Module 7: Healthy Living Fitness to work The UN treats HIV as any other chronic disease. Regardless of your HIV status, you have the right to work and also not to be discriminated against in the workplace. Speak to a medical professional who is specialized in dealing with HIV for advice on your own health, especially if you are living with HIV. Think of contacting UN Plus, the group of UN staff members living with HIV for advice, advocacy and support (www.unplus.org). HIV can only be transmitted through unprotected sex, exposure to infected blood, using unsterilized injection equipment or from mother to child during pregnancy, childbirth and breast feeding, so there is no reason why your colleagues should be afraid of working and interacting with you. At the UN, if your ability to perform at your job is affected by HIV-related illness, you can discuss with your supervisor reasonable measures that can be taken to help you manage both work and health needs. You are not required to tell your supervisor any medical information, including your HIV status, if you do not wish to. List of people to contact about HIV in the workplace 1. UN Plus: If you are living with HIV you may wish to join UN Plus, the UN System HIV- Positive Staff Group. Write to them in confidence at: unplus@unaids.org or visit www.unplus.org. 2. UN Cares Country-Level Contacts: There are HIV focal points in most UN organizations, and UN Cares Learning Facilitators have been trained in most countries (a list can be found at www.uncares.org/facilitators). 3. UN Cares Headquarters-Level Contacts: In addition, you may consult your human resources officer or UN system workplace HIV focal point, both of whom are knowledgeable about the UN system s HIV-related policies. Their contacts can also be found at www.uncares.org/facilitators. 4. Medical Contacts: You may also direct medical questions about HIV to the UN Medical Services or to another healthcare provider. Refer to the UN Cares Services Directory on HIV (www.uncares.org and click on the link on the right-hand side) or to your own UN system workplace to find the names of and contact information for local service organizations. 5. UN Cares Ask an Expert: A special website on HIV in the UN workplace features the information contained in this course, as well as additional resources. The UN Cares website is available in English, French and Spanish at www.uncares.org. You can also send in any questions you have through this website. Click on contact us and fill out the Ask an expert box.
HIV treatment The treatment for HIV is comprised of a combination of medicines or combination therapy. Because HIV is constantly mutating, it quickly becomes resistant to any single medicine. Your doctor will prescribe two or three different anti-retroviral medicines. Many combination therapies are now available in one single pill. Just over 8 million people in low- and middle-income countries were receiving treatment in 2011, with coverage reaching 54% [range 50-60%]. It is important to know that eligible UN System staff members and their recognized dependents are entitled to HIV-related care and anti-retroviral treatment through their medical insurance. The UN Cares Services Directory on HIV is the online resource providing countryspecific information on the availability of HIV-related services. The future of HIV prevention research Vaccine: At present an effective HIV vaccine is not available. Vaginal Microbicides: Also sometimes referred to as anti-viral gels, vaginal microbicides are intended to protect against sexually transmitted infections, including HIV. Pre-exposure prophylaxis (PrEP): This is a strategy in which HIV-negative people take an anti-retroviral medicine, or a combination of medicines, on a regular basis with the aim of reducing their risk of acquiring HIV. Current Prevention Methods: As research continues on the above methods, safer sex practices, such as use of male or female condoms, avoiding penetrative sex, male circumcision, and other existing HIV prevention strategies (see Chapter 2) offer the only feasible means for avoiding or decreasing the likelihood of HIV transmission. Just diagnosed No-one living with HIV is required to disclose his or her status. It s natural to worry about being rejected by family, friends, neighbours or colleagues. Discrimination against people living with HIV remains all too common, so those of us who are HIV-positive should think about whom we can trust with this information. Prevent yourself from becoming infected with sexually transmitted infections, including re-infection by HIV, by always having protected/safer sex. Prevent yourself from becoming infected with hepatitis B and hepatitis C by having protected/safer sex, using safe injection practices and getting appropriate vaccinations. Avoid complications of HIV by ensuring that you get regular medical check-ups and care from a doctor specialized in HIV. Prevent HIV drug resistance by adhering to your treatment protocol. Prevent transmitting HIV to your partner by:
Disclosing your status to your partner if you feel comfortable doing so. Encouraging your partner to get tested for HIV. Using male or female condoms during sex. Using single-use sterile syringes (no reuse). Not sharing sex toys during sex. When to start treatment The following factors are taken into account: Your overall health. How well your immune system is working (CD4 count). The amount of HIV in your blood (viral load). Whether you are pregnant. Your ability and willingness to commit to lifelong treatment. Once someone starts treatment and takes their anti-hiv medications exactly as directed it s possible to have an undetectable viral load within 3 to 6 months. This doesn t mean they are cured but that the medication is working effectively to keep them healthy. An undetectable viral load also means the person is much less likely to transmit the virus to another person. You should aim to start treatment (with the advice of a medical professional) if you are HIVpositive and: Your CD4 count is less than 350 cells/mm 3 Your partner is HIV-negative. You are pregnant. You have HIV-related kidney disease. You need treatment for hepatitis B virus (HBV). Positive living Nutrition Eat appropriate amounts of food and consume healthy foods from the different food groups, which are: Proteins meat, fish, soya beans and nuts help to build and maintain muscles. Carbohydrates they supply energy and can be found in grains, cereals, vegetables and nuts. Vitamins found in fresh fruits and vegetables. Vitamins strengthen the immune system and help fight infections. Fats they should be consumed modestly. Put emphasis on monounsaturated fats found in nuts, seeds, vegetable oils and pulses (like peas, lentils, and beans) while avoiding saturated fats, including butter and products with animal fat, such as salami or bacon.
Clean water Drink plenty of liquids. If you are not sure about the purity of your public water supply, boil your drinking water or, if necessary, use bottled water. Food hygiene Follow these rules: Wash your hands carefully before food preparation. Keep raw and cooked food separate. Choose foods that are safe (avoid unpasteurized milk and wash fresh fruits and vegetables well with clean water). Cook foods thoroughly. Eat foods soon after they are cooked. Minimize stress and anxiety Having a social support network helps. Remember to get regular exercise and adequate sleep. Avoid smoking Smoking damages the lungs and other organs and increases susceptibility to infection. Healthcare Have regular medical follow-ups. Medicines Avoid unnecessary medicines and if you are on other medications not related to HIV, discuss them with your physician. Tuberculosis and HIV Be aware of the risk of TB for individuals living with HIV. Know that TB is both preventable and treatable and get checked regularly for TB if you are living with HIV. Mental health and HIV Living with HIV can have an adverse effect on an individual s mental health. Discrimination, stigmatization and fears for the future can all contribute to physical, psychological and social stress and may lead to mental health conditions such as depression. In some cases, HIV and AIDS themselves can biologically induce mental health issues such as depression, acute psychotic disorders and dementia.
Being well informed, taking care of one s health, and having a good support network can help people living with HIV maintain positive mental well-being. Persons with mental health conditions such as depression, substance-use disorders or other mental health disorders may have increased vulnerability to HIV transmission or acquisition. An estimated one in four people globally will experience a mental health condition in their lifetime. Therefore, it is important to integrate mental health as a priority into all HIV prevention strategies. Talking about HIV Talking about HIV with someone you are about to have a sexual relationship with can be a bit awkward. In some countries however, it s a legal requirement that you tell any future sexual partner if you are HIV-positive. You may want to refer to this course, the booklet and other informative materials and make clear that you just learned that not knowing either your own HIV status or your partner s presents a health risk for both of you. By talking about HIV to your family, you will be able to correct any misconceptions they might have, clarify their values about sex, and teach them how to prevent HIV transmission. It is a difficult decision whether to disclose one s HIV status to people outside one s closest circle. The UN enforces a very strict policy of no tolerance for discrimination in the workplace. You can call the HIV hotline if you would like more advice. Everyone has to make their own decision, and if you choose to do it, do it on your own terms and only when you are ready. If you want to talk to someone about the decision, you can contact UN Plus (www.unplus.org).