HIV+ Participants

The following health tips for HIV+ participants are courtesy of Positive Pedalers of California, with revisions by Paolo Troia-Cancio, Medical Director of CARES and Assistant Clinical Professor of Medicine, Division of Infectious and Immunologic Diseases, UC Davis Medical Center; and, Guillermo Acuna, PhD., Health Educator for CARES.

Please note that this list is not inclusive of all possible circumstances. Consult your physician before beginning your training.

Nutrition

  • Eat 2-3 times a day, even if you’re not hungry.
  • HIV+ Cyclists need more protein – take a supply of supplement bars and drinks, especially if keeping weight on is a challenge.
  • Food-drug interactions
    • Grapefruit juice may increase blood levels of non-nukes: (Rescriptor; Sustiva; Viramune) and Pis: (Lexiva, Agenerase, Crixivan, Fortovase, Invirase, Kaletra, Norvir, Reyataz, Viracept). Consider not drinking grapefruit juice during the event.
    • Caffeine may increase dehydration.
    • Alcohol can also increase dehydration.
    • Special attention in both cases if you’re taking Crixivan, which requires additional fluid intake to prevent kidney stones.
  • Food supplement-drug interactions
    • Mega Garlic Supplements (regular garlic in food is fine) can decrease Fortovase and other protease inhibitors levels in your body.
    • St. Johns Wort decreases amount of Crixivan and other PIs (see above) in your body.
    • High levels of Vitamin E already included in Agenerase.
    • The old Videx tablets contain Antacid.
  • Meds that need to be taken WITH FOOD
  • Norvir
  • Reyataz (no antacids)
  • Kaletra
  • Viracept
  • Fortovase
  • Invirase
  • Meds that need to be taken on an EMPTY STOMACH; i.e. one hour before or two hours after a meal.
    • Videx, Videx EC
    • Crixivan (a light low-fat snack is alright), can’t take together with the old Videx tablets (Videx EC is fine)
    • Sustiva (food increases med levels in blood, which can increase side effects)
  • Meds that can be taken WITH OR WITHOUT FOOD
    • Epivir
    • AZT
    • Combivir
    • Ziagen
    • Epzicom
    • Viread
    • Truvada
    • Trizivir
    • Zerit
    • Viramune
    • Rescriptor
    • Fuzeon
    • Lexiva
    • Agenerase
    • Crixivan (but only if taken together with Norvir)

Hydration

  • Drink a balance of water and electrolyte replacement fluids.
  • Be sure to ask event volunteers if ice is filtered.
  • Drink water all day and all evening long! Dehydration can continue while you sleep, so keep a full water bottle with you at night to drink.
  • Adequate fluids are especially important with Septra/Bactrim, or any other antibiotic.
  • If you take Crixivan, keep a close watch on your fluid intake to avoid problems with your kidneys. You need to add an additional 1.5 liters above your replacement fluid requirement [which is already increased from exercise and exposure].

Side Effects

  • The big ones are diarrhea, nausea, indigestion, and headache.
  • Diarrhea: expect to get it! Many things can contribute to diarrhea during the ride: heat, stress, change in foods, etc. As all these things can add to existing GI side effects. Be prepared! Take Imodium or lamotil with you!
  • Nausea and indigestion: before the ride, think about what upsets your stomach. Vitamins? Certain vegetables? Spices? Some of your medicines? Avoid foods that do this.
  • Taking medicines with food can help reduce nausea and indigestion.
  • A few tips: cool foods help calm your stomach. Hard candies can sometimes help. Get out of the sun, and rest as much as you can. A cool cloth on your head and/or wrist can help to alleviate heat.
  • Headache: dehydration can cause headache, take some ibuprofen or acetaminophen with you. Also, stopping caffeine abruptly can cause headache, so if you drink coffee regularly, drink it on the ride.
  • Besides the medicines, the sun, the new food, and the stress can contribute to existing side effects.
  • Bottom line: if you’re not feeling right, tell somebody and get help. Talk with other Positive Pedalers, your tent mate or riding partner. Nothing is more important than staying well.
  • Do not hesitate to consult medical personnel for questions and concerns.

Adherence

  • You’re out of your normal setting – how will you remember to take your medicines? Make a plan before you leave. Discuss treatment options and tips for adherence with your medical provider and/or other Positive Pedalers.

Medical Tips

  • Before the Challenge:
    • Make a list of all your medications and doses and keep it with you.
    • Talk with your doctor about the Challenge and ask about special needs before you leave.
    • Make sure you have your medical provider information and telephone numbers.
    • Best not to start a new regimen within one month before the ride.
  • During the Challenge:
    • Keep medications out of direct sunlight, as much as possible.
    • Medication sets may be easier to deal with on rides than individual pill bottles; these are readily available at pharmacies or often from medical providers.
    • No anti-retrovirals need to be refrigerated if they’ll be used within one month.
    • If you have special needs or feeling “off”, always check in with medical personnel in camp or at rest stop.

Sun

  • Sun causes dehydration – drink plenty of water and electrolyte replacement fluids!
  • Septra/Bactrim and some antibiotics, such as doxycycline and tetracycline, cause sun sensitivities. Wear high SPF sunscreen on all exposed body parts and reapply regularly – you’re sweating the sunscreen off, too!
  • Use plenty of sunscreen with SPF even if you’re not taking antibiotics.

Hygiene

  • If you have the opportunity to wash your hands, use warm water and wash for 15 seconds.
  • Wash hands or use Purell/antibiotic lotion/sanitizer after using the portable toilets and bathroom whenever possible. Carry your own supply in case it is not available at all locations.

Wash hands in evening camp before all meals.