Q and A

Question

Do HIV positive people need to reduce stress?

I am HIV+, I haven’t started my treatment as my CD4 is still ok and I do my best to exercise and eat healthy.

As part of my job I tend to go through work stress, mostly it is positive stress in the sense that it does not have any side effect on me as I enjoy what I do and the stress is usually related to working hard to meet a deadline etc. Being busy helps me keeps my mind off any health concerns and as I result I tend to be optimistic and have a positive attitude which gives me the energy that I need to have a productive day.

I read in many publications that HIV patients need to avoid stress and have enough rest. I think if I do that, it might have the reverse effect on me as I will be spending any more time that I am not putting into work, thinking of my health and what could go wrong. This is how I am wired.

I have decided not to slow down or avoid work stress as the alternative is probably a depressive mindset. Am I taking any significant risk by doing this? Also can you tell me why they advise that HIV+ people avoid stress and have more rest / sleep than those are not infected?

Thank you for your help

Answer

Hi

It sounds like you are doing pretty well at coming to terms with HIV and have made good lifestyle changes in terms of keeping active and looking after youself. Positive stress for work is not going to have any bad impact on your health and it sounds like it is helping you take your mind off HIV.

Stress can also relate to very different aspects of life including physical, mental, emotional, financial and psychological situations.

Although stress is such a commonly used word it is difficult to measure in a scientific way. You can know that one day is more stressful than another, or that certain events are generally stressful but also that different people handle different situations very differently. Some people get stressed by things that are easier for other people to deal with. Some people also handle stress differently, or learn skills to cope with stressful situations. Learning skills to deal with stress are an important part of learning, at any age.

Your are also right that there is probably stress that is broadly good/positive and bad/negative.

Good stress is an important part of life. It can contribute to an energy or drive to achieve certain goals that otherwise maybe wouldn’t happen. Again, this varies between people, but it sounds like you are happy that the stress you are referring to broadly fits in to this category. Exercise can be another example of stress (on your muscles) – and this is good so long as you warm up first and rest properly afterwards and bad if you don’t.

Examples of bad stress include being over-worked, under-appreciated and under-paid. If stress affects the rest of your life in a bad way, this may not be healthy. For example, if you are always thinking about work or stop doing other things you used to enjoy, or if you are too tired for a social life, or never take breaks or holidays.

Bad stress is related to poorer health, including mental health and depression, fatigue, tiredness and not sleeping properly. It also relates to other lifestyle activities: people under negative stress might drink more alcohol or take less care over their health including taking more risks for catching HIV.

A lot of information about HIV and stress was produced before there was effective treatment. Early HIV studies reported faster HIV progression in people who experienced especially stressful situations including bereavement. Back then, reducing stress could have a impact on your health because lifestyle changes were all we had. The biological mechanisms for the link between stress and immune function and how this occurs are not really understood though.

For someone on treatment with an undetectable viral load, HIV is no longer exerting a direct impact on your immune system. A few researchers suggest there may be a residual effect of very low levels of virus, but this is tiny compared to pre-treatment years. On this basis, the connection between good stress and HIV is unlikely to harmful and likely to be good.

Bad stress though is never good for anyone. In someone on treatment, bad stress has been linked to poor adherence for example, which increases the risk of drug resistance and treatment failure. Cutting out bad stress was pretty good advice in early HIV days: if life is short, why waste it on things that cause you to be stressed. But it has always been pretty good advice for anyone irrespective of HIV status.

Life is a balance between good and bad stress. It sounds like you have a balance that you are happy about at the moment. For this reasons it is unlikely to have any negative impact on your health.

But it also sounds like this is part of your way to deal with HIV. At some time in the future, when this is right for you, you may want to look at other ways that you could deal with some of these issues relating to HIV directly.

14 comments

  1. Roy Trevelion

    Hi,

    It’s good to hear that you’re taking your meds every day and that you don’t have side effects.

    But I’m sorry that you are under stress, it sounds tough. As Simon says on this question above, being under stress can mean that you forget your meds or don’t take them in the right way.

    Can you ask the doctor or clinic for support about making sure you and your kids are well and happy? Most people have stressful times in their lives. But getting help from the doctor to cope with stress can help you look after your own health, and care for your kids too.

  2. annonymus

    I’m hiv positive and taking my meds everyday and lucky I dnt hv any side effect since I take the medication my problem isor that my partner cheat on me and he dnt want to use protection while he is buzy fooling around I’m scared that I will loose my kids because of the situation I’m in couse it stressing me all the time

  3. Lisa Thorley

    Hi Agnes,

    It sounds like you need some support, is there someone who you can talk to? Are you able to access some professional help?

  4. Agnes

    Hi im on arv ‘s and on highblood pressure tablets,and those two are not stressing me,but i’ve been in a lot of stress this year,financial,work and i even tried to commit suicide at 1 stage,my kids are troubling me,they can stress me a lot lately every single day,i cant take it anymore,its like im loosing my mind sometime headaches and i loose appetite when im stressed,what can i do please help my son is 24yrs and my doughter is 15 im a widow and trying very hard to make them happy,they dont seem to appreciate im giving up please help

  5. Lisa Thorley

    Hi Anonymus,

    Being diagnosed with HIV can be a shock. What you need to do is give yourself some time. Slow down and breath. You’re going to be OK. Having someone to talk to might help. Is there a member of your family that you can talk to or a close friend? If not, is there a support group near to where you live?

    Unlike in the past, HIV is now a very manageable health condition. If someone is on medication their life expectancy will be the same as what it would have been had they not have contracted HIV. This is great news. You’re 20, you have a life ahead of you.

    Its important though that you take ARVs. If you aren’t already on them, then you should really consider starting them. There’s more about treatment here:

    http://i-base.info/guides/starting

    The stress that you’re feeling is common. As too is crying. In time this will go. In time you might not even think about your status.

  6. Anonymus

    I have tested positive the past 4 Months. I have sleepless nights thinking about my health and that i’m gonna die soon every night i have headache stress i sometimes Cry alone.
    I’m still young um 20 i’m on a second gap year. How can i heal the stress and sleepless nights

  7. Rebecca McDowall

    Hello,
    It’s true that douching is generally not a great idea for sexual health. If you are worried about STIs or reinfection (which is uncommon) please speak to your doctor or a sexual health clinic.

  8. junior

    I am 53 under treatment and VL undetectable. I just had an unprotected sex. Unfortunately I was so scared after that I douched my anus…I just saw that it was the wrong thing to do. What should I do now?

  9. Simon Collins

    Hi Bill, thanks for the nice feedback, good luck with everything :)

  10. Bill

    Thank you very much for the detailed response. The level of detail and comprehensive perspective that you offer in this website is of high quality and I am truly grateful for your help.

    I agree with you about the distinction you made between positive and negative stress. Positive stress has been an impetus for me to stay motivated which I have found extremely helpful to deal with the psychological side affect of the diagnosis. I believe it makes a huge difference not only with HIV but with any other terminal illness to have the right mindset, as the saying goes: broken bones don’t kill, broken hopes do.

    I also appreciate the insight that you have provided with regard to the relation between viral load and stress and this could actually testifies to another important benefit of the medication which is to offer an assurance to the patience that the medication is keeping their virus in check and as a result help the patient feels better about their health prospect and hence improve their psychological well being.

    Thank you again

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