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The holidays can be a bowl of mixed nuts: sweet, salty, highly caloric, and not always as satisfying as we'd like. At the top of the to-do list for many people living with HIV during the holidays? Thankfully, no one out there has to go at it alone: Plenty of people have to go through the holiday season with HIV. If you're worried about ending up on the naughty list for lack of adherence during this challenging time, we have a few tips to remind you how to make your health the best present of the season.

Planes, Trains and Automobiles

Eva Hansen is HIV positive and loves to travel and Eva told us, "If there's a plane leaving, I want to be on it!" She travels so much with her meds that she has a lot of tips on how to adhere when you're not in your own home:

"Some of my drugs need to be refrigerated, or kept on ice. So I found a way to cold-pack them and wrap them really well and put them in my suitcase. Or, some places I go, I just take the prescription bottles with me in a separate [case], and I also take a letter from my doctor saying that she has prescribed these medications for me, and her number, in case I have any trouble travelling."

Too Much on Your Plate, Literally

The holidays may not be a time for focusing on tip-top nutrition, but you can think about balance in your holiday diet. Many people living with HIV already have problems with fatigue, and if the holidays have you running a mile a minute, fatigue can set in very naturally. You can offset feelings of holiday fatigue by balancing your plate of sweet favorites with some good-for-you staples:

"Having a taste of your favorite foods is great, but complement that with foods that are good for you. Finding a balance that works for you allows you to eat what you enjoy while making sure your body has the nutrients it needs for appropriate energy to allow you to stay active during this busy time of the year."

A Cold Reception

The holidays are a time for cold weather in many parts of the world, but it can be worse if it's also a time for cold shoulders from family members. Some relatives may not be very supportive, or may not be able to get past the stigma they attach to HIV. Feeling alone or depressed can affect a person's ability to take their HIV meds on time. For those of you who feel that way, reach out to people who love you, go to support group meetings or visit your friends instead. Aaron Laxton has been there around holiday time, and has some advice to share: 

"Nobody has to be alone on the holidays. Everybody has somebody out there; you just have to seek them out. Make plans now and don't be alone. Also, your HIV status does not mean that people will not love you and people will not care for you. There are people out there who love you regardless of your HIV status."

Between Your Wallet and a Hard Place

You're buying presents for your parents, your siblings, your nieces and nephews. You're bringing bottles of wine to others' holiday parties. You're giving to charities. Yes, it's the season of giving, but charity starts at home. The best present you can give to your loved ones is your physical health. Don't cut corners with your meds to afford presents for others. Financial stress -- or too many money problems -- can lead to physical problems, including adherence issues.

"Meds: My meds are what keep me undetectable. Money: Money is what keeps me from sometimes getting my meds," HIV-positive working mom Brooke Davidoff writes; "My new health insurance is not so easy. I have to go into the pharmacy and pay for the meds at the time of pickup. I don't always have money in the bank when I need my refill."

Mixing Cocktails With Your Cocktail

Many HIV-positive individuals on treatment skip taking their meds if they plan to drink, under the false belief that mixing meds and alcohol is harmful. During the holidays, it's hard to go to a party, or even home for the holidays, without someone thrusting some alcoholic eggnog or cider in your face. Guess what: If you choose to drink, you don't have to worry! The main point is to stay adherent, regardless of what you're drinking.

"There are many who hold the belief, not only those with HIV infection but those with other chronic diseases, that if they mix their medications with alcohol it creates a toxic poison that is harmful. ... However, there is no evidence that mixing alcohol [with antiretroviral medications] increases the harm of the alcohol itself."

The New Normal

Yeah, the holidays mess up your schedule. But that doesn't mean you shouldn't take your meds.

"People sometimes worry about hitting the bull's-eye every time, every dose. It's not necessary with today's medications." If you miss the regular time, don't beat yourself up over it, just take them!

"What is essential is to find the easiest, or most reliable, part of the day (or night) and stick with it (give or take a few hours). Try a pillbox, or clock reminder. Some folks use their email or text messages to help. Link taking your medication to a routine, daily activity: brushing teeth, checking email, going to the bathroom, eating, etc."

Don't Let "Blue" Be the Only Holiday Color You See

There are a lot of reasons, many we've gone over, for the holiday blues. Times are hectic; many people have negative memories tied to the holiday season; you may have to change your schedule; you may have to face your family; and some people face becoming non-adherent due to various holiday stressors. Between the bleak weather and the media telling us it's the most wonderful time of the year, we're under a lot of pressure to be happy, and the pressure can sometimes be too much.

"Make the holidays a time when you won't watch television, listen to the radio, or read. In The Artist's Way, Julia Cameron wrote that we can unleash our creativity if we remove distractions like the media. You can buy some crayons and color if nothing else or you can write a hundred pages on your life to date. With glue, scissors, a scrap of cardboard, and a stack of magazines, you can make collages. Learn to let your creativity flow."

A Well-Tailored Treatment Plan Is Always in Fashion

Picking out an outfit for a big holiday gathering is a challenge. It can require days of window shopping before you find that perfect ensemble. According to fashion star and HIV-positive advocate Mondo Guerra, the same is true for finding an HIV med regimen, and HIV care providers, that work for you.

"If you ask questions, and you know how you're navigating the disease and how you're approaching your every day, if you know what you're taking and how it affects you, and you talk about all this to your doctor, your doctor's going to recognize that you really are taking control," says Mondo. In the midst of all that the shopping, eating and connecting with those dearest to your heart, find some time to make a pre-holiday appointment with your doctor. If you'll be going away, speak to him or her about any concerns you think might come up. Seeing your doctor before the holidays can be a one-way ticket to a successful season:

"Being HIV positive is a big job. But you want to work on your HIV treatment, and work with your doctor, so that you can be able to do the things that you love. Because without effective treatment, you're not going to be able to pursue bigger things. So that communication is really important."


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