What Most People Don’t Know About HIV
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What To Know About HIV This World AIDS Day
Yesterday, we asked you to engage in a hypothetical thought experiment with us, and putting aside for a moment any reason you might feel the scenario wouldn’t apply for you, asked:
❝You have unprotected sex with someone who, afterwards, conversationally mentions their HIV+ status. Do you…❞
…and got the above-depicted, below-described, set of responses. Of those who responded…
- Just over 60% said “rush to hospital; maybe a treatment is available”
- Just under 20% said “ask them what meds they’re taking (and perhaps whether they’d like a snack)”
- Just over 10% said “despair; life is over”
- Two people said “do the most rigorous washing down there you’ve ever done in your life”
So, what does science say about it?
First, a quick note on terms
- HIV is the Human Immunodeficiency Virus. It does what it says on the tin; it gives humans immunodeficiency. Like many viruses that have become epidemic in humans, it started off in animals (called SIV, because there was no “H” involved yet), which were then eaten by humans, passing the virus to us when it one day mutated to allow that.
- It’s technically two viruses, but that’s beyond the scope of today’s article; for our purposes they are the same. HIV-1 is more virulent and infectious than HIV-2, and is the kind more commonly found in most of the world.
- AIDS is Acquired Immunodeficiency Syndrome, and again, is what it sounds like. When a person is infected with HIV, then without treatment, they will often develop AIDS.
- Technically AIDS itself doesn’t kill people; it just renders people near-defenseless to opportunistic infections (and immune-related diseases such as cancer), since one no longer has a properly working immune system. Common causes of death in AIDS patients include cancer, influenza, pneumonia, and tuberculosis.
People who contract HIV will usually develop AIDS if untreated. Untreated life expectancy is about 11 years.
HIV/AIDS are only a problem for gay people: True or False?
False, unequivocally. Anyone can get HIV and develop AIDS.
The reason it’s more associated with gay men, aside from homophobia, is that since penetrative sex is more likely to pass it on…
- If a man penetrates a woman and passes on HIV, that woman will probably not go on to penetrate someone else
- If a man penetrates a man and passes on HIV, that man could go on to penetrate someone else—and so on
- This means that without any difference in safety practices or promiscuity, it’s going to spread more between men on average, by simple mathematics.
- This is why “men who have sex with men” is the generally-designated higher-risk category.
There is medication to cure HIV/AIDS: True or False?
False (though there have been individual case studies of gene treatments that may have cured people—time will tell).
But! There are medications that can prevent HIV from being a life-threatening problem:
- PrEP (Pre-Exposure Prophylaxis) is a medication that one can take in advance of potential exposure to HIV, to guard against it.
- This is a common choice for people aren’t sure about their partners’ statuses, or people working in risky environments.
- PEP (Post-Exposure Prophylaxis) is a medication that one can take after potential exposure to HIV, to “nip it in the bud”.
- Those of you who were rushing to hospital in our poll, this is what you’re rushing there for.
- ARVs (Anti-RetroVirals) are a class of medications (there are different options; we don’t have room to distinguish them) that reduce an HIV+ person’s viral load to undetectable levels.
- Those of you who were asking what meds your partner was taking, these will be those meds. Also, most of them are to be taken in the morning with food, so that’s what the snack was for.
If someone is HIV+, the risk of transmission in unprotected sex is high: True or False?
True or False, with false being the far more likely. It depends on their medications, and this is why you were asking. If someone is on ARVs and their viral load is undetectable (as is usual once someone has been on ARVs for 6 months), they cannot transmit HIV to you.
U=U is not a fancy new emoticon, it means “undetectable = untransmittable”, which is a mathematically true statement in the case of HIV viral loads.
See: NIH | HIV Undetectable=Untransmittable (U=U)
If you’re thinking “still sounds risky to me”, then consider this:
You are safer having unprotected sex with someone who is HIV+ and on ARVs with an undetectable viral load, than you are with someone you are merely assuming is HIV- (perhaps you assume it because “surely this polite blushing young virgin of a straight man won’t give me cooties” etc)
Note that even your monogamous partner of many decades could accidentally contract HIV due to blood contamination in a hospital or an accident at work etc, so it’s good practice to also get tested after things that involve getting stabbed with needles, cut in a risky environment, etc.
If you’re concerned about potential stigma associated with HIV testing, you can get kits online:
CDC | How do I find an HIV self-test?
(these are usually fingerprick blood tests, and you can either see the results yourself at home immediately, or send it in for analysis, depending on the kit)
If I get HIV, I will get AIDS and die: True or False?
False, assuming you get treatment promptly and keep taking it. So those of you who were at “despair; life is over” can breathe a sigh of relief now.
However, if you get HIV, it does mean you will have to take those meds every day for the rest of your (no reason it shouldn’t be long and happy) life.
So, HIV is definitely still something to avoid, because it’s not great to have to take a life-saving medication every day. For a little insight as to what that might be like:
HIV.gov | Taking HIV Medication Every Day: Tips & Challenges
(as you’ll see there, there are also longer-lasting injections available instead of daily pulls, but those are much less widely available)
Summary
Some quick take-away notes-in-a-nutshell:
- Getting HIV may have been a death sentence in the 1980s, but nowadays it’s been relegated to the level of “serious inconvenience”.
- Happily, it is very preventable, with PrEP, PEP, and viral loads so low that they can’t transmit HIV, thanks to ARVs.
- Washing will not help, by the way. Safe sex will, though!
- As will celibacy and/or monogamy in seroconcordant relationships, e.g. you both have the same (known! That means actually tested recently! Not just assumed!) HIV status.
- If you do get it, it is very manageable with ARVs, but prevention is better than treatment
- There is no certain cure—yet. Some people (small number of case studies) may have been cured already with gene therapy, but we can’t know for sure yet.
Want to know more? Check out:
Take care!
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Peace Is Every Step – by Thích Nhất Hạnh
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Mindfulness is one of the few practices to make its way from religion (in this case, Buddhism) into hard science. We’ve written before about its many evidence-based benefits, and many national health information outlets recommend it. So, what does this book have to add?
Thích Nhất Hạnh spent most of his 95 years devoted to the practice and teaching of mindfulness and compassion. In this book, the focus is on bringing mindfulness off the meditation mat and into general life.
After all, what if we could extend that “unflappability” into situations that pressure and antagonize us? That would be some superpower!
The author offers techniques to do just that, simple exercises to transform negative emotions, and to make us more likely to remember to do so.
After all, “in the heat of the moment” is rarely when many of us are at our best, this book gives way to allow those moments themselves to serve as immediate triggers to be our best.
The title “Peace Is Every Step” is not a random collection of words; the goal of this book is to enable to reader to indeed carry peace with us as we go.
Not just “peace is always available to us”, but if we do it right: “we have now arranged for our own peace to automatically step in and help us when we need it most”.
Bottom line: if you’d like to practice mindfulness, or practice it more consistently, this book offers some powerful tools.
Click here to check out Peace Is Every Step, and carry yours with you!
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It’s Not You, It’s Your Hormones – by Nicki Williams, DipION, mBANT, CNHC
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So, first a quick note: this book is very similar to the popular bestseller “The Galveston Diet”, not just in content, but all the way down to its formatting. Some Amazon reviewers have even gone so far as to suggest that “It’s Not You, It’s Your Hormones” (2017) brazenly plagiarized “The Galveston Diet” (2023). However, after carefully examining the publication dates, we feel quite confident that this book is not a copy of the one that came out six years after it. As such, we’ve opted for reviewing the original book.
Nicki Williams’ basic principle is that we can manage our hormonal fluctuations, by managing our diet. Specifically, in three main ways:
- Intermittent fasting
- Anti-inflammatory diet
- Eating more protein and healthy fats
Why should these things matter to our hormones? The answer is to remember that our hormones aren’t just the sex hormones. We have hormones for hunger and satedness, hormones for stress and relaxation, hormones for blood sugar regulation, hormones for sleep and wakefulness, and more. These many hormones make up our endocrine system, and affecting one part of it will affect the others.
Will these things magically undo the effects of the menopause? Well, some things yes, other things no. No diet can do the job of HRT. But by tweaking endocrine system inputs, we can tweak endocrine system outputs, and that’s what this book is for.
The style is very accessible and clear, and Williams walks us through the changes we may want to make, to avoid the changes we don’t want.
Bottom line: this book is aimed at peri-menopausal and post-menopausal women. It could also definitely help a lot of people with PCOS too, and, when it comes down it it, pretty much anyone with an endocrine system. It’s a well-evidenced, well-established, healthy way of eating regardless of age, sex, or (most) physical conditions.
Click here to check out It’s Not You, It’s Your Hormones, and take control of yours!
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Train For The Event Of Your Life!
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Mobility As A Sporting Pursuit
As we get older, it becomes increasingly important to treat life like a sporting event. By this we mean:
As an “athlete of life”, there are always events coming up for which we need to train. Many of these events will be surprise tests!
Such events/tests might include:
- Not slipping in the shower and breaking a hip (or worse)
- Reaching an item from a high shelf without tearing a ligament
- Getting out of the car at an awkward angle without popping a vertebra
- Climbing stairs without passing out light-headed at the top
- Descending stairs without making it a sled-ride-without-a-sled
…and many more.
Train for these athletic events now
Not necessarily this very second; we appreciate you finishing reading first. But, now generally in your life, not after the first time you fail such a test; it can (and if we’re not attentive: will) indeed happen to us all.
With regard to falling, you might like to revisit our…
…which covers how to not fall, and to not injure yourself if you do.
You’ll also want to be able to keep control of your legs (without them buckling) all the way between standing and being on the ground.
Slav squats or sitting squats (same exercise, different names, amongst others) are great for building and maintaining this kind of strength and suppleness:
(Click here for a refresher if you haven’t recently seen Zuzka’s excellent video explaining how to do this, especially if it’s initially difficult for you, “The Most Anti-Aging Exercise”)
this exercise is, by the way, great for pretty much everything below the waist!
You will also want to do resistance exercises to keep your body robust:
Resistance Is Useful! (Especially As We Get Older)
And as for those shoulders? If it is convenient for you to go swimming, then backstroke is awesome for increasing and maintaining shoulder mobility (and strength).
If swimming isn’t a viable option for you, then doing the same motion with your arms, while standing, will build the same flexibility. If you do it while holding a small weight (even just 1kg is fine, but feel free to increase if you so wish and safely can) in each hand will build the necessary strength as you go too.
As for why even just 1kg is fine: read on
About that “and strength”, by the way…
Stretching is not everything. Stretching is great, but mobility without strength (in that joint!) is just asking for dislocation.
You don’t have to be built like the Terminator, but you do need to have the structural integrity to move your body and then a little bit more weight than that (or else any extra physical work could be enough to tip you to breaking point) without incurring damage from the strain. So, it needs to not be a strain! See again, the aforementioned resistance exercises.
That said, even very gentle exercise helps too; see for example the impact of walking on osteoporosis:
Living near green spaces linked to higher bone density and lower osteoporosis risk
and…
So you don’t have to run marathons—although you can if you want:
Marathons in Mid- and Later-Life
…to keep your hips and more in good order.
Want to test yourself now?
Check out:
Building & Maintaining Mobility
Take care!
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The Doctor’s Kitchen – by Dr. Rupy Aujla
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We’ve featured Dr. Aujla before as an expert-of-the-week, and now it’s time to review a book by him. What’s his deal, and what should you expect?
Dr. Aujla first outlines the case for food as medicine. Not just “eat nutritionally balanced meals”, but literally, “here are the medicinal properties of these plants”. Think of some of the herbs and spices we’ve featured in our Monday Research Reviews, and add in medicinal properties of cancer-fighting cruciferous vegetables, bananas with dopamine and dopamine precursors, berries full of polyphenols, hemp seeds that fight cognitive decline, and so forth.
Most of the book is given over to recipes. They’re plant-centric, but mostly not vegan. They’re consistent with the Mediterranean diet, but mostly Indian. They’re economically mindful (favoring cheap ingredients where reasonable) while giving a nod to where an extra dollar will elevate the meal. They don’t give calorie values etc—this is a feature not a bug, as Dr. Aujla is of the “positive dieting” camp that advocates for us to “count colors, not calories”. Which, we have to admit, makes for very stress-free cooking, too.
Dr. Aujla is himself an Indian Brit, by the way, which gives him two intersecting factors for having a taste for spices. If you don’t share that taste, just go easier on the pepper etc.
As for the medicinal properties we mentioned up top? Four pages of references at the back, for any who are curious to look up the science of them. We at 10almonds do love references!
Bottom line: if you like tasty food and you’re looking for a one-stop, well-rounded, food-as-medicine cookbook, this one is a top-tier choice.
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Cooking for Longevity – by Nisha Melvani
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Before it gets to the recipes, this book kicks off with a lot of science (much more than is usual for even healthy-eating recipe books), demystifying more nutrients than most people think of on a daily basis, what they do and where to get them, and even how to enhance nutrient absorption.
As well as an up-front ingredients list, we additionally get not just meal planning advice in the usual sense of the word, but also advice on timing various aspects of nutrition in order to enjoy the best metabolic benefits.
The recipes themselves are varied and good. It’s rare to find a recipe book that doesn’t include some redundant recipes, and this one’s no exception, but it’s better to have too much information than too little, so it’s perhaps no bad thing that all potentially necessary bases are covered.
In terms of how well it delivers on the title’s promised “cooking for longevity” and the subtitle’s promised “boosting healthspan”, the science is good; very consistent with what we write here at 10almonds, and well-referenced too.
Bottom line: if you’d like recipes to help you live longer and more healthily, then this book has exactly that.
Click here to check out Cooking For Longevity, and cook for longevity!
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Fast Diet, Fast Exercise, Fast Improvements
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Diet & Exercise, Optimized
This is Dr. Michael Mosley. He originally trained in medicine with the intention of becoming a psychiatrist, but he grew disillusioned with psychiatry as it was practised, and ended up pivoting completely into being a health educator, in which field he won the British Medical Association’s Medical Journalist of the Year Award.
He also died under tragic circumstances very recently (he and his wife were vacationing in Greece, he went missing while out for a short walk on the 5th of June, appears to have got lost, and his body was found 100 yards from a restaurant on the 9th). All strength and comfort to his family; we offer our small tribute here today in his honor.
The “weekend warrior” of fasting
Dr. Mosley was an enjoyer (and proponent) of intermittent fasting, which we’ve written about before:
Fasting Without Crashing? We Sort The Science From The Hype
However, while most attention is generally given to the 16:8 method of intermittent fasting (fast for 16 hours, eat during an 8 hour window, repeat), Dr. Mosley preferred the 5:2 method (which generally means: eat at will for 5 days, then eat a reduced calorie diet for the other 2 days).
Specifically, he advocated putting that cap at 800 kcal for each of the weekend days (doesn’t have to be specifically the weekend).
He also tweaked the “eat at will for 5 days” part, to “eat as much as you like of a low-carb Mediterranean diet for 5 days”:
❝The “New 5:2” approach involves restricting calories to 800 on fasting days, then eating a healthy lower carb, Mediterranean-style diet for the rest of the week.
The beauty of intermittent fasting means that as your insulin sensitivity returns, you will feel fuller for longer on smaller portions. This is why, on non-fasting days, you do not have to count calories, just eat sensible portions. By maintaining a Mediterranean-style diet, you will consume all of the healthy fats, protein, fibre and fresh plant-based food that your body needs.❞
Read more: The Fast 800 | The New 5:2
And about that tweaked Mediterranean Diet? You might also want to check out:
Four Ways To Upgrade The Mediterranean Diet
Knowledge is power
Dr. Mosley encouraged the use of genotyping tests for personal health, not just to know about risk factors, but also to know about things such as, for example, whether you have the gene that makes you unable to gain significant improvements in aerobic fitness by following endurance training programs:
The Real Benefit Of Genetic Testing
On which note, he himself was not a fan of exercise, but recognised its importance, and instead sought to minimize the amount of exercise he needed to do, by practising High Intensity Interval Training. We reviewed a book of his (teamed up with a sports scientist) not long back; here it is:
Fast Exercise: The Simple Secret of High Intensity Training – by Dr. Michael Mosley & Peta Bee
You can also read our own article on the topic, here:
How To Do HIIT (Without Wrecking Your Body)
Just One Thing…
As well as his many educational TV shows, Dr. Mosley was also known for his radio show, “Just One Thing”, and a little while ago we reviewed his book, effectively a compilation of these:
Just One Thing: How Simple Changes Can Transform Your Life – by Dr. Michael Mosley
Enjoy!
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Learn to Age Gracefully
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