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.

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

• 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

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.