Day One: After You've Tested Positive

Interventions Against HIV

There are several approaches that you can take against HIV. Many are useful, but using any of them alone is not enough to keep you healthy. Unfortunately, some of these are promoted with extreme passion or as a fad, to the exclusion of the others. The best overall approach for you may be one that is inclusive, combining the best of each of those explained below that best suits your lifestyle.

General Health Maintenance

This means doing all of the things that are normally recommended for leading a healthy life. These include eating properly with nutritional support; getting enough rest; avoiding alcohol, smoking, drugs and unnecessary stress; and getting exercise and fresh air -- in short, all things our doctors recommend. Taken alone, maintaining good health won't prevent you from progressing to AIDS or cure it, but it will give you the best fighting chance you have. A good defense to HIV builds upon a solid foundation of general health. For more information, read Project Inform's publication, Strategies for Maintaining Your General Health.

Supportive Therapies

This category, sometimes called a holistic approach, can include various complementary approaches. These include stress reduction; massage; visualization, yoga and relaxation; emotional and spiritual support; natural medicines; and many others. Many of these can help you deal with symptoms of illness, drug side effects and keep your peace of mind. Taken alone, however, they won't solve the problem.

Unfortunately, some promoters of complementary therapy become strict, urging people to use them to the exclusion of all others, even the medicines recommended by doctors. When used in this way, supportive therapies can be harmful and may discourage one from getting necessary medical attention. The best promoters view these therapies as complementing other therapies rather than replacing them. For more informaion, read Project Inform's publication, Herbs, Supplements and HIV Disease.

HIV Treatment Strategy

HIV attacks and misdirects the immune system, and medicines can help slow its spread. Currently approved HIV drugs are found in the Drug ID Chart.

The challenge of using these drugs is knowing when and how much to use, how to combine them, and in what order. Used alone, none of them will work for long. When used together in rational combinations, they can suppress HIV for many years and lengthen your life.

For more information on HIV treatment strategies, read Project Inform's publications, Strategies for When to Start HIV Therapy and Strategies for HIV Therapy, available at 1-800-822-7422. You can also ask for information on each of the specific drugs listed in the chart above.

Immune Therapies

Because the immune system is sometimes suppressed, overactive and misdirected by HIV, it makes sense to seek out medicines that might help correct some of these problems. The goal of using immune therapies is to increase the number or function of lost cells (such as CD4 cells) to restore the balance of the various parts of the immune system or to reduce the harmful activities caused by infected cells. This is easy to describe but difficult to do.

Many researchers feel that we don't yet know enough about the immune system to try to regulate it. Some therapies do influence the immune system. And similar claims have been made about some natural products. There is great popular appeal to the notion that we should somehow "boost the immune system" to help the body naturally regulate itself against HIV.

For the most part, this is little more than an empty advertising slogan. There's little evidence that anyone really knows how to do this. Moreover, the body's natural defenses almost always seem to fail in the fight against HIV. It would be unrealistic to expect that this approach on its own would solve the problems of HIV.

At this point, there's no clear or simple way to address the defects of the immune system in HIV infection. Some of the most complete information on immune therapies is available in Project Inform's publications, Strategies for Improving Your Immune Health and Interleukin-2.

Opportunistic Infection Strategy

Once the immune system has failed to a significant degree, it becomes necessary to try to prevent the most common OIs, or prevent them from coming back. OI prevention or prophylaxis should be considered when CD4 counts are in or nearing a danger zone. For example, the risk of getting PCP becomes high at CD counts of 300 or less. The risk of other infections, like CMV and MAC, increase dramatically when CD4 counts fall below 100.

The careful and timely use of medicine can prevent PCP altogether. As the rate of tuberculosis (TB) rises among HIV-positive people, testing and preventive treatment (if necessary) is recommended. Preventive treatment for other infections, including MAC and recurrent fungal infections, are available as well.

In advanced HIV disease, a person often must try to treat or prevent several OIs at the same time. This can lead to difficult choices, since many medicines can interact with each other. Two publications from Project Inform can help sort this out: Opportunistic Infections Chart and Strategies for Managing Opportunistic Infections.

The key to successful interventions is comprehensive inclusion -- doing all of the things that make sense for you. The biggest mistake is to rigidly choose one approach over the others. HIV is not a political debate or a matter of opinion; it can be a life-threatening illness. Every decision you make about treatment has consequences, and each person has little room for mistakes. So it makes no sense to bet your life on any one philosophy of medicine.