Improvements in antiretroviral (ARV) therapy, a better understanding of the virus and fewer people testing late have improved the outcomes for most people with HIV. The images of wasted faces and bodies covered with lesions are largely history; although HIV is not the death sentence it once was a diagnoses is still a traumatic event for most people.  However, once people come to terms with their infection, their thoughts inevitably turn to quality and length of life. Recent research has suggested the length of life has improved dramatically over the last 10 years – a 20-year-old HIV-positive person starting antiretroviral ARV therapy today can expect to live, on average, to the age of 69, according to results published in The Lancet. The study involved over 40,000 patients and found that Life expectancy at age 20 years increased from 36•1 (1996-99) years to 49•4 (2003-05).

Although life expectancy has increased people with HIV still, on average, face a shortened life expectancy. Given that ARV doesn’t eradicate HIV from the body, that HIV causes inflammation in the brain and heart and that most people suffer some immune damage it is logical to conclude that all things being equal the same person with HIV will have shorter life than they would otherwise have had.

However things are never equal – people are a product of their experiences and many people with HIV will take steps to improve their life chances once diagnosed. This can include quitting things that could be bad such as smoking, excessive recreational drug use or drinking or improving other areas of life such as taking more exercise and eating better. Some of these changes (such as quitting smoking) can have a very positive impact on life expectancy.

So the question for many people is not how long will I live but what else can I do to improve my chances of a long and happy life. Some things we have no control over such as hereditary conditions; others are common sense such as exercising regularly, eating well and giving up smoking.

The difficulty for many people living with HIV is that they will inevitably use the internet to look for other options to improve their health, where they will find confusing and conflicting advice.  They will be proffered vitamins, supplements and other interventions that are claimed to help alleviate treatment side effects or increase CD4 counts. It is estimated that more than half of all those with HIV will spend money on complementary or alternative medicines  – though most of these have never been scientifically proven to help and some might even cause harm .

For most people with HIV the areas of interest are:

• Alleviating side effects such as fatigue, sleep disorders, sexual dysfunction, gastrointestinal problems, facial wasting  or high cholesterol, bone or kidney problems etc…
• Improving CD4 count
• Protecting – against dementia, heart disease etc..

UKfAR has been specifically set up to help people living with HIV improve the length and quality of life. In some cases new and rigorous research will be needed which UKfAR will raise funds for. In other cases UKfAR will undertake systematic reviews of current research to find the answers. Members will guide this research and can suggest areas of investigation that they believe have been neglected here.