"How are you?"
I can't imagine a day in the past 20 years that I haven't been asked this question or asked someone this question myself. It has become second nature, so we often aren't really taking stock of how the person may be actually feeling or what they are going through. But truly considering, "how are you," can have much deeper implications about being in care and living healthy.
In addition to medication, the food and drinks we put into our bodies must be considered when we look at our overall health as people with HIV. Speaking for me, I love Southern food. My grandmother was born and raised in the South and, like any Southern grandmother, has never been shy about using butter, batter and frying everything but the kitchen sink.
Being on meds now, I have had to think realistically about factors that could have adverse effects on my health if I didn't change my way of life and view of what healthy living means. In addition, black people, are also disproportionately predisposed to hypertension, diabetes and several other conditions compared with other races, and must also take that into account in protecting our health while living with HIV.
I knew that I could not go cold turkey. There was no way that I was going to give up some of my favorite foods and drinks. However, I learned that taking an active approach to reducing the harm to my body had important health implications for the quality and extension of life.
So what is harm reduction? By one definition, harm reduction is "policies, programs and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop." This approach is used at methadone clinics or needle exchange programs to reduce disease and virus transmission from drug use and provide healthy, clean supplies for those users. But what many others and I have done is take this approach and apply it to anything in our lives that can cause harm to the body and use it as a guide for living a healthier life. This approach is easy and custom-made to not only provide a healthier lifestyle, but also promote self-care and self-efficacy in the process.
Let's say that you drink alcohol five times a week and have three drinks each time. Assuming this causes 100% of the potential for alcohol-related stress or harm to your body, you could, for example, reduce the amount of drinks to two and only drink four days a week, bringing the total down from 15 to eight. Even though there's no exact measure for the impact of that number of drinks for any particular individual, it may be that you're reducing possible harm by close to 50%.
I myself do this with the foods I eat. Instead of eating out everyday, I do a meal prep at the beginning of the week and portion it out so that I can monitor what I am eating and reduce the amount of junk foods I putting into my body. I also only allow myself one cheat day to eat anything I want and the rest of the week make sure that I am eating healthful foods and vegetables. I went from not actively working out to going to the gym five days a week as another technique to promote better health. For some, it's going from zero times working out to maybe two or three times. Maybe take the stairs instead of taking the elevator at work. If you smoke a pack a day, change it to half a pack. The goal of this technique is to provide a way for you to have your cake and also be able to eat it too!
Living well is more than just taking one pill a day for the rest of your life. Being in care is more than seeing a doctor four times a year for your check-ups. Living well is taking a look at health and analyzing the social, mental, physical and spiritual aspects of your being and making better decisions about what you do in those areas to have a better life. We only have one life to live, why not live it well?