Maintaining a Healthy Body Image With HIV


Chris Iliades, MD

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You're probably working hard to manage all the physical aspects of HIV. Don't ignore the emotional issues that may be bothering you, too.

Issues Affecting Your Self-Esteem

An HIV diagnosis can be devastating to self-esteem. You may feel a certain stigma, a loss of support, and a tremendous amount of stress. You may face relationship problems when you tell a new partner that you're HIV positive.

Managing HIV goes beyond just taking your medications—you’ve also got to live a healthy life. These patients and physicians share how you can give your body what it needs to thrive with HIV.

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Your self-esteem could suffer from these HIV-related issues:

  • Post-traumatic stress disorder (PTSD)

  • Depression

  • Anxiety

Also, your HIV treatments can cause side effects that affect your mood and make it hard to feel good about yourself. You may lose your sex drive, experience fatigue, have nightmares, become nervous, and feel confused.

Issues Affecting Your Sexuality

You don't have to give up your sex life because of HIV. With today’s treatments, you can remain sexually active and enjoy many years of healthy sex. However, you may find it hard to think about sex if you're struggling with your sexuality and sexual health.

You may be facing:

  • Worries about safe sex

  • Worries about unintended pregnancy

  • Loss of desire and satisfaction

  • Side effects of medication

Issues Affecting Your Body Image

You may have body image issues if you're overweight, underweight, or out of shape. You can solve most of these problems by working with your doctor to find a good diet and exercise plan.

You may also be struggling with HIV-related lipodystrophy. Up to 75% of people taking HIV medications experience this buildup of body fat or a loss of body fat. The changes may also be due to HIV itself.

Symptoms of lipodystrophy include:

  • Increased fat in your breasts and belly (accumulating around deep abdominal organs)

  • Fatty hump between the shoulders

  • Loss of fat from your face, arms, legs, and bottom

  • Lumps beneath your skin

What to Do About Self-Esteem, Sexuality, and Body Image

If you are dealing with self-esteem issues, ask for help. Talk to your doctor about mental health counseling. Help is available for depression or PTSD, domestic violence, child care, and substance abuse.

Talk to your doctor and your partner about sexuality issues. Try bringing your partner with you to a doctor visit. Or you may be able to work out relationship problems with the help of a sexual health therapist.

If you have lipodystrophy, ask about switching to another HIV medication. Don’t just stop your HIV medications on your own though. Liposuction may also help, but fat recurrence is common. Select patients benefit from taking the oral diabetic drug metformin. And injectable cosmetic fillers can provide temporary relief for facial fat.

Join an HIV support group to share feelings and find solutions to these problems. You have the right to feel good about yourself and have a healthy sex life.

Key Takeaways

  • Sexuality, self-esteem, and body image issues are common when you have HIV.

  • Managing emotional and mental health issues is as important as caring for physical issues if you want to live well with HIV.

  • Talk to your medical team to get help with body image and sexuality issues.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Jan 8, 2016

© 2018 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Side Effects of HIV Medicines: HIV and Lipodystrophy. AIDSinfo.
  2. Sex and Sexuality, University of California, San Francisco.
  3. Body Shape Changes (Lipodystrophy). AIDS Info Net.
  4. Wilson TE, et al. HIV Infection and Women's Sexual Functioning. J Acquir Immune Defic Syndr. 2010;54(4):360-367. 
  5. Mental health and HIV/AIDS.

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