78 SARPCCO Training: HIV/AIDS MODULE 7 POSITIVE LIVING Contributors: Capt Marili Williams SAPS: Social Work Services
79 MODULE 7: POSITIVE LIVING Module Goal: To provide the infected and affected with the knowledge to live positively with HIV/AIDS. Module Outline: 1. Options available after the test 2. Myths and misconceptions 3. Healthy living 4. ARV therapy and treatment 5. Support networks 6. Other sources of help and advice 1 Introduction There exists a strong belief that once diagnosed with HIV/AIDS, life will be traumatic, painful and short. This is not true. By adopting a healthy lifestyle and attitude and protecting one's health, it is possible to live a long and healthy life despite having HIV. The increasing availability of antiretroviral treatment in the developing world is also increasing the number of options available to people with HIV, with improved accessibility of these drugs promising to improve life expectancy and quality of life for peopleliving with the virus. This module explores how those infected with the virus can live positively with it and those affected by it can help those they care about live happier, healthier lives. Much of the information contained in this module is not solely for those who are infected or affected by HIV/AIDS. Much of what is described in this module can help you live a healthier, happier lifewhether you are affected by the virus or not. 2 Options available after the test Section objective: Debunk three key myths about what it means to have HIV. Contrary to what many people believe, HIV is not necessarily a death sentence. Although there are many people who become ill and die from HIV/AIDS in a short period of time, with a healthy diet and lifestyle and a positive attitude, people with HIV can live long and productive lives. This section explores some of the common myths and misconceptions that people have about living with HIV/AIDS. MYTH: Being diagnosed with HIV means imminent death While people who are diagnosed with AIDS when they are seriously ill often do die quite quickly after their diagnosis, people who are diagnosed before they become seriously ill can live long, healthy lives. Even sick people have been known to have recovered their health. There are increasing numbers of people who have lived with HIV/AIDS for upwards of 15 years and who are still healthy.
80 MYTH: There is nothing I can do to protect my health once diagnosed with HIV Experience over the last two decades has shown that a positive attitude and a healthy diet and lifestyle can be powerful tools in helping to preserve health. It is also possible to obtain effective treatment for most of the opportunistic infections that affect people with HIV and early treatment can prevent such infections from becoming serious. There are also a number of herbal and other remedies available which can help to boost the immune system, in order to both prevent and treat infections. Antiretroviral drugs, which reduce the levels of HIV in the body, are becoming increasingly available and can help a person with AIDS to regain their health and to live a long and productive life. MYTH: People with HIV/AIDS are 'useless' or burdens on their families This idea is linked to the notion that people with HIV/AIDS are sick and are going to die quickly. People with AIDS do become extremely ill, but people in earlier stages of the virus are generally healthy and productive and can take steps to protect and maintain their health. People living with HIV/AIDS still have a great deal to offer their families and community. Many people have been inspired by their diagnosis to make positive changes in their lives; changes that have enabled them to make an even greater contribution to the world around them. 3 Healthy living Section objectives: 1. Identify key strategies for maintaining a healthy body 2. Identify key strategies for maintaining a healthy mind 3. Identify key strategies for maintaining a healthy soul or spirit Health is not only about knowing all the facts; it is about wanting to be alive and using knowledge to achieve this. In order to live with and manage HIV/AIDS, you need to want to live and beat the virus. Once this decision is made, you can take steps towards creating and sustaining a healthy body, healthy mind and healthy soul or spirit - all of which are vital in both fighting off infection and leading a more fulfilling life. Diagramme 8: The 'survival recipe Source: N Orr, Positive Health, 2003.
81 Maintaining a healthy body, mind and soul in the context of HIV/AIDS is often referred to as 'living positively'. Important elements of living positively are explored in the remainder of this section. 3.1 Healthy body Improve your nutrition: Certain foods help to build the immune system and protect you from disease. People with HIV need to increase their intake of such foods in order to better fight off infection. Such foods include: Fresh fruits and vegetables. These contain vitamins and minerals which help to protect the body. Dark green, leafy vegetables (like spinach and morogo), yellow vegetables (such as pumpkins) and vegetables or fruit high in vitamin C (like oranges, tomatoes, lemons, naartjies, guavas and mangos) should be eaten every day. Starches. Mielie meal porridge, bread, potatoes, ndumbi and sweet potatoes provide energy for one's body to work. They should be eaten every day and are best eaten in the morning so that that can provide the body with energy during the day. Whole wheat and brown bread are better than white bread. Proteins. Meat, chicken, fish, eggs, cheese milk, amasi, beans, peas and lentils help the body to build and repair itself. These should also be eaten everyday. Oils. Fish oil, olive oil, sunflower oil and other vegetable oils provide energy and should be eaten regularly. The oils and fats found in meat and milk should be avoided as they are not good for your heart. Trim meat of fat and try to drink lower fat milk. These and other immune boosting foods are summarized in the table below: Much of the information included in this section is taken from a book by N Orr, Positive Health, published by Metropolitan in 2003.
82 Table 5: Examples of foods that build the body After N Orr, Positive Health, 2003. Following a balanced diet should provide most of the things your body needs in order for it be healthy and better fight off infection. If you can afford them, it can also be good to take additional vitamin and mineral supplements. The table below highlights the most important vitamins and minerals required.
83 Table 6: Important vitamins and minerals After N Orr, Positive Health, 2003. Drink lots of water and other beverages in moderation: Most of our body is made up of water and water is important for flushing toxins out of our bodies. We need to drink at least two litres of water a day to be healthy. Other drinks, such as tea and coffee are okay, but should be drunk in addition to water. Small amounts of alcohol are also fine, but drinking large amounts of alcohol everyday can reduce the ability to fight off infection. Cut down on the amount of sugar in tea and coffee, as sugar may stimulate infections such as thrush and shingles. Sugar and HIV: Sugar encourages the growth of unhealthy fungus on a person's tongue, in their vagina, stomach and other areas resulting in thrush and other infections. More than 20 teaspoons of sugar per day reduces the number of fighter cells by half. This can cause severe health problems, such as severe weight loss, diarrhea, fatigue and vulnerability to illness and infection. Ensure good hygiene: People with HIV/AIDS are more likely to die from stomach infections than any other kind of illness. Good hygiene is extremely important in order to avoid introducing germs into the digestive system. It is important to: Clean food: Wash all food thoroughly - if the water comes from borehole, well, river or lake, add one cap full of bleach to a basin of water. Use this to thoroughly wash vegetables, eggs and meat. The bleach will evaporate and will not affect the taste of the food.
84 Keep meat and vegetables separate when preparing food. Keep cooking and cutting surfaces clean. Cook meat well: Meat often contains worms and other parasites. Cook meat until there is no pink or red inside, especially chicken, bacon and other meat from pigs. Fish must be either consumed fresh, or frozen immediately and consumed as soon as it is defrosted. Cook eggs well: Do not use cracked eggs. Do not eat raw eggs and cook them until they are no longer runny inside. Avoid eating left-over food: Food that has been cooked and then left to cool down can gather many germs. Try to cook only as much as a person can eat. If you must eat left over food, heat the food to boiling point to kill any germs. Fermented foods, such as fermented porridge, are alright to eat although if eaten excessively they may aggravate fungal infections such as thrush. Clean water: Water from boreholes, rivers and lakes must be boiled. A major cause of illness in people with HIV is dirty water. This causes stomach problems such as diarrhoea and dysentery. Keep warm: A person's body fights infections, including HIV, better when it is warm. Heat weakens the virus and at the same time increases the body's ability to fight infections. One of the easiest - and best - methods of staying healthy with HIV, or any other infection, is to ensure that your body does not get cold. Normal body temperature for adults is 37 degrees Celsius (98.6 degrees Fahrenheit). Exercise: Physical movement keeps a person's body temperature higher and helps the body to fight infection by keeping the lymph glands working properly (the body's soldier cells are stored in the lymph glands, which depend on the movement of muscles to work). Walking or jogging for at least 20 minutes per day is sufficient to boost your temperature and immune system. Stretching exercises are also good. If you are ill, just try to move your arms and legs to the get the lymph glands working. Don't overdo such exercise; stop if you experience any pain. Seek treatment for infections as early as possible: Everyday infections and illnesses can become life threatening for people living with HIV/AIDS. Effective treatment of infections will also help to prevent both serious illness and further strain on the immune system. Most clinics and hospitals can provide treatment for common illnesses associated with the virus. Even if you are only suffering from a minor illness, seek treatment as quickly as possible.
85 There are a range of cheap western and traditional medicines available that effectively alleviate the symptoms of many common opportunistic infections. For example, leaving amasi (sour milk) on the affected area overnight has been shown to be effective in easing the symptoms of thrush. A few drops of fresh lemon juice applied several times a day has also proved effective in healing cold sores and shingles blisters. The staff at your local clinic should be able to provide you with further information about such treatments. Ensure healthy sexuality: There is no reason why people with HIV can not continue to have a fulfilling sex life. Taking simple precautions, such as using either a male or female condom during every sexual encounter, can protect both you and your partner from re-infection or infection. Again, your doctor should be able to provide you with information on additional things that you can do to ensure healthier sexual relationships. Healthy sexuality: The dangers of re-infection HIV changes itself all the time and there are a number of different strains of the virus. Even if your partner is also HIV positive, it is important to use condoms to avoid re-infecting each other with different variations of the virus. The introduction of new forms of the virus increases the viral load in the blood and makes it more difficult for the body to fight the infection. This is because the body has to fight more than one strain of the virus at the same time. It also makes it much more difficult to treat the virus, as varying forms may respond differently to treatment. 3.2 Healthy mind Having a healthy mind involves taking control of your life; knowing what you want, who you are, what is important to you and how you want to live. It requires having family and friends who love and support you. It also requires having a purpose in life: religion or some other belief system helps. Research shows that a healthy state of mind helps the immune system and improves health. Remember: Don't give up on the future! Who knows what the future may hold in terms of treatment or cure? In the meantime, you need pleasure and excitement in your life. These things help to keep your body and mind well. Avoid: Stress. This releases hormones (chemicals) in the body which suppress the immune system. Keep things in perspective and try to avoid stressful situations. Boredom. This drains your energy and enthusiasm. Keep active and do things that you enjoy. Fear. If not resolved, it can cause great damage to your ability to fight infections. Take action and deal with the fear, develop a plan of action and be prepared to deal positively with the unknown. Where you encounter stress, fear and boredom, deal with these emotions and move on.