When it comes to their health, people living with HIV often have more than just HIV to deal with. It’s common for people living with HIV to have other illnesses and conditions that affect their physical or mental health. This can mean more doctors’ visits, lab tests, and medications to keep up with. Some of these health problems may be directly related to HIV or its treatment. Others are linked to HIV by sex or drug use, and others are completely unrelated to HIV. People living with HIV are first and foremost people. They are at-risk for the same health problems that anyone else is. They may have health conditions that they had years before they were infected and did not have anything to with their risk for HIV infection, like allergies, asthma, back problems, or migraines.
Other pre-existing conditions may have added to their risk for HIV infection. Chief among these are behavioral health issues related to mental health, alcohol use, and drug use. The risk of HIV infection is higher among people whose lives are affected by mental health issues like depression, anxiety, or the psychological effects of bullying, sexual abuse, physical abuse, and other forms of violence. These issues can cause some people to take more risks in their lives in general, including risks that are associated with sexual behavior, alcohol use, drug use, and injection drug use. People who experience mental health issues sometimes use alcohol or drugs as a coping mechanism, which can also put them at risk for getting HIV by lowering their ability to use condoms consistently or take PrEP every day. If they are living with HIV, alcohol and drug use can make it harder to lower the HIV viral load to very low or undetectable levels and keep these levels suppressed over time.
The same behaviors that put people at risk for HIV can also put them at risk for other health problems. This means that people living with HIV re also more likely to have hepatitis B virus (HBV), hepatitis C virus (HCV), and other infections that can be transmitted sexually or by injection drug use.
Having HIV increases the risk for some health problems because of the damage the virus does to the immune system and other parts of the body. Over time, HIV destroys the immune system and the body’s ability to prevent infection. This puts people living with HIV at greater risk for many different health problems that include: pneumonia, tuberculosis (TB), and other respiratory infections; lymphoma, cervical cancer, and other cancers; cardiovascular disease; and problems that affect the brain and central nervous system such as dementia, nerve damage, and memory problems. People with HIV are at greatest risk for life-threatening opportunistic infections if they do not have a suppressed viral load and their immune system has been severely weakened.
The benefits of HIV treatment outweigh the risks, but medications that are used to treat HIV can cause side effects and lead to other health problems over time. These problems were much more common and severe in the past. Today, most of the medications that are used to treat HIV infection have fewer, and less serious, side effects. These medications are also much better at fighting HIV infection and reducing viral load to very low or undetectable levels (also known as suppressed viral load).
It is common for people to experience some problems or symptoms when they first start HIV treatment. These include things like nausea, diarrhea, or headaches that usually go away after the first weeks of treatment.
People living with HIV have to take medication every day, and the use of HIV medications over long periods of time can cause other health problems. In some people, long-term treatment of HIV infection can lead to diabetes, high cholesterol and cardiovascular disease, problems with kidney and liver function, a loss of bone strength (osteoporosis), or other conditions. Older medications that most doctors do not prescribe today caused other problems that are not as common today such as nerve damage and pain (neuropathy), the loss of fat under the skin of the face (facial wasting), and the abnormal distribution of fat in the body (lipodystrophy).
Your health care provider will do lab tests and watch for any signs of problems associated with HIV infection or the medications that you are taking. Make sure to tell your provider about any health problems or symptoms you are having. If they are caused by medications, your provider may be able to take care of them by changing your medications or providing you with information or other medications that can manage the side effects. It is also important that you tell your provider about any other health problems you have and any other medications that you are taking. Medications used to treat other conditions can interact with your HIV medications and sometimes reduce their effectiveness or cause other problems.
Fortunately, there are more options for treating HIV infection than ever before. This means that people living with HIV have fewer health problems because the can get the virus down to very low or undetectable levels, reducing the impact HIV has on the body, and they can usually switch medications if they have side effects or other health problems because of treatment.