How can I avoid complications from HIV?
If you are HIV positive, you need to take very good care of yourself. Be sure to eat a balanced diet, exercise regularly and get plenty of rest. Make sure you follow your doctor's instructions and take all of your medicines exactly as directed. You can also take steps to keep yourself from getting infections or diseases that are more common in people who have HIV.
How do I practice “safe sex”?
Use a condom every time you have sex. A latex condom will help reduce the risk of you and your partner getting a sexually transmitted infection (STI), such as herpes, human papillomavirus (HPV) or a new strain of HIV that might be resistant to antiretroviral drugs. To reduce your risk of getting intestinal infections, avoid sex that results in oral exposure to feces (oral-anal contact).
What about my job and leisure time activities?
Certain activities or jobs (such as working in homeless shelters, hospitals, clinics, nursing homes or prisons) can increase your risk of exposure to tuberculosis (TB) and other infectious diseases. Talk with your doctor about where you work. Your doctor can decide if you should be tested for TB and how often.
Parents of children in day care and people who provide child care are at increased risk of catching cytomegalovirus (CMV) infection, cryptosporidiosis, hepatitis A and giardiasis from the children. The risk can be reduced through good hygiene practices, such as always washing your hands after changing diapers, after touching urine or saliva, after going to the bathroom and before a meal. If your child has HIV, inform the people who help care for your child.
If you work with animals (for example, veterinary work or at a pet store, farm or slaughterhouse), you may be at higher risk for infections such as cryptosporidiosis, toxoplasmosis, salmonellosis, campylobacteriosis or Bartonella infection. The risk of catching these infections probably is not high enough for you to give up your job, but you should take the following special precautions:
- Avoid contact with young farm animals, especially those that have diarrhea.
- Wash your hands after gardening or other contact with soil.
- If you live where histoplasmosis is common, avoid activities such as cleaning chicken coops, exploring caves or disturbing the soil.
- If you live where coccidioidomycosis is common, avoid exposure to disturbed soil, such as excavation sites or dust storms.
Is it safe for me to have a pet?
Although owning a pet may have risks for people who have HIV, many of the risks can be avoided. Pets provide emotional benefits, so don't be hasty about deciding to give up your pet. The following are some steps to keep you and your pet healthy:
- Keep your pet up to date on all its vaccinations (shots) to prevent disease.
- Take your pet to the vet right away if it gets diarrhea. Your vet will want to find out if the diarrhea is caused by a germ that might be harmful to you. If possible, have a friend take care of your pet when it has diarrhea.
- Always wash your hands after handling your pet, especially before you eat. Avoid contact with your pet's feces. If your child has HIV, make sure your child washes his or her hands after playing with the pet.
- If you want to get a new dog or cat, the animal should be at least 6 months old and it shouldn't have diarrhea. This reduces your risk of cryptosporidiosis.
- Be careful about where you get your pet. Some pet-breeding facilities, animal shelters or pet stores have better hygiene than others.
- Avoid stray animals. If you decide to adopt a puppy or kitten, your vet should check the pet to be sure it doesn't have a germ that could give you an infection.
- If you have a cat, the litter box should be cleaned every day, preferably by someone who does not have HIV and is not pregnant. This helps prevent toxoplasmosis. Keep your cat inside, and don't let it hunt other animals (such as mice or rats). Do not feed it raw or undercooked meat. Avoid the kind of play that may result in cat scratches or bites. If you do get bitten or scratched, wash the wound site right away. Never let your cat lick an open scratch or wound on your body.
- Flea control is an effective way to help keep you and your cat or dog healthy.
- Limit your contact with reptiles (such as snakes, lizards, iguanas and turtles) to reduce your risk of salmonellosis. Wear rubber gloves if you must clean an aquarium or a birdcage. Avoid contact with exotic pets such as monkeys.
How can I avoid diseases from food and water?
The following are some things that you can do to avoid getting sick from food or drinking water:
- Avoid eating raw or undercooked eggs (including foods that may contain raw eggs, such as cookie dough, some preparations of hollandaise sauce, Caesar salad dressing and mayonnaise).
- Avoid raw or undercooked poultry, meat and seafood. Also avoid dairy products that haven't been pasteurized. Cook poultry and meat until it is well-done or has no trace of pink in the middle. The internal temperature of cooked beef should be at least 170°F. For poultry, the internal temperature should be at least 180°F.
- Wash fruits and vegetables carefully before you eat them.
- Wash your hands, cutting boards, counters and knives with soap and water after they come in contact with uncooked foods, especially uncooked meat.
- If you are severely immunosuppressed and want to reduce your risk of listeriosis (an uncommon disease transmitted through food contaminated with the Listeria monocytogene bacteria), be careful about soft cheeses and ready-to-eat foods, such as hot dogs and cold cuts from the deli. Before you eat hot dogs and cold cuts, reheat them until they are steaming to kill any germs.
- Never drink water directly from lakes and rivers. Avoid swimming in water that might have human or animal feces in it. Avoid swallowing water while swimming or during other recreational water activities.
- If your city has an outbreak of waterborne disease or issues a "boil water" advisory, boil your water for 1 minute before you use it for drinking or brushing your teeth. Or use personal-use water filters or bottled water.
- Although it isn't necessary to boil tap water if there is no "boil water" advisory in effect, you may want to in order to further reduce your risk of infection. Talk with your doctor about this, since avoiding tap water completely can be inconvenient and expensive.
- If you choose to avoid tap water completely, remember that ice made from contaminated water may also cause infection, as can fountain beverages served in public places.
- Bottled or canned carbonated soft drinks are safe to drink. Noncarbonated soft drinks and fruit juices that do not require refrigeration until after they are opened also are safe. Frozen fruit juice concentrate is safe if you prepare the juice with water from a safe source.
- If you drink fruit juice that is sold refrigerated (not frozen) drink only juices that are labeled "pasteurized." Make sure you keep them refrigerated, also. Other pasteurized beverages and beer are also considered safe to drink, although no data are available about the safety of wine.
How can I be safe while I travel?
Travel may be riskier for HIV-infected people, especially if their immunosuppression is severe. Travel to developing countries may put you at higher risk of food-borne and water-borne illnesses than traveling in the United States. Talk with your doctor before you travel.
- Remember to be very careful with food and drinks. Avoid ice, raw vegetables and fruits, tap water, raw or undercooked seafood or meat, milk and dairy products and food bought from street vendors.
- Items that are generally safe include steaming-hot foods, fruits that you peel yourself, bottled (especially carbonated) beverages, hot coffee or tea, beer and water that has been boiled for 1 minute.
Although some studies have shown that medicine to prevent traveler's diarrhea may reduce the risk, none of the studies have specifically included HIV-positive patients.
It isn't generally recommended that you take medicine to prevent an upset stomach or diarrhea before traveling, but you may want to talk with your doctor about this. You should bring an antibiotic with you in case you do get diarrhea. See a doctor right away if your diarrhea is severe and doesn't get better with medicine, if you have blood in your stool, if you get dehydrated or if you have a fever (with or without chills).
Avoid direct skin contact with soil or sand, especially if it's likely the soil may be contaminated with animal feces. Wear shoes and protective clothing. Sit on a towel if you go to a beach.
Talk with your doctor about the vaccinations you need before your trip. Many vaccinations are okay for people who have HIV, but some common vaccinations shouldn't be given to people who have HIV. If you can't have certain vaccinations, your doctor may need to give you special instructions. Your doctor will also want to talk with you about avoiding exposure to fungal infections and protozoal infections, depending on where you will be traveling.
Written by familydoctor.org editorial staff