Staying Healthy with HIV as You Age

About This section

This booklet describes some common health problems older adults with HIV may face. Since many of them cannot be cured at present, this booklet focuses on how to manage them successfully so you can age. Each chapter includes an overview of the condition, how you can manage it in partnership with your doctor, and what you can do on your own.

This booklet does not provide advice on HIV in general. Instead, it focuses on problems that occur in older adults with HIV and what to do about them. It is not a replacement for doctors’ visits. Each person is different, so no booklet will ever be as good as your doctor’s advice. Follow your doctor’s advice, even if it differs from the advice in this booklet.

We welcome your comments and questions. Please send them to: ageisnotacondom@acria.org.

HIV Basics

HIV (Human Immunodeficiency Virus) is usually contracted through unprotected sex or sharing needles. When left untreated, it can badly damage the immune system, preventing the body from fighting the infections a normal immune system can handle. People with HIV who have severe immune damage are diagnosed with AIDS, or Acquired Immune Deficiency Syndrome. Untreated AIDS leads to death.

New HIV medications have transformed HIV from an often fatal disease into a chronic disease, like diabetes, that many people live with. Some people have lived with HIV for decades. We are just beginning to learn what this means for their long-term health.

Even in people whose HIV is well controlled with treatment, the virus can still cause long-term damage. This is because HIV not only suppresses the immune system, it also activates it. This leads to inflammation, and chronic inflammation can damage organs such as the heart, kidneys, and liver and may cause other problems. People with HIV also tend to have a higher rate of other illnesses (comorbidities) than people who are HIV-negative.

In addition, people who took the older HIV drugs may still suffer from the long-term side effects of those medications. Fortunately, the new HIV meds cause few fewer side effects in most people.


Neuropathy

HIV, and older HIV meds, can cause a condition known as neuropathy (nerve damage). Peripheral neuropathy causes pain, tingling, and numbness in the feet and fingers. Neuropathy can disrupt daily life, make it difficult to walk, sleep, and it can lead to depression or anxiety. When neuropathy affects the feet, it can lead to falls and injuries.

What you can do with your doctor

Ask your doctor if any of your meds can cause neuropathy. If so, see if you can switch to another med.

If you have neuropathy from meds you took in the past, be aware that nerve damage heals very slowly. As a result, treating it takes time and patience. Set realistic goals with your doctor, such as:

  • Pain relief: Set goals about how much your pain should decrease, and when. For example, a goal might be to lower your pain by 25% by next month. Ask your doctor what is realistic, since your goal will depend on the kind of pain you have. If you try a new pain med and it does not lessen your pain symptoms within a few weeks, ask about changing it. Keep a pain diary to record what effect the med is having.
  • Functional goals: Ask your doctor about how much function you can expect to regain with pain treatment. Examples include sleeping without waking up from pain, returning to work, or climbing stairs without help.

Ask if there are options for your pain other than taking meds. Some non-pill treatments can work together with your pain meds to improve your symptoms. They may help you avoid the side effects of pain meds. Examples include creams, heat, cold, massage, or exercise. Ask if these might help.

What you can do yourself

Take the right amount of pills at the right time of day. Use a pillbox or set an alarm on your ph

one. This will help you:

  • Get control of your pain: It is easier to prevent pain than to get rid of it once you have it. This may mean taking pain pills even when you have no pain. Work with your doctor on a pill schedule that meshes with your daily life.
  • Avoid side effects: Taking too many pain pills can cause sleepiness, problems breathing, overdose, and even death. Never take more pain pills than what was prescribed.

Wear the right shoes!  Most people who have peripheral neuropathy have pain in their feet. Finding shoes that minimize this pain is essential. Find a shoe store that specializes in shoes for medical conditions. Neuropathy is common in people with diabetes, and there are stores that cater to them.

Since any pressure on the toes can cause considerable pain for people with neuropathy, ask for shoes with a large “toe box”. This is the part of the shoe that surrounds the front of the foot – having it as large and wide as possible can make a big difference when it comes to foot pain. The shoes may not be as fashionable as you’d like, but they’ll feel a lot better.

Wear comfortable slippers at home and, if possible, at work. Loose-fitting, padded slippers can go a long way to easing foot pain. If you can’t wear slippers, take your shoes off as often as possible in places where no one will notice – at your desk or at the movies, for example.

Take breaks when walking. Learn how long you can walk without pain, and take a break after reaching that point, before the pain gets severe. After a break, and perhaps taking off your shoes, you should be able to walk farther.

Get enough sleep. Good sleep heals the body and can help reduce pain. It also puts you in a good mood, which helps you deal with pain better. If you have problem sleeping because of your pain, ask your doctor for help.

Be careful when walking. Even though we are unaware of it, our feet send large amounts of information to our brain to help us balance and make us aware of uneven surfaces when we walk. Neuropathy can significantly decrease the amount of information our nerves are sending, making walking riskier. Avoid falls by being alert, walking carefully, and watching the surface ahead of you – especially sidewalks, which often have bumps and holes. Always hold, or at least touch, the handrail when using stairs.


Too Many Pills

People tend to have more illnesses as they age. As a result, many older adults with HIV take many pills for other conditions. Often, all the meds you take are needed. But a pill may be one too many if:

  • It’s not the right pill: Some people don’t use the right pill for their problem. For example, some people use cold medicine to help them sleep, even if they don’t have a cold, because it makes them sleepy. This is wrong. Sleep aids, not cold medicines, should be used if you have problems sleeping.

 

  • The pill isn’t needed: Not every illness needs to be treated with meds. For example, back pain may get better with massages instead of drugs. Also, some meds are not needed after a while. For example, antibiotics are usually only needed for a few days.

 

  • It affects the way other pills work: One drug can affect another drug you’re taking, causing a “drug interaction”. Sometimes, one med can make another less active. Sometimes it can make the other drug too strong, causing unwanted side effects.

 

  • It makes you sick: Many meds have side effects that can lower your quality of life. If any of your meds are causing unpleasant side effects, ask your doctor what can be done.

Taking many meds makes it harder to take them all correctly. Also, the more pills you take, the more likely you are to have side effects. Finally, taking many meds can lead to drug interactions.

What you can do with your doctor

Do a “brown bag” check-up

Put everything that goes into your mouth (prescription meds, over-the-counter meds like Tylenol or Nyquil, vitamins, herbs, even things like Rolaids) and put them all in a bag. Bring the bag to your next appointment and ask your doctor if any pill should be stopped or changed. Your pharmacist is also a good person to help you with this.

Changing your meds

It’s important to tell your doctor if you stop taking one med or start another. This includes over-the counter meds, vitamins and herbs, supplements, etc. Your doctor can check for any drug interactions before you start the new pill. Never stop your HIV meds without talking it over with your doctor first! 

If you feel sick, ask if the cause might be one of your meds

If you get sick after starting a new med, ask if your illness might be a side effect. If a drug is making you sick, ask if you can switch to a different one.

What you can do yourself

Create your own system

Find the best way to take the right number of pills at the right time. For many, using an “organizer pillbox” is the best way to know if you have taken a dose or not. Among the pillboxes that can help are those that have compartments for each day of the week and for different times of each day. Some of them are very sophisticated, with timers and alarms and automatic dispensers to help you organize your dosages. Setting an alarm on your phone is also very useful. Or take your dose along with something you do at the same time every day, like brushing your teeth. Ask your doctor to set up an appointment with an adherence counselor, who can help you create the system that is best for you.

Avoiding missed doses is critical for your HIV meds. Missing more than two or three doses a month can lead to drug resistance. And once an HIV drug stops working for you, it will never work for you again.

Talk to your pharmacist

Pharmacists are a great resource for people who are taking multiple meds and can answer many questions. Introduce yourself to a particular pharmacist and build a relationship so that she or he becomes familiar with your situation. Some pharmacies will sort your meds into plastic packages, called blister packs. All you have to do is open the packs and take the pills inside, no sorting needed.

If you can, find a pharmacy that has worked with people with HIV. They may have more experience with HIV drug interactions and with helping people take their HIV meds correctly.


Memory and Brain Problems

Age puts you at risk of memory problems, from many causes. The most common cause in the U.S. is Alzheimer’s disease, which damages brain cells. People aging with HIV may get Alzheimer’s like anyone else, but HIV itself can also damage brain cells. This makes brain problems more likely in people with HIV compared with those who are HIV-negative.

How does HIV affect the brain?

HIV can damage brain function, affecting your work, social, and family life.

  • Brain function: memory problems, lower reading and math skills, lower attention, and problems dealing with information.
  • Mood: anxiety, lack of interest, and depression.
  • Movement: shaky hands, making it hard to hold utensils or get dressed; poor leg movements leading to falls.

 

What you can do with your doctor

Start HIV treatment

HIV meds can ease brain problems and prevent them from getting worse. If you are not already on HIV treatment, it is now recommended for almost everyone with the virus.

Get referrals

If you have memory problems, ask your doctor if you should see a geriatrician. If you have mood problems, ask to see a psychiatrist or therapist. If you have problems with movement, ask to see a physical or occupational therapist. If you have problems with work or family life, ask to see a social worker.

What you can do yourself

Take your meds correctly

Take the right amount of pills at the right time of day. Use an organizer pillbox, set an alarm on your phone or elsewhere, or ask someone to remind you. This is particularly important for your HIV meds. The lower your HIV viral load, the less likely you will have brain problems.

Brain games

Some people try to maintain their brain skills by doing crossword puzzles or brain teasers.  But according to Harvard Health, “There is some evidence that challenges like playing a musical instrument or learning another language have more benefits than repetitive exercises like crossword puzzles. Although “brain-training” programs are a multi-million-dollar industry, there is no conclusive evidence that any of them improves memory or reasoning ability. We don’t know whether playing brain games is helpful.  Getting together with family and friends to play cards may be as good.”

Plan for the future

Brain problems can cause trouble with health and money down the line. Plan ahead. Pick someone you trust to make decisions about money and health. This person will be a backup if the day comes when you cannot make decisions on your own. Tell him or her in advance how you want your money and health handled. If you do not know how to plan for your future health, ask your doctor. If you do not know how to pay for your future finances, ask a lawyer. Make a Living Will and a Healthcare Proxy and give copies to your lawyer, family members, and the person you designate to make your decisions. Keep your copy somewhere you can easily get to in case you need it in an emergency.


Frailty

Frailty, or weakness, means the body cannot handle problems as well as it should. When they have an infection, frail people cannot fight it off very well. When they have accidents, their injury is worse than in stronger people. When they work or exercise, they tire easily. They slow down and are limited in what they can do.

Why do older adults with HIV have frailty?

People with HIV may get weak sooner than people who are HIV negative. This might be because of what HIV does to the body, but we’re not sure.

What happens when you are frail?

Frail people are weak and cannot get around very well, making it harder to work, exercise, do housework, go to the store, or do what they enjoy. They are more likely to fall, more likely to be injured if they do, and more likely to be hospitalized because of an injury. When they have surgery, they often need more time to heal. They also have a greater risk of death.

How do I know if I am frail?

There are many tests for frailty, but researchers don’t agree on the best ones. Different doctors may use different tests. In general, you might be frail if you are weak, slow, easily tired, or losing weight.

What you can do with your doctor

Tell your doctor if you are losing weight

Losing weight can worsen frailty. Find out why you are losing weight. If the cause can be identified, treatment can often help. Ask if a nutritionist can help.

Tell your doctor if you are weak

Your doctor may send you to a physical therapist, who can teach you how to exercise to get your strength back. Don’t be embarrassed to use a cane or walker if you’re advised to – it can literally save your life.  If you are given a cane or walker, ask for clear education on how to use it properly.

Talk to your doctor before having surgery

Frail people are more likely to have problems after surgery. Ask your doctor if the procedure is worth the extra risks caused by frailty. If you need the procedure, ask what can be done to avoid a long hospital stay or other problems. Your doctor might send you to a nutritionist or physical therapist to work on your weight and your strength before the surgery. Follow-up physical therapy is important to anyone who has had surgery, and more important if the person is frail.

What you can do yourself

Take your meds correctly

Take the right amount of pills at the right time of day. Use a pillbox, set an alarm, or ask someone to remind you. Taking pills correctly helps prevent and control illnesses, and allows the body to become stronger.

Eat a healthy diet

The body needs the right foods to stay strong, since food helps the body fight infection and gives it energy. If you’re not sure how to eat what is best for you, ask a nutritionist for help. This is especially important if you have other conditions, such as diabetes or kidney disease, that have their own dietary restrictions.

Exercise

Exercise, including weight-lifting or weight machines, has been shown to be beneficial even for people in their 70s and 80s. It builds muscle, which makes you stronger, and helps you gain the right kind of weight. It also helps with energy, mood, and sleep. Exercise at least a few times a week – walking is good, but if you can do more strenuous exercise, that’s better.


Bone Health

Bone is a living organ. Throughout your life, the body removes old bone and replaces it. As you get older, the body is less able to do this, leaving bones thinner and weaker. Other things can also weaken bones, like smoking, low vitamin D levels, medication side effects, and having HIV. The word “osteoporosis” comes from the Greek terms for “porous bones" and means that the bones become porous, brittle, and subject to fracture. Osteopenia is a lack of bone minerals that can lead to osteoporosis.

How does HIV weaken your bones?

HIV causes the body to remove old bone more quickly than normal and slows down the creation of new bone. In addition, certain HIV meds can weaken bones.

What happens when bones weaken?

When bones are weak, even a light fall can break them, leading to a loss of function. For example, people with hip fractures have hip pain and cannot walk until they have surgery. Even after surgery, some people cannot walk as well as they used to. Broken bones can also lead to other health problems, and to death.

What you can do with your doctor

Ask if you should get your bone health checked

People with HIV over 50 should get checked for weak bones, since they may not have any symptoms until a lot of damage has been done.  A bone density scan, sometimes called a DEXA scan, is a painless way to check your overall bone health. Even if you have little bone damage, getting a bone scan may be a good idea since it can give you a baseline to look at as you age.

Ask if you need treatment

There are medications that can slow down bone loss and help the body build bone faster. Your doctor may also prescribe calcium and vitamin D, which the body can use to build new bone.

What you can do yourself

Take pills correctly

If your doctor recommends medications for bone health, take them as prescribed. Bone treatments will not work if not taken correctly. Also, the lower your HIV viral load, the stronger your bones will be.

Eat a healthy diet

Our body uses calcium and vitamin D to build bones. A good diet can usually provide all your bones need to stay healthy. If you’re not sure your diet has enough calcium and vitamin D, ask a nutritionist.

Exercise

Exercise strengthens bone and lowers the chance of accidents and falls. Even a little bit of exercise helps, so any exercise is better than none. Simply walking and using stairs instead of elevators can help. Load-bearing exercise (lifting weights or using weight machines) has been shown to be particularly effective at improving bone strength, even in people over 70. If you are not sure where to start, see a physical therapist – don’t just join a gym without getting some training first.

Don’t smoke cigarettes or drink too much alcohol

Smoking and too much alcohol weaken bone and cause many health problems. Too much alcohol is unhealthy, but one drink per day may actually lower your risk of heart disease. “One drink” means a bottle of beer, a glass of wine, or a shot of liquor, like gin or vodka. (But if you don’t drink at all, don’t feel the need to start.) It is important to be honest with your doctor about how much you drink. Ask if that amount is right for you, and be sure to drink safely (never while driving or using machinery). Also, ask if alcohol will interact with any of your meds.


Heart Disease

Are older adults with HIV more likely to have heart disease?

Yes. Apart from the other common causes of heart disease, the virus itself can raise your cholesterol, or cause direct heart damage over time. In addition, the chronic activation of the immune system caused by HIV, known as “inflammation”, increases your risk of heart disease even if your viral load is undetectable.

Is that serious?

Heart disease is the number one killer in the U.S. It can also cause weakness, pain, or problems breathing. Even if heart disease doesn’t kill you, it can lessen your ability to be active, to work, and to enjoy life. Even if your HIV is under control, your risk of heart disease is higher than someone who is HIV negative, so talk to your doctor about what you can do to lower your risk.

What you can do with your doctor

Tell your doctor if you don’t feel well

Many symptoms can be signs of heart disease, including chest pain, problems breathing, and pain in the left arm or jaw. Women may experience these same symptoms, or may have pain in the upper abdomen, dizziness, lightheadedness, fainting, or extreme fatigue. Tell your doctor if you have any of these symptoms, so tests can be done. If they’re ignored, you might not find out until you have a heart attack and it’s too late. The symptoms of a stroke are different and involve the face drooping on one side, weakness or feeling numb on one side of the body, or speech difficulty.  If any of these symptoms develop suddenly call 911 immediately.  Don’t just go to the ER, since you will be seen more quickly if you are brought in by an ambulance.  In the case of a stroke or heart attack, every minute counts!

Control other diseases

Many conditions can worsen heart problems. These include high blood pressure, diabetes, and high cholesterol. Your doctor should check your blood pressure, glucose level, and cholesterol regularly. Making sure these are under control will protect your heart.

 

What you can do yourself

Take your meds

Take your meds as prescribed – especially those for blood pressure. Your heart does better if your blood pressure, diabetes, cholesterol, and other diseases are under control.

Eat a healthy diet

Diets that are high in fat, salt, or sugar can cause heart disease. A balanced diet lowers your risk of heart disease. To plan a balanced diet, ask for help from a nutritionist.

Exercise

Exercise helps your heart stay strong. It also helps lower things that worsen heart disease, like high glucose, blood pressure, and cholesterol. Even a bit of exercise helps, and any type of exercise is better than none. Walking is great, but it’s best to do more than that if you can. If you’re not sure where to start, ask to see a physical therapist.

Don’t smoke!

Smoking dramatically increases your risk of heart disease and many other diseases. If you want to quit smoking, ask your doctor for help.

Drink in moderation

Too much alcohol is unhealthy, but one drink per day may actually lower your risk of heart disease. “One drink” means one bottle of beer, one glass of wine, or one shot of gin, vodka, or other liquor. (But if you don’t drink at all, you don’t need to start.)  It’s important to be honest with your doctor about how much you drink. Ask if that amount is right for you, and be sure to drink safely (never while driving or using machinery). Also, ask if alcohol will interact with any of your meds.


Lung Disease

Why might older adults with HIV have lung disease?

Lung diseases are more common in people with HIV. They are more likely to have lung cancer, lung infections, and emphysema (difficulty breathing). Apart from common causes of lung disease like smoking, HIV itself, and the chronic inflammation it causes, can also damage lung tissue over time.

What happens when you have lung disease?

Lung disease makes it hard to breathe and do the things you enjoy. It can cause pain or death, especially if lung cancer is the cause. Since the lungs work with the heart, people may also have heart damage if their lung disease is not controlled.

What you can do with your doctor

Tell your doctor if you’re short of breath

Shortness of breath can be serious. Don’t just chalk it up to age. Tell your doctor, even if your shortness of breath goes away once you rest. If ignored, it may start to happen even when you are resting and may never get better again. Deal with shortness of breath as early as possible to prevent lasting damage to your lungs.

Ask if you need vaccines

Get a flu shot every year, since flu can cause serious complications in people with HIV or lung disease.  A higher dose flu vaccine, Fluzone, is available for people over 65.  It’s designed to create a stronger immune response – ask your doctor if it’s right for you.  Also, get vaccinated against pneumonia. Severe pneumonia can cause decreased lung function and death, so it’s better to prevent it rather than to treat it after it happens.  The CDC recommends that people over 65 and all people with HIV get both the Prevnar and Pneumovax vaccines.

What you can do yourself

Take your meds correctly

Take the right amount of pills at the right time of day. If you use an inhaler, show your doctor how you use it, to make sure you’re using it correctly. The right pills and inhalers can help relieve coughing and breathing problems.

Eat a healthy diet

Eating proper food and keeping a healthy weight are important, since being overweight can make it harder to breathe. But being underweight might mean you’re not eating the right food to keep your lungs healthy. To plan a balanced diet, ask to see a nutritionist.

Exercise

Exercise expands and strengthens your lungs. Even a small amount of exercise helps, so any exercise is better than none. If you’re not sure where to start, ask to see a physical therapist. Besides helping you develop an exercise regimen, a therapist can teach you breathing exercises that reduce shortness of breath and allow you to do more.

Don’t smoke!

Smoking causes lung problems and many other diseases. Don’t smoke, and avoid secondhand smoke. If you plan to quit smoking, ask your doctor for help. Avoid other things that may affect your lungs, like car exhaust and fumes from paint, cleaning supplies, and the like.

Protect yourself around sick people

Lung disease makes it harder to heal from lung infections. Take extra care when around sick people, especially those who are coughing, and wash your hands often.


Kidney Disease

Apart from common causes of kidney disease like diabetes and high blood pressure, people with HIV have additional risk factors for kidney disease. HIV itself, or the inflammation is causes, can damage the kidneys, even if the viral load is undetectable. Certain HIV medications can also decrease kidney function.

What happens when you have kidney disease?

Kidneys filter waste products out of the blood and make urine. They also control blood pressure and keep your body chemicals in balance. When the kidneys are damaged, blood pressure can get so high that it damages other organs, like the heart or the brain. This can cause heart attacks or strokes, leading to decreased function or death. A buildup of waste or chemicals can cause confusion, bone problems, or death.

What you can do with your doctor

Talk to your doctor if you have diabetes or high blood pressure

People with high blood pressure or diabetes should be checked regularly for kidney disease, since these conditions can damage the kidneys. Work with your doctor to keep them under control.

Ask if you might need to change or stop some of your meds

Kidneys filter the unwanted chemicals from your meds and pass them out of your body as urine. If your kidneys are damaged, you may need to change your meds or change the dose to prevent a toxic buildup. Bring all your pill bottles to your doctor, including over-the-counter and herbal pills. Sit down with your doctor and go through them one by one, to see if you need to change any of them. Any time you start a new med or alternative treatment, be sure to discuss it with your doctor.

Ask your doctor exactly which over-the-counter meds you should avoid. For example, most people with reduced kidney function should not take drugs like aspirin, Advil, Motrin, or Aleve. Ask your doctor which pain meds are right for you.

Talk to your doctor before your kidney disease worsens

In some cases, kidney function can worsen to the point where the kidneys are unable to function. When this happens, people may need to go on dialysis (using a machine to filter the blood) or get a kidney transplant. Plan ahead and talk to your doctor early about your options. Bring a friend or family member you trust who can help you decide what to do if your kidneys get worse.

What to do on your own

Take pills correctly

Take the right amount of pills at the right time of day. This is especially important for people with kidney disease. Uncontrolled HIV, blood sugar, or blood pressure can damage your kidneys. Also, the right pills will keep your chemicals balanced and prevent you from feeling ill. If you have reduced kidney function, alert any new doctor you see, since the dose of many medications needs to be taken into consideration.

Eat a balanced diet

If you eat a lot of salt or protein, the kidneys must work harder to filter them out. To protect your kidneys, eat a low-salt diet with the right amount of proteins. To plan a diet that is easier on your kidneys, see a nutritionist.  Ask your physician if a multiple vitamin or mineral supplement would be a good idea.


Sexual Health

Sexual function changes as people age. These changes happen to everyone, including people with HIV, and they can cause a strain on their sex life.  As people age, their sex hormones decrease, and they may take longer to become aroused and achieve orgasm. Men may take longer to get an erection. Women may have vaginal dryness. These changes can make sex more difficult.

In addition, age-related illnesses can limit your sexual activity. For example, arthritis can make it difficult to get into sexual positions, and heart disease can make it tiring to have sex. Problems getting or maintaining an erection may make condom use difficult.
Why is a healthy sex life important?

Good sex is about more than just having an orgasm. It helps you relax, gives you pleasure, boosts self-esteem, and is an important part of life. A healthy sex life can strengthen your closeness with your partner.

What to do with your doctor

Tell your doctor about your sexual habits

Your doctor may not ask you about sex. People often assume that older adults do not have sex at all, or they may be reluctant to talk about sex and safer sex with someone of their parents’ age. Don’t wait for your doctor to ask. Talk frankly about your sex life and any concerns you have. That way, if there’s anything you need to do to stay healthy and maintain a satisfying sex life, you can address it before it becomes a serious problem…

Ask if your sexual problems may be a side effect

Some meds can dampen sexual desire or response. Ask if any of your meds can cause sexual problems, and if you can switch to ones with fewer side effects. If you are having sexual problems, your doctor can evaluate whether or not this might be due to a hormone deficiency or whether you might benefit from medications that help with sexual desire or erections.  For women, make sure you let your doctor know if you’re having problems with vaginal dryness.   It’s always important to discuss safer sex with your doctor before becoming more sexually active.

Ask about PrEP

PrEP (Pre-Exposure Prophylaxis) is a medication for HIV-negative people that reduces the risk of getting HIV. It is close to 99% effective in preventing HIV if it is taken every day. But it does not prevent other STDs, and is meant to be used with condoms, not instead of them. Ask your doctor if PrEP might be right for you or your partner.

What you can do yourself

Take your meds correctly

When your other conditions are not controlled, you may not feel well enough to enjoy sex. Keep them under control by taking the right amount of pills at the right time of day. This is especially important for PrEP, which must be taken every day to be effective. If this is difficult, use a pillbox or alarm to remind you.

Always practice safer sex

Condoms protect you from STDs and prevent the spread of HIV. PrEP is designed to be used with condoms, since it does not protect against STDs and is not 100% effective against HIV.

Look forward not back

As you age, it might not be possible to get back the sexual function you had in your 20s. Instead, try to make the best of the sexual function you have. If you need help with how to make the most of your sexual function, ask your doctor or see a sex specialist.

Talk with your sexual partner(s)

Communication between partners is key to a healthy sex life. Be honest about what you need and how you feel. Help your partner do the same by listening to his or her needs and feelings. Talking will help create a sexual life that satisfies both of you.

Conclusion

You can age with HIV in a healthy way.  Following your doctor’s advice, taking all medications as prescribed, eating a balanced diet, exercising, avoiding substances that are bad for you, and reporting any changes in your body are the keys to healthy aging.  It’s also important to be an active partner with your doctor and bring your questions and concerns to every appointment.  We hope this booklet has provided answers to some of your questions, as well as sparking some new thoughts and questions you can bring to your doctor.