialized blood cells which normally recognize and destroy invaders such as cancerous cells, viruses, and bacteria. Of special importance in HIV infection are the CD4 T cells, which are invaded by the HIV virus and thus unable to function in the immune response system. Additionally, HIV uses these cells to create more viruses. The result is a compromised immune system resulting in increased susceptibility to other infections, along with the symptoms listed above. Other complications of HIV/AIDS other than increased infections include kidney disease and neurological changes (such as confusion, forgetfulness, anxiety and depression), and physical wasting (loss of greater than 10% of your body weight along with diarrhea, fever, and fatigue). Nervous system complications could possibly progress to dementia-like symptoms, termed AIDS Dementia Complex. The combination of medications used to treat the disease and the inflammatory response associated with the infection itself can increase systemic inflammation, and cardiovascular risk factors in particular. Cardiovascular risk is associated with increase in lipid profile, such as increased cholesterol and triglycerides, due to infection and/or medications used for treatment. Changes in blood sugar, insulin resistance, and metabolism often seen in HIV/AIDS can increase the risk for diabetes as well.
The risk of contracting and/or transmitting HIV/AIDS can be minimized or prevented through measures such as using preventative barriers such as condoms during sex, being tested for HIV, and using clean needles. Though previously contraindicated, the World Health Organization now recommends that HIV positive mothers who are being treated for the disease can breastfeed their infants. Male circumcision could reduce the risk of sexual viral transmission as well.
Aside from following medically advised treatment plans, those infected with HIV/AIDS can employ lifestyle modifications to decrease the risk of complications. Because this virus destroys the immune system response, it is important to minimize exposure to other bacteria and viruses. Some foods can carry food-borne bacteria and preparation and storage of some foods should be properly attended to. Further, animals in the home can carry viruses and bacteria which could be problematic for immunocompromised individuals. Other lifestyle modifications include adequate diet along with nutritional supplementation (which should be guided by a physician as some supplements can interfere with medication) and staying hydrated (by drinking safe, clean water, and liquids which do not act as a diuretic such as caffeinated drinks and alcohol). Guided physical activity can help reduce the effects of fatigue and sleep disruption. Inadequate sleep can affect normal physiological function and the immune system. Chronic stress, such as a job change, relationship difficulties, or chronic illness, may cause dysfunction of the immune system. This is in part due to the influence of the adrenal glands, located atop the kidneys, which are in large part responsible for the stress reaction. The adrenal glands are part of a stress signaling system, called the Hypothalamus-Pituitary-Adrenal Axis. Disturbance in this system, often caused by exposure to chronic stress, can affect hormone levels and immune function. Because repeated exposure to stress can cause adrenal dysfunction and potentially alter the function of the immune system, stress management techniques such as moderate exercise, meditation, breathing techniques, yoga, adequate amounts of sleep, etc. can support the immune system. Some other alternative therapies which can reduce the stress response and may be helpful in increasing quality of life in those with HIV/AIDS include massage, meditation, visualization, tai-chi, etc. Stress can also affect the microbiota of the gastrointestinal tract, which then can affect healthy immune and nervous system responses. Some research indicates using aspects of Traditional Chinese Medicine, including herbal remedies and acupuncture could be helpful adjunct therapies to antiretroviral medications.
2. Emotionally – Diagnosis with a chronic illness can create significant psychological stress and disruption of normal lifestyle. Finding support via support groups, supportive relationships, and/or talking with a health professional or counselor can decrease stress and increase likelihood of adherence to treatment plans. Emotional responses, such as anger, fear, frustration, happiness, and joy, can communicate to the immune system via chemicals called neuropeptides and neurotransmitters, and through the adrenal glands (glands which respond to stressors and then biochemically communicate with other organs and tissues). Research indicates that engaging in positive emotional response beneficially effects the inflammatory response, immune system, and overall health. During times of stress and illness, certain relaxation practices, such as diaphragmatic breathing, guided imagery, mindfulness, meditation, or gentle yoga can be utilized to reduce the stress response and its subsequent effects on the body’s health status. The rate of co-occurring mood disorders such as depression, anxiety disorders, and substance abuse disorders in HIV positive people is high, and can sometimes be linked to some medications used for treatment.
3. Nutritionally – Nutrition in those with HIV/AIDS is very important, especially since many of the complications of HIV, such as diarrhea and wasting, can contribute to malnutrition and cause further immune system compromise. In general, the food we eat has the potential to communicate health or illness to the rest of the body. The gastrointestinal tract includes both nervous system tissue and immune system tissue, thus the chemicals and nutrients in foods, and our reactions to them, can be communicated outside the GI tract. The messages communicated can contribute to further dysfunction and illness. In general proper diet which limits processed food, alcohol, caffeine, sugar, starches, trans-fats, etc., and focuses on fresh (organic if possible), plant-based foods, healthy fats and high quality protein choices will support health. During times of stress and to appropriately nourish the endocrine and adrenal gland stress response system, diet should consist of healthy sources of cholesterol, protein, vitamins A, C, E, and B complex, essential fatty acids, and essential minerals. Since elevated lipids can become problematic for those with HIV/AIDS and can further increase cardiovascular risk, cholesterol and fat intake should be monitored. The inflammatory process can also increase cardiovascular risk, thus following an anti-inflammatory diet may be beneficial. Food and water safety is important in those who are immunocompromised. Guided dietary supplementation, such as with vitamin D, probiotics, may be beneficial, especially in vulnerable populations such as children and breastfeeding mothers. Some research indicates the consumption of certain probiotic fermented foods could be beneficial for those with HIV/AIDS in part by protecting the barrier functions of the gastrointestinal tract and contributing to health gut microbiota, which contributes to healthy immune responses.
4. Environmentally – Environmental stimuli, such as air pollution, abrupt changes in weather, loud noises, bright lights, even odors can affect overall stress levels, which may then affect the immune system, quality of life, and wellbeing in general. Controlling exposure to bacteria and viruses, such as in large groups of people or unsafe drinking water and food, is important for those who have compromised immune systems. Research indicates that spending time out-of-doors could potentially confer health benefits by decreasing the stress response and increasing immune response. Guided exercise programs can be offered to reduce risks associated with the compromised immunity, lipid profile and cardiovascular disease often associated with HIV/AIDS. Since difficult relationship dynamics may contribute to overall stress, choosing environments which are calm, quiet, offer supportive relationship and opportunities to experience positive emotions may increase quality of life and reduce some symptoms.
5. Beliefs, Values and Worldview – also identified as Spirituality – Spiritual expression, whether through prayer, meditation, yoga, traditional worship, etc. has an influence on health and wellbeing, often by encouraging an understanding and connection between mind, body, and spirit. Some studies indicate that participating in experiences of faith and/or spirituality may assist in adherence to healthy behaviors in those with HIV/AIDS. Possible feelings of isolation, living in discordance with one’s values, or inability to connect with support and the natural surroundings due to illness or other factors could increase stress and exacerbate symptoms. Finding connection between self, others, and the natural world can communicate health to the immune and endocrine systems and decrease stress during times of illness.