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

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 others, your tentmate, crew 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 riders.

Medical Tips

  • Before the Ride:
    • Make a list of all your medications and doses and keep it with you.
    • Talk with your doctor about the Ride 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 Ride:
    • 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.