December 1 is World AIDs Day. It is on this day that people worldwide unite in the fight against HIV, show their support for people living with HIV and to commemorate the lives lost due to the illness. Many campaigns on creating awareness and preventing the disease take place all over the world during the course of the month.
According to World Health Organisation (WHO), HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2017, 940, 000 people died from HIV-related causes globally.
"There were roughly 36.9 million people living with HIV at the end of 2017 with 1.8 million people becoming newly infected in 2017 worldwide. 59 per cent of adults and 52 per cent of children living with HIV were receiving lifelong antiretroviral therapy (ART) in 2017. Global ART coverage for pregnant and breastfeeding women living with HIV is high at 80 per cent,” states WHO report.
Therefore, there is still more awareness needed for people, especially the youth, to protect themselves, prevent and reduce the spread of the virus.
Doctors say that there is still hope after acquiring the virus, but that is if you follow the right steps as advised by your medical practitioner. You could be wondering how you can stay healthy even after getting infected, how to fight stigma, what to eat, or worried about taking ARVs for the rest of your life, and much more. Here is what experts say;
WHAT YOU SHOULD KNOW
Dr Raoul Kabadi Gizenga, the head of Gastroenterology, Endoscopy Unit at Hôpital La Croix du Sud (HCS), Remera, says that people should know that millions of people have HIV. They are definitely not alone. Most people get at least one STD (Sexual Transmitted Disease) in their lifetime, and having HIV or another STD is nothing to feel ashamed of or embarrassed about. It doesn’t mean you’re "dirty” or a bad person.
He adds that you should be aware that there’s no cure for HIV, but medications can help you live longer, healthier than ever before. HIV treatments called antiretroviral therapy (ART) can slow down the damage that HIV causes. The reality is people with HIV can be in relationships, have sex, and live normal lives by taking a few precautions.
"Patients living with HIV (whether newly diagnosed or living with HIV for a while) should know and always remember that knowledge is power. If you are not comfortable asking questions, make sure you read up as much as you can about HIV and living positively with HIV,” he notes.
Eric Mutabazi, a senior physiotherapist at Oshen-King Faisal Hospital, Kigali, says that several studies have suggested that aerobic physical activity is safe and beneficial for HIV-infected adults. However, there is information lacking regarding whether HIV-infected patients practice physical activity and to what extent.
He adds that physical therapists take a primary role in relation to diseases which have an association with low levels of physical activity, including HIV/ AIDS. As experts in movement and exercise, and with a thorough knowledge of pathology and its effects on body systems, physical therapists are the ideal professionals to promote, guide, prescribe and manage exercise activities that enable people living with the disease to maintain or improve their level of physical activity.
"The use of structured exercise is a strategy used to reduce the disabling consequences of the chronic health problems caused by HIV infection. Physical therapists tend to work in inter-professional teams, providing rehabilitation services to individuals with HIV/AIDS,” Mutabazi says.
"ARV treatment requires commitment, do not start antiretroviral treatment unless you are ready to take responsibility and be dedicated to medication times. Make sure you understand why you have to take it and how it works,” Gizenga adds.
He further says that HIV is not a death sentence, if you are well informed and make the necessary lifestyle changes, you can live a long life with it.
HOW TO STAY HEALTHY
Gizenga says that starting antiretroviral treatment as soon as possible, and sustaining it as part of your everyday routine, is the best way of ensuring that your immune system stays strong.
"Getting enough rest and quality sleep is vital to maintaining your health. Your mental wellbeing is just as important as your physical health,” he adds.
Mutabazi says that the current physical activity guideline suggests that adults should engage in moderate-to-vigorous physical activity for at least 30 minutes a day, five days a week. Additional evidence suggests that the effect of long-term endurance exercise can increase CD4. Improve functional capacity, and quality of life, as well as reduce the prevalence of depression and pre-hypertension.
Mutabazi says that moderate-to-vigorous exercise improved cardio-respiratory fitness and promoted weight loss with no detrimental influence on immunological profile or viral load level increase in subjects on antiretroviral treatment.
He further notes that rehabilitation can make a real difference to people living with HIV. It can help them keep active and healthy, and allow them to continue participating in daily activities.
THE DOS AND DON’TS
"When dealing with a person living with HIV / AIDs, you must treat them the way you would like to be treated if you were infected with the virus. Sympathise and empathise with them, for instance, provide them with family and social support, allow them to be part of the family like any normal person,” Gizenga says.
He adds that you should allow HIV patients to get back to their work as soon as they are physically fit, since HIV infection doesn’t require special rest. Keep them engaged in some activity, as an empty mind is the devil’s workshop.
Gizenga advises you to make efforts to reduce the HIV patients stress, encourage them to exercise and meditate as these help prolong the lifespan. Convince them to stop all addictions such as smoking, drinking alcohol, and most importantly, advise them to practice safe sex (using condoms) with their partner, even if their partner is already infected.
Don’t ridicule them for getting infected, it doesn’t help. Don’t try to probe into when and where the person was infected. Shun making them feel guilty. Don’t isolate them in their home or at the workplace, he stresses.
Gizenga adds that you shouldn’t humiliate the infected person, their spouse or children. Don’t scare them about suffering and death. Don’t separate them from spouse or children, since they are the best support for them. It is important for them to spend quality family time together. Don’t use gloves in feeding the infected person or to wipe their saliva, sweat, nasal secretions and tears.
WHAT PEOPLE LIVING WITH HIV SHOULD OBSERVE
"Go in for regular CD4+ T-cell and viral load tests (the best way to find out if someone with HIV is under control is to keep appointments with your healthcare provider for regular lab testing, usually once every three to six months. This will include checking CD4+ T-cell count and viral load. CD4+ T-cell count should go up and stay up, and the viral load should be as low as possible,” Gizenga says.
He notes that you should keep track of your side effects (people living with HIV may not have to accept it as "just the way it is”. If someone is untraceable, and is experiencing side effects, they should discuss with their doctors).
Another part of staying healthy is "staying informed”. The more people know about their HIV medicine and whether it may be time to consider another, the better. Here, the healthcare provider is a good source of information, he adds.
WHAT TO EAT
Sapience Kengayiga, a nutritionist at University Teaching Hospital of Butare, says that HIV/AIDS patients should eat enough food every day and a balanced diet, as the body needs all nutrients in order to help the immune system stay stronger, rebuild cells, get energy for working and also, for the body to continue functioning well.
She says that the balanced diet should be composed of macro-nutrients and micro-nutrients, for instance, macro-nutrients are nutrients which are consumed in high quantity like carbohydrates (Irish potatoes, maize), fats (cheese, avocado, cooking oil) and proteins (meat, eggs, beans, peanuts, peas, fish, chicken) and micro nutrients like vitamins.
Dr Emmanuel Nsabimana, a general practitioner at Polyclinique de l’Etoile in Kigali, says that adequate nutrient intake has to be encouraged by identifying locally available and acceptable foods, encouraging a diet adequate in energy, proteins and other essential nutrients.
PREVENTION
Due to the recent report by WHO, individuals can reduce the risk of HIV infection by limiting exposure to risk factors, for instance; male and female condom use, testing and counselling, linkages to tuberculosis care, voluntary medical male circumcision (VMMC) — this reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent — antiretroviral drug use for prevention, harm reduction for people who inject and use drugs, and elimination of mother-to-child transmission of HIV (EMTCT).
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