Living with HIV

There have been significant advances in the care and treatment of HIV, and with the right treatment, you can stay healthy. Here is a helpful tool online or can be picked up at the HIV Edmonton office! A Practical Guide to a Healthy Body for People Living with HIV, 2015 CATIE

Disclaimer
HIV Edmonton in good faith provides information resources to help people living with HIV and AIDS who wish to manage their own health care in partnership with their care providers. Information accessed through or published or provided by HIV Edmonton, however, is not to be considered medical advice. We do not recommend or advocate particular treatments and we urge users to consult as broad a range of sources as possible. We strongly urge users to consult with a qualified medical practitioner prior to undertaking any decision, use or action of a medical nature.

Coming to Alberta from another province

Coming to Alberta from another province:

Bring enough medication to last at least 3 months (preferably 6 months) from your existing province because it can take up to 3 months for a changeover from AB Health from another province to take effect.
All medication costs are covered in Alberta
For more information, please check the AB Health Insurance Program website
Find an Infectious Disease (ID) specialist (HIV Doctor) at the STI Clinic or the Northern Alberta Program (NAP) at the University of Alberta Hospital or the Royal Alexandra Hospital

Coming to Alberta from another country

All foreign nationals applying for permanent residence in Canada, and certain applicants for temporary residence, are required to undergo an immigration medical examination (including an HIV test).
The rules governing the eligibility of foreign students and temporary foreign workers for health insurance coverage very from one province or territory to another.
For a short term visitor coming for more than 6 months:
- Your HIV status will not be a barrier to entering Canada – no demand on publicly funded health and social services.
- Depending on the circumstances, you could be eligible for publicly funded health and social services. This depends on the length of your stay, whether you are eligible for health insurance under the rules of the province to which you are going, whether you have private health insurance, and your overall state of health.
For those seeking to enter Canada as a refugee: HIV status will NOT be a barrier.
For more information, please contact the Canadian HIV/AIDS Legal Network
Citizenship and Immigration Canada: htt://www.cic.gc.ca/english/index-can.asp

Once in you’ve arrived in Canada:
- Find an Infectious Disease (ID) specialist (HIV doctor) at the STI Clinic, or the Northern Alberta Program (NAP) at the University of Alberta Hospital or the Royal Alexandra Hospital in Edmonton
- Find a family doctor you are comfortable with as your ID specialist will only treat your HIV infection.

Disclosure:
- You only have a legal responsibility to tell your HIV status to your sexual partner. You may choose to disclose your status to other individuals such as your doctor, employer, family members and friends, etc. but you do not have a legal responsibility to tell them.
  - When do you have a legal duty to disclose your HIV-positive status to a sexual -partner? Here is a resource to help!
- The Supreme Court of Canada says that you must disclose your status before having sex that poses “a realistic possibility of transmitting HIV.” But the Court also found that almost any risk is “realistic,” no matter how small.
- Based on the Court’s decisions, you have a legal duty to disclose:
  - before having vaginal or anal sex without a condom (regardless of your viral load); or
  - before having vaginal or anal sex (even if you use a condom) with anything higher than a “low” viral load.

For more information, please contact the Canadian HIV/AIDS Legal Network.

Medications

HIV drug treatment is a combination of antiretrovirals that reduce HIV’s ability to make copies of itself. The drugs are not a cure and how long a combination works depends on not developing resistance and quality of life. There are a variety of options for treatment but it’s important to remember that once you start treatment you need to commit to that regimen for the rest of your life. Some things to think about and speak to your doctor about before starting treatment are side effects, long term effects of treatment, adherence, pill fatigue, and quality of life.

Some side effects include: digestive problems (nasea, vomiting, loss of appetite, diarrhea, gas), metabolic problems (fat redistribution, heart problems, diabetes), bone problems (bone death), liver problems, skin problems, problems with mental and emotional health, and peripheral neuropathy.
HIV drug resistance means that an individual’s HIV is no longer responding to the drugs used to treat it. Treatment failure is linked to drug resistance in 75% of people taking HIV drug therapy. Another factor in increasing drug resistance is the length of time that someone has been on a specific drug for. Individuals who have been on the ARV drug therapies for over 20 years have acquired greater resistance to some drugs compared to others.

For more information about HIV treatment medications go to http://www.catie.ca/en/practical-guides/hiv-drug-treatment/appendices or http://www.catie.ca/en/practical-guides/hiv-drug-treatment/appendices/e

Relationships

For sero-discordant or mixed-status couples, the possibility of HIV infection is a constant reality. There is always a risk, but you can minimize it.

If you are in a mixed-status relationship and you have sex (anal, oral, or vaginal), you can protect against HIV and other sexually transmitted infections by using condoms and dental dams consistently and correctly.

If you are part of a mixed-status couple, it is important that you and your partner communicate openly and often about safer sex practices and HIV prevention. Healthcare providers and local HIV and AIDS Service organizations can be important sources of information and support for you and your partner.

If you are the HIV-positive partner, you can lower the risk of transmitting HIV to your partner if you are on antiretroviral therapy. Taking all your medications, on time, will help to lower the viral load in your body fluids and decrease the chance that you will transmit HIV to your partner. But remember, even if you have a low viral load, you can still transmit HIV to your sex partner. So it is important to always use a condom and practice safer sex. And, if you inject drugs, never share syringes, water, or drug preparation equipment with others since HIV-infected blood can be transmitted through them. These cautions are important even if your partner is also HIV-positive. You and your partner may have different strains of HIV and cross infection could make treatment very complicated.

If you are the HIV-negative partner in a mixed-status relationship, talk with your partner about condoms and safer sex practices. If you are in an ongoing relationship with your partner, support him/her in taking all of his/her HIV medications at the right times. This "medication adherence" will lower his/her viral load and makes the risk negligible HIV can be transmitted. You may also want to stay up-to-date on developments about pre-exposure prophylaxis (PrEP) as this is an exciting addition to HIV prevention however condoms are still the only prevention that also prevents against other STIs.

HIV and Aging

Thanks to advances in treatment, people with HIV are living much longer than ever before. However, treating HIV can become more complicated as we get older. This is because the chances of having other health problems that also require treatment, such as high blood pressure, arthritis, or cancer also increase with age. Taking several drugs at the same time can raise your risk of drug interactions, side effects, and toxicities. This is why it is especially important to carefully monitor the medications you are taking. Some conditions associated with HIV and aging are:

Changes to the Immune System
Heart Disease
Early Menopause
Bone Loss
Cancer
Diabetes
Depression:

To find out about counselling services, support groups, and housing, income, and other supports in your area, contact your local AIDS service organization. You can also call CATIE toll-free at 1-800-1638, or visit www.catie.ca to find out about support services and AIDS service organizations near you.

Sexual Health
Cognitive Changes