Living with HIV

Health care providers are an essential part of successful HIV treatment. They prescribe HIV medicines and order tests to monitor their patients' health. People with HIV work with their health care providers to select an HIV treatment regimen that works best for their needs.

The following resources can help you find a health care provider:

• State HIV/AIDS Hotlines, from HRSA
  If you need help finding a health care provider or HIV/AIDS-related services in your area, call your state's HIV/AIDS hotline. The Health Resources and Services Administration (HRSA) maintains a list of HIV/AIDS hotlines for the United States, the U.S. Virgin Islands, and Puerto Rico.
• Find a Ryan White HIV/AIDS Program Medical Provider, from HRSA
  The Ryan White HIV/AIDS Program provides HIV treatment services to people with HIV who have no health insurance or who are underinsured. Use the Find a Ryan White HIV/AIDS Program Medical Provider search tool linked above to find medical providers in your area participating in the Ryan White HIV/AIDS Program.
• Find HIV Services Near You, from HIV.gov
  This search tool from HIV.gov can help you locate services, programs, and centers for HIV testing, sexually transmitted infection (STI) testing, pre-exposure prophylaxis, mental health, family planning, housing assistance, substance abuse, and the Ryan White HIV/AIDS program.

There are several resources that can help people with HIV get the medicines they need:

• ADAP Directory, from the ADAP Advocacy Association
  Use this directory to find AIDS Drug Assistance Programs (ADAPs) in the United States and several U.S. territories that provide HIV medicines and other services to those without sufficient health insurance or who need financial assistance.
• NASTAD Membership Directory
  Use the National Alliance of State and Territorial AIDS Directors' (NASTAD) directory to find health care specialists who administer HIV health care programs in your state.
• Drug Companies
  Some companies that make HIV medicines also have drug assistance programs. To find the contact information for the manufacturer of an HIV medicine, search for the drug in the Clinicalinfo Drug Database and then scroll down the drug fact sheet to the section titled "Manufacturer Information."

A stable living situation makes it easier for people with HIV to keep appointments with their health care provider and stick to an HIV treatment regimen.

• Housing Opportunities for Persons with AIDS Program, from HUD
  The U.S. Department of Housing and Urban Development (HUD) manages the Housing Opportunities for Persons with AIDS (HOPWA) program, which is designed to provide housing assistance to people living with HIV or AIDS, as well as their families.

Anyone can have problems with mental health, but people with HIV are more likely to experience some mental health conditions (such as depression) than people without HIV. Read the HIVinfo HIV and Mental Health fact sheet for more information.

Below are some places to find mental health treatment services:

• Find Help, from SAMHSA
  Substance Abuse and Mental Health Services Administration (SAMHSA) is a U.S. government agency that offers resources for those looking for help with mental health problems or substance abuse. SAMHSA's treatment locator allows people to search for mental health and substance use treatment facilities in the United States. SAMHSA also operates a 24-hour National Suicide Prevention Lifeline.
• Help for Mental Illnesses, from NIMH
  As part of HHS, the National Institute of Mental Health (NIMH) funds research on ways to prevent and treat mental health disorders. Their website includes a resources page to help people find health care providers and treatment services, locate clinical trials, and learn more about mental health.

If you have questions about HIV treatment or need help finding HIV treatment resources, HIVinfo health information specialists (available in English or Spanish) can assist you. Contact HIVinfo by phone (1-800-448-0440) or email (HIVinfo@NIH.gov) for confidential assistance. For more information, visit the HIVinfo Contact Us page.

Also see the HIV Source collection of HIV links and resources.

COVID-19 is caused by a virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can be spread from person to person. Transmission of SARS-CoV-2 primarily occurs when a person inhales respiratory droplets or particles that contain the virus or when a person touches their mucous membranes with hands that have been contaminated with the virus.

Anyone can get infected with SARS-CoV-2 and become severely sick or die from COVID-19. However, people with underlying medical conditions or those who are immunocompromised or have a weakened immune system are more likely to get very sick, be hospitalized, need intensive care, require a ventilator to breathe, or die from COVID-19. People with HIV have higher rates of certain underlying medical conditions. The human immunodeficiency virus (HIV) weakens the immune system and can cause a person to be immunocompromised.  

People with HIV, especially those with advanced HIV or untreated HIV, may have an underlying condition or a comorbidity that can make them severely sick if they become infected with SARS-CoV-2.

You should follow CDC recommendations regarding symptoms of COVID-19 and get tested immediately if you think you may be infected with SARS-CoV-2. A person can be infected with SARS-CoV-2 but show only a few symptoms or no symptoms at all (also known as asymptomatic infection). Testing is the only way to know that someone has been infected with SARS-CoV-2. Testing also ensures that people are not spreading the virus to others.

Most health care providers offer COVID-19 testing. Contact your health care provider if you are experiencing COVID-19–related symptoms or have come in contact with an infected person. People can also get tested for COVID-19 at their local pharmacies by making scheduled appointments or drive-throughs or by purchasing at-home rapid tests over the counter at local pharmacies. Residential households in the United States can now order free at-home testing kits from the U.S. Postal Service. Visit the CDC website for more information about self-testing and free at-home COVID-19 tests, and visit your state or local health department’s website for information on additional testing sites.

Important: If you have HIV you should immediately contact their health care provider if you test positive for COVID-19, and you should also continue taking your HIV medicines (also known as antiretroviral drugs) as prescribed.

There are several COVID-19 vaccines that are Food and Drug Administration (FDA)-approved or authorized for emergency use in the United States. CDC recommends that people with HIV who are eligible should get COVID-19 vaccines regardless of viral load or CD4 T lymphocyte cell count. Vaccination schedules depend on age and vaccine manufacturer. See the CDC’s Interim COVID-19 Immunization Schedule (PDF), or the (easier to understand) infographics COVID-19 Vaccination Recommendations Infographic (PDF) for most people, or COVID-19 Vaccination Recommendations Infographic (Immunocompromised) (PDF).

CDC also recommends that people with advanced or untreated HIV get an additional primary dose to boost their immune response. An additional primary dose is the dose given after a person receives the initial dose of a COVID-19 vaccine. If you have HIV, you should talk to your health care provider about getting additional doses of updated COVID-19 vaccines.

People who are vaccinated against COVID-19 can still get infected with SARS-CoV-2 but getting vaccinated decreases the risk of severe illness, hospitalization, and death from COVID-19.

COVID-19 vaccines are safe for people with HIV. People with HIV were included in COVID-19 vaccine clinical trials. COVID-19 vaccines meet the FDA’s standards of safety, effectiveness, and quality. According to CDC, there is no evidence that COVID-19 vaccines interfere with medicines to treat or prevent HIV. HIV medicines that prevent HIV are called pre-exposure prophylaxis.

There are drugs that are FDA-approved or authorized for the treatment of COVID-19. Some of these approved drugs have drug-drug interactions with certain HIV medicines. If you take HIV medicines, you should talk to your health care provider about potential drug-drug interactions taking COVID-19 treatment. To learn more about drug-drug interactions, read the What is a Drug Interaction HIVinfo fact sheet.

If you have HIV, you should follow the general CDC protocols on how to protect yourself and others from COVID-19. Getting fully vaccinated against COVID-19 can protect you and others from COVID-19. People with HIV can also protect themselves from COVID-19 by—

• Maintaining a healthy lifestyle.
• Continuing to take antiretroviral drugs to strengthen the immune system.
• Ensuring that all vaccinations, including vaccination against the flu, are up to date.
• Maintaining adequate supply of antiretroviral drugs (at least 30 days’ supply) and other drugs needed to manage HIV; you can talk to your health care provider about getting your HIV medicine by mail.
• Keeping all medical appointments and observing safety protocols during in-person medical visits; people with HIV should use telemedicine when possible.

From CDC:

• How to Protect Yourself and Others
• COVID-19 Vaccines for People Who Are Moderately or Severely Immunocompromised

From National Institutes of Health: 

• Guidance for COVID-19 and People with HIV
• Coronavirus Disease 2019 (COVID-19) Treatment Guidelines
  • Special Considerations in People with HIV
• COVID-19 Testing

Also see the HIV Source collection of HIV links and resources.

Mental health refers to a person's overall emotional, psychological, and social well-being. Mental health affects how people think, feel, and act.

Good mental health helps people make healthy choices, reach personal goals, develop healthy relationships, and cope with stress. In contrast, poor mental health means people find it difficult to manage how they feel, think, act, or cope with stress.

Poor mental health is not the same as mental illness (also known as a mental disorder). Mental illnesses are diagnosed mental, behavioral, or emotional disorders that can vary in severity and may impact different areas of life, including jobs and relationships. 

Mental illnesses include many different conditions, such as anxiety disorders, mood disorders (such as depression), eating disorders, post-traumatic stress disorder (PTSD), bipolar disorder, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, and schizophrenia.

A person can have poor mental health and not have a diagnosed mental illness. Likewise, a person with a mental illness can still enjoy good mental well-being. While there are some differences between poor mental health and mental illnesses, they will be referred to collectively as mental health conditions throughout this fact sheet.

If you are living with HIV, it is important to take care of both your physical and mental health.

Mental health conditions are common in the United States. Anyone can experience poor mental health or a mental health illness. According to the National Institute of Mental Health (NIMH), about one in five American adults lived with a mental illness in 2021.

People with HIV are at high risk of some mental health conditions because of HIV-related stress. For example, people with HIV are twice as likely to have depression as people who do not have HIV.

It is important to remember that mental health conditions are treatable and that people can recover from poor mental health.

The following factors can increase the risk of mental health conditions in anyone, including people without HIV:

• Major life changes, such as the death of a loved one or the loss of a job
• Negative life experiences, such as abuse or trauma
• Biological factors, such as genes or brain chemistry
• A family history of mental health conditions

In addition to these factors, the stress of having a serious medical illness or condition, like HIV, may also negatively affect a person's mental health. Situations that can contribute to mental health conditions in people with HIV include:

• Difficulty in telling others about an HIV diagnosis
• Stigma and discrimination associated with HIV
• Loss of social support and isolation 
• Difficulty in getting mental health services

In people with HIV, both HIV infection and related opportunistic infections can affect the brain and the rest of the nervous system. This may lead to changes in how a person thinks and behaves. 

In addition, some medicines used to treat HIV may have side effects that affect a person's mental health. For example, doravirine has been linked to depression and sleep disturbances in some people. 

However, side effects from HIV medicines that affect mental health can usually be fixed by changing HIV medicines. Be sure to talk to your doctor if you think your HIV medicine is affecting your mental health.

Changes in how a person feels or acts can be a warning sign of a mental health condition. For example, potential signs of depression include:

• Losing interest in activities that are usually enjoyable
• Experiencing persistent sadness or feeling empty
• Feeling anxious or stressed
• Having suicidal thoughts

If you have any signs of a mental health condition, it is important to get help. You can reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline for immediate help.

People with HIV can talk to their health care provider about how they are feeling. They can also tell their health care provider if they are having any problems with drugs or alcohol, which can also impact mental health.

Health care providers will consider whether any HIV medicines may be affecting the person’s mental health. They can also help people with HIV find a mental health care provider, such as a psychiatrist or therapist.

Here are additional ways that people with HIV can improve their mental health:

• Join a support group.
• Try meditation, yoga, or deep breathing to relax.
• Get enough sleep, eat healthy meals, and stay physically active.

To find mental health treatment services, use these resources from the NIMH and the SAMHSA.

From the Centers for Disease Control and Prevention:

• About Mental Health
• Stigma and HIV

From Medline Plus:

• Mental Disorders

From the NIMH:

• HIV and AIDS and Mental Health
• Mental Illness

From SAMHSA:

• What Is Mental Health?

From the U.S. Department of Veterans Affairs:

• Mental Health and HIV

From the World Health Organization

• Mental Disorders

Also see the HIV Source collection of HIV links and resources.

Good nutrition is about finding and maintaining a healthy eating style. Good nutrition supports overall health and helps maintain the immune system. It also helps people with HIV maintain a healthy weight and absorb HIV medicines.

HIV attacks and destroys the immune system, which makes it harder for the body to fight off infections. People with HIV take a combination of HIV medicines (called an HIV treatment regimen) every day. The medicines prevent HIV from destroying the immune system. A healthy diet also helps strengthen the immune system and keep people with HIV healthy.

In general, the basics of a healthy diet are the same for everyone, including people with HIV. Some general recommendations include:

• Eating a variety of foods from the five food groups: fruits, vegetables, grains, proteins, and dairy.
• Eating the right amount of food (measured in calories) to maintain a healthy weight.
• Choosing foods low in saturated fat, sodium (salt), and added sugars.

To learn more about healthy eating, visit the U.S. Department of Agriculture’s (USDA’s) MyPlate.gov website.

HIV and HIV medicines can sometimes cause nutrition-related problems. For example, some HIV-related infections can make it hard to eat or swallow. Side effects from HIV medicines, such as loss of appetite, nausea, or diarrhea, can also make it hard to stick to an HIV regimen. 

If you have HIV and are having a nutrition-related problem, talk to your health care provider. Otherwise, to avoid nutrition-related problems, people with HIV must also pay attention to food safety.

Food and water can be contaminated with germs that cause illnesses (called foodborne illnesses or food poisoning). Food safety is about how to select, handle, prepare, and store food to prevent foodborne illnesses. For instance, the Food and Drug Administration (FDA) provides guidelines on the minimum food temperatures to use when cooking to prevent foodborne illnesses.

Water quality is also important because most people drink and cook with water. While there are many regulations in the United States to help make sure people have access to clean water, it’s important to read local water quality reports and to test your own water supply to make sure you aren’t consuming harmful germs or chemicals.

Because HIV damages the immune system, foodborne illnesses are likely to be more serious and last longer in people with HIV than in people with a healthy immune system. Following food safety guidelines reduces the risk of foodborne illnesses.

If you have HIV, follow these food safety guidelines to reduce your risk of foodborne illnesses:

Do not eat or drink the following foods:

• Raw eggs or foods that contain raw eggs, such as homemade cookie dough
• Raw or undercooked poultry, meat, and seafood
• Milk, dairy products, and fruit juices that are unpasteurized

Follow the four basic steps to food safety: clean, separate, cook, and chill.

• Clean: Wash your hands, cooking utensils, and countertops often when preparing food.
• Separate: Separate foods to prevent the spread of any germs from one food to another. For example, keep raw meat, poultry, seafood, and eggs separate from foods that are ready to eat, including fruits, vegetables, and breads.
• Cook: Use a food thermometer to make sure that foods are cooked to safe temperatures (see the FDA’s Safe Minimal Internal Temperature Chart).
• Chill: Refrigerate or freeze meat, poultry, eggs, seafood, or other foods that are likely to spoil within 2 hours of cooking or purchasing.

For more information, visit the FDA’s Food Safety for Older Adults and People with Cancer, Diabetes, HIV/AIDS, Organ Transplants, and Autoimmune Diseases webpage. If you are planning a trip outside the United States, read the Centers for Disease Control and Prevention’s (CDC’s) recommendations on Traveling With HIV.

From the Health Resources and Services Administration:

• Guide for HIV/AIDS Clinical Care: Nutrition

From the CDC:

• Living With HIV
• Water Quality and Your Health

From the U.S. Department of Veterans Affairs:

• Living With HIV: Nutrition and Exercise

From the USDA:

• MyPlate.gov

Also see the HIV Source collection of HIV links and resources.

Substance use refers to the use of recreational drugs and alcohol as well as the misuse of prescription drugs and over-the-counter medicines. Examples of each of these substances include: 

• Alcohol: Beer, wine, and liquor

• Recreational Drugs: Opioids (such as heroin), methamphetamine (meth), cocaine, and inhalants (poppers)

• Prescription Drugs: Amphetamines (such as Adderall), depressants (such as Xanax), pain killers (such as Vicodin), and sleep medicines (such as Ambien)

• Over-the-counter Medicines: Cough medicine and laxatives (for weight loss)

Substance use is related to HIV in the following ways:

• Use of alcohol and recreational drugs can lead to risky behaviors that increase the chances of getting HIV or passing it on to others (called HIV transmission).

• Some prescription drugs and over-the-counter medicines contain stimulants that can also lead to risky behaviors when misused.

• The use of recreational drugs and alcohol can weaken the immune system and damage the liver.

Drug and alcohol use affects the brain (including memory, attention, and reasoning), impairs clear thinking, and increases the likelihood of poor decisions and risky behaviors. Using prescription drugs and over-the-counter medicines for purposes other than prescribed, in excessive amounts, or over a longer period than necessary can have similar effects.

Some risky behaviors can increase the risk of getting or transmitting HIV. For example, a person using drugs or alcohol may have sex without a condom or share needles when injecting drugs.

In the United States, HIV is spread mainly by:

• Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV
• Sharing injection drug equipment (works), such as needles, with someone who has HIV

Substance use can harm the health of a person with HIV in several ways, including reduced immune function, reduced liver function, or adverse reactions with HIV medicines.

Drugs and alcohol can weaken the immune system.
HIV damages the immune system, making it harder for the body to fight infections and certain cancers. While HIV medicines can effectively improve immune function, drugs and alcohol can counteract those effects.

Drugs and alcohol can damage the liver and cause liver disease.
One of the main functions of the liver is to remove harmful substances (toxins) from the blood. Toxins are produced when the liver breaks down the chemicals in drugs or alcohol.

Drug and alcohol use can damage the liver, making it harder to remove toxins from the body. The buildup of toxins can weaken the body and lead to liver disease.

Some recreational drugs can interact with HIV medicines.
Drug interactions between HIV medicines and recreational drugs can increase the risk of dangerous side effects. For example, overdoses have been linked to interactions between some HIV medicines and recreational drugs, such as ecstasy (MDMA) or painkillers.

Drug and alcohol use can make it hard to take HIV medicines as prescribed.
People with HIV often take HIV medicines (called an HIV treatment regimen) on a strict daily or monthly schedule. Drug or alcohol use can make it hard to focus and stick to an HIV treatment regimen. Skipping HIV medicines allows HIV to multiply and damage the immune system.

If you use drugs or alcohol:

• Do not have sex if you are high or drunk.
• Use a condom correctly every time you have sex. Read this fact sheet from the Centers for Disease Control and Prevention (CDC) on how to use condoms correctly.

If you drink alcohol:

• Drink in moderation. Moderate drinking is up to one drink per day for women and up to two drinks per day for men. One drink is a 12-oz bottle of beer, a 5-oz glass of wine, or 1.5-oz shot of liquor.
• Visit Rethinking Drinking, a website from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This website can help you evaluate your drinking habits and consider how alcohol may be affecting your health.

If you inject drugs:

• Use only new, sterile needles and drug injection equipment (works) each time you inject.
• Never share needles and works. Syringe Service Programs may help provide resources to people who inject drugs.
• Visit CDC’s webpage on injection drug use for more information on how to reduce the risk of getting or transmitting HIV from injection drug use.

Therapy, medicines, and other methods are also available to help you stop or cut down on drinking alcohol or using drugs. You can talk with a counselor or a health care provider about options that might be right for you. 

To find a substance abuse treatment center near you, visit the Substance Abuse and Mental Health Services Administration’s treatment locator or call 1-800-662-HELP (4357).

From CDC:

• HIV and Injection Drug Use 
• HIV and Substance Use
• Preventing HIV

From the NIH Office of AIDS Research: 

• Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV:
  • Substance Use Disorders and HIV

From the Department of Veterans Affairs:

• Drugs, Alcohol, and HIV

From the Department of Health and Human Services, Office of Disease Prevention and Health Promotion:

• 2015 – 2020 Dietary Guidelines for Americans: Appendix 9. Alcohol

From HIV.gov:

• Substance Use and HIV Risk

From the National Cancer Institute:

• Substance Abuse 

From the National Institute on Drug Abuse (NIDA):

• Drug Use and Viral Infections (HIV, Hepatitis) Drug Facts

• Misuse of Prescription Drugs Research Report: Overview

• Over-the-Counter Medicines Drug Facts

From the Substance Abuse and Mental Health Services Administration:

• Chronic Substance Use and Cognitive Effects on the Brain: An Introduction

Also see the HIV Source collection of HIV links and resources.