I was recently diagnosed with HIV but I am not on medications. I heard when you are on meds, you have a lot of side effects. I would rather opt for a healthy lifestyle. What is your opinion on this?

L.K.

Your question is very common among those who are recently diagnosed with HIV (human immunodeficiency virus, the virus that causes AIDS) Many patients with HIV have been previously healthy and have never taken any medications in their lives. Often, such people had taken the HIV test as a screening test, not because they felt ill at all. These factors may make a person feel that the key to remaining healthy is opting for a healthy lifestyle. But while patients with HIV do derive some benefit from exercise and eating well, it is not good enough for most patients.

As you may know, after infection with HIV, it takes an average of 10 to 12 years for a patient to die of AIDS. Some people do better than this, while others do worse. Until about six years ago, there were not many good treatments to attack the virus itself and alter the course of the disease. Most of what physicians did was give medication to prevent certain infections from developing.

Today, there are many antiviral drugs that directly fight the virus. The protease inhibitors, as part of a several-medication "cocktail," have been shown to improve a patient's immunity. In fact, many studies have shown that these drugs decrease the rate of progression to AIDS -- that is, these drugs prolong the life of HIV-positive patients. The U.S. death rate due to AIDS has leveled off and declined in the last few years, in large part because of these treatments. I think anyone with HIV would be naive to think that a healthy lifestyle could replace these proven therapies.

It is true that many of these medications have side effects. Every medication does. However, most of these side effects are reversible and manageable. I often have patients who are worried about various side effects of many medications, not just HIV drugs. I tell them this: Try the medicines. If you cannot tolerate the side effects, you can always stop taking them. There will usually be another choice of medication that is almost as effective. I suggest you find a physician skilled in caring for patients with HIV, and find out if treatment is a good idea in your case.