compiled by Martin Flynn
News
SEX AND DRUGS
Several
warnings have gone out this month to gay men living with HIV about
the potential dangers of recreational drug use.
As many as one in five gay men in London have used the drug crystal meth in
the last year, according to new research, and HIV positive gay men are bigger
users than HIV negative gay men.
Professor Jonathan Elford, from City University, interviewed more than 2,700
gay men and found 12.6 per cent questioned at HIV clinics, 8.3 per cent at
sexual health clinics and 19.5 per cent at gyms had used crystal meth in the
last year.
Crystal meth greatly reduces sexual inhibition as the study found. “Men
who used crystal meth, as well as those who used other recreational drugs,
were more likely to report high-risk sexual behaviour than other men,”
the study authors reported: “They were also more likely to use Viagra,
look for sex online and to have had a sexually transmitted infection.”
The finding could have implications for people living with HIV because even
infrequent crystal use could interact with their medication.
Meanwhile, in south London, police report a second death and 15 known collapses
recently at Vauxhall nightclubs attributable to GHB (Gamma Hydroxy Butyrate)
or GBL (Gamma Butyrolactone).
‘G’ or liquid ecstasy, lowers blood pressure to dangerous levels
and is linked to clubbers passing out and, in recent cases, to fatal collapses.
Police said: “This is a particularly dangerous drug that is causing
misery on the gay scene. People are unaware of the potentially fatal reaction
it can have on their bodies especially when mixed with other recreational
drugs and alcohol.”
“It is like playing Russian roulette with your life - with very short
odds,” they added.
Door searches for drugs have stepped up and HIV positive clubbers are advised
to take a copy prescription with them to identify their legal drugs.
US CLAMPS DOWN ON
TRANS FATS
News
that New York health authorities are banning trans fats from the
city’s restaurants comes as a timely reminder to avoid these dangerous
food additives.
These fats are dangerous because they lower the levels of good cholesterol
(HDL) but increase the levels of bad cholesterol (LDL).
They contribute to Type 2 diabetes and may be particularly dangerous to people
on HIV medications that already boost fat levels in the bloodstream (see page
44).
As much as 40 per cent of supermarkets foods contain high levels of trans
fats that increase shelf-life and flavour. It is commonly used in vegetable
shortenings, biscuits, cakes, snack foods and takeaways.
Health experts want British authorities to add a warning on food labels. But
thus far only three types: saturated, poly and monounsaturated fats are listed
on UK food labels.
To figure out whether trans fats are in your food you have to read between
the lines. Look for the words ‘hydrogenated’, ‘partially
hydrogenated’ or ‘fractioned’ on the list of ingredients.
REASONS TO BE CHEERFUL
Some good news (for once) this month with reports that the death
rate for people living with HIV on antiretroviral therapy has dropped to less
than one per cent, from a high of over 10 per cent ten years ago.
A recent British HIV Association (BHIVA) mortality audit showed that more
than 40,000 HIV positive people are now being seen for treatment and care.
Deaths in Britain related to the disease have dropped from 1,400 a year ten
years ago to just 400 last year. A third were not related to HIV infection
itself, and one in six were from cancers.
Some cancers were HIV-related, such as lymphomas, but others were not traditionally
related to HIV, such as cancers of the liver, lungs, kidneys and anus.
Cardiovascular disease accounted for one in fifteen reported deaths and liver
diseases, including co-infection with hepatitis B or C, was responsible for
six per cent of all deaths among HIV positive patients in the UK.
Deaths from reactions to anti-HIV therapy and multi-drug resistant HIV were
responsible in three per cent of cases. Five per cent of deaths were due to
individuals declining treatment and seven per cent were put down to poor adherence.
Most worrying of all, the BHIVA audit showed one in four HIV-related deaths
were due to people being diagnosed too late for antiretroviral treatments
to work effectively.
“People are simply coming into HIV care too late and their deaths are
preventable,” said Professor Sebastian Lucas, who also told the BHIVA
autumn conference that most ‘late presenters’ were black people.
Exercise & HIV FIT
FOR PURPOSE
One size doesn’t fit all when it comes to keeping fit, writes John Clarkson
Looking
at your new gym membership and trying to think up yet another reason
not to bother today? Don’t beat yourself up - you’re not alone.
Gyms make a fortune out of the resolution-driven hoards who sign up after
New Year but whose resolve has failed them by the first gloomy week of February.
Why bother - I’ve got HIV
Everyone knows exercise reduces the risk of heart attack, stroke and diabetes.
For people with HIV, regular exercise counters the effects of lipodystrophy
and lowers the levels of bad fats caused by some combos (see p44 for the science).
Scientists don’t know exactly why people who exercise regularly are
better able to fight off illnesses, but they are. One six-year study found
HIV positive people who exercised moderately three times a week had higher
levels of white blood cells (the body’s defenders) and were less likely
to develop an Aids-defining illness than their more sedentary counterparts.
Mind over matter
Fitness fan Dr Simon Portsmouth, lead HIV clinician at St Mary’s, London,
believes exercise is a key weapon against HIV: “When I discuss starting
antiretrovirals with my patients I always talk about exercise too. The two
are similar as you have to work at both, though adherence to an exercise program
can be more difficult than to a treatment regime. But if you get it right,
exercise is especially good at controlling depression, anxiety disorders,
and boosting self-esteem.”
This connection between your mental state and immune system is not just common
sense. Research presented at the 3rd International Aids Conference stated:
“Moderate exercise can decrease some components of mood disturbance
... leading to improved quality of life and disease management, and slower
progression of HIV.”
Exercise makes you feel better, look better and live longer. Trampoline or
tread-mill, there’s a type of exercise out there to suit everyone. Try
one, if you don’t enjoy it then pick another instead.
Always talk to your GP or HIV clinic before taking up any exercise.
No-brainer fitness tips
• Take stairs not lifts or escalators
• Get off the bus/metro a stop early and briskly walk remaining distance
• Use local shops and carry groceries home and burn 300 calories an
hour
• Jogging or cycling to work or to the shops keeps you fit and saves
cash
GYMS
Great one-stop fitness shops with qualified trainers offering a range of exercise
options tailored for you
PLUS SIDE
4 council gyms lack glamour but are cheaper - you’re not there to look
at the scenery
4 ask your clinic about exercise referral schemes
DOWN SIDE
8 expensive and make you sign a yearly contract. Shop around, ask exactly
what’s included and read the small print
8 can be intimidating - go with a buddy
SWIMMING
This great cardio-vascular exercise builds lean muscles, improves flexibility
and blood pressure
PLUS SIDE
4 low-impact activity works every muscle
4 ideal for those with peripheral neuropathy, arthritis or back pain and pregnant
women
4 public pools are inexpensive
DOWN SIDE
8 does not improve bone density
8 not so great for weight loss
8 not great if you can’t swim, so take a class - a new skill can boost
confidence
YOGA & TAI-CHI
Ancient practices that aim to unify the physical, intellectual and spiritual
through stretching, breathing and mental relaxation
PLUS SIDE
4 empowering - making you feel more in control of your health
4 can be either gentle or high impact - so suitable for all levels and ages
DOWN SIDE
8 there are many different types of both, so make sure you find a class right
for you
8 have a girly image, but tai-chi is a martial art and have you seen Madonna
lately?
BELLY DANCING
More than just erotic wiggling, this ancient Egyptian dance is a great form
of exercise too
PLUS SIDE
4 fantastic cardio-vascular workout
4 works ‘core’ abdominal muscles and backs 4 self-esteem through
sexual confidence
DOWN SIDE
8 blokes will have to be really confident about their masculinity, but it’s
not unheard of
Food for thought
VITAMIN A
It gives you good night vision but can vitamin A boost your health if you
are HIV positive?
What
is vitamin A?
Vitamin A performs numerous essential functions in the body. The term describes
a group of compounds that occur in animal (retinol) and vegetable (carotenes)
food sources. Animal sources are around six times more potent than vegetable
sources. It is fat-soluble and is stored in the body so it can be toxic if
you take too much. An ounce of polar bear liver contains enough Vitamin A
to kill you, apparently.
What does it do?
Your body needs vitamin A to grow, grow healthy skin and build mucous membranes
in your mouth, intestines, vagina and urinary tract. It is most famous for
giving good night vision. Your body needs fat and bile to absorb vitamin A.
You can store two years’ worth of vitamin A in your liver. Vitamin A
deficiency can cause blindness or, in milder cases, your ability to see at
night.
Which foods?
Fish oils, liver, eggs, butter and orange or yellow vegetables or fruits are
all good sources. Broccoli is also good source, but the green chlorophyll
camouflages the yellow carotene. If it weren’t for chlorophyll, broccoli
would be yellow or orange.
How much do I need?
The Food Standards Agency recommends 0.7mg a day for men and 0.6mg a day for
women. Some research suggests taking more than 1.5mg can cause bones to weaken
over time and harm unborn babies.
Our expert* says...
Vitamin A is important in the diet, but it can be ‘too much of a good
thing’ when it comes to supplements. Studies on HIV positive women in
Tanzania showed that taking vitamin A alone did not improve health and in
some cases had a detrimental effect. But when this same group of women added
a regular micronutrient, their health improved. Taking beta-carotene is the
safest way to supplement vitamin A. Deficiencies in vitamin A (retinol &
beta-carotene) are seen in some people with advanced HIV. But it is unclear
whether vitamin A supplements can help people with HIV beyond correcting the
problems associated with deficiency or whether it interacts with HIV medications.
*Karen Klassen is lead HIV dietitian at St Mary’s Hospital, London
Why not try...
3CARROT AND CORIANDER SOUP
Saute four peeled and diced carrots in melted butter for 5-6 minutes until
soft. Add 425ml chicken or vegetable stock, bring to the boil and simmer gently
for 10-12 minutes.
Add to two large handfuls of chopped, fresh coriander, 110ml cream, and season
to taste.
Liquidise until smooth.
Return to pan, heat and serve.
20 mins/Serves 2
SURVIVAL TIPS
Tom
Matthews DX1986:
‘Passivity kills’
When I was given two years to live at 38 I thought it wasn’t too bad,
because I’d had a full life. My HIV positive friends thought I was hell-bent
on suicide when I got a new job the year after. Ironically, by 1993 all those
friends had died and I was forced to wonder why I was still there.
I think it was because I accepted and talked about it. If a significant part
of you is in denial it will handicap whatever plan you come up with. My way
of dealing with HIV was to embrace it.
Few gay men are truly happy with their sexuality; society tells us we are
‘perverted’. Add in HIV and they automatically think: ‘it’s
my fault’. I felt no shame about being gay, so it was easier for me
to take the next step. There is no reason on earth why anyone should feel
ashamed of being HIV positive.
In 1993 I had two strokes and suspected HIV encephalitis. Having dementia
is scary – for two months I was a zombie.
I had been on AZT but had seen what it did to my friends at high doses. I
funded myself to a conference, discovered what is now called abacavir and
was eventually accepted on to a study. I was almost bed-bound and ready to
die, but when I started the combination things started to improve.
All my friends who died were passive about their health care and it made me
angry. It’s not like taking your car into the garage and it comes back
perfect – you have to be actively involved in this.
Having HIV is an opportunity to take stock and ask yourself what you want
to do with your life. When you realise you might not have too many tomorrows
you focus on the now.
