Drinking too much alcohol can have a range of long and short term effects on the body. Many of these are worse for people living with HIV.

Some studies have shown that after drinking the same amount, people living with HIV will have higher blood alcohol levels than people who don't have HIV, especially if they're not taking antiretroviral treatment. This means that they will feel the effects of alcohol more intensely and become drunk faster. Being drunk can be dangerous in the short term, as it lowers your perception of risk and makes you less in control of your body.

Drinking alcohol can damage your health in the long term too. Over time alcohol damages your liver. Some studies have shown that the livers of people living with HIV are more easily damaged by alcohol. If someone living with HIV also has hepatitis - a common co-infection with HIV - this damage can be even more serious, as having hepatitis can also cause serious damage to your liver.

Your liver plays an important role in processing your antiretroviral treatment, so for people living with HIV it's really important to keep it healthy. Having a damaged liver will mean that you are more likely to have side-effects to your antiretroviral treatment.

Some antiretroviral drugs can cause blood fat increases, which can be worsened if you drink heavily. Having more blood fat puts strain on your heart. This could increase your risk of heart diseases, which can be very serious.

‘Opportunistic infections', are illnesses or infections that are more likely to affect people with a weakened immune system. This includes people living with HIV with lower CD4 counts. For people with healthy immune systems, these infections are easier to fight off, making them both less likely to occur and less likely to be serious.

Opportunistic infections may vary depending on where you are, but they often include:

  • Thrush (also known as candidiasis): this is an infection caused by yeast. It can affect different areas of the body, including the mouth, vagina, penis and skin. It's very common, but can be more persistent and more serious in people living with HIV.
  • Cryptococcal meningitis: this is an infection that affects the brain and spine. It's caused by a fungus that can be inhaled. People with weak immune systems are less able to clear the infection by themselves. The results can be very painful, disabling and even fatal if not treated.
  • Pneumocystis pneumonia (PCP): this is a type of lung infection that's very rare in people who are HIV-negative. It can affect other areas of the body including the eyes, skin and liver. It's caused by a fungus and normally has respiratory symptoms such as a cough, difficult breathing and a temperature.

If you're living with HIV and taking your antiretroviral treatment, you're less likely to be affected by opportunistic infections. Keeping healthy and having a high CD4 count is your best protection from them. In some cases you will also be able to take preventative medication. Whether this is recommended may depend on your CD4 count.

Smoking is bad for everyone's health but the effects can be particularly serious for people living with HIV. Some studies have shown that people living with HIV are twice as likely to die as a result of smoking compared to people who don't have HIV.

Cigarettes contain ingredients that make the blood thicker. This increases your risk of getting blood clots and can put pressure on your heart. The added pressure on your heart can lead to you becoming more likely to get heart disease, which people living with HIV already face higher risks of. This is partly because of the effects of HIV itself and can also be a side-effect of some antiretroviral drugs, some of which can increase blood fat levels.

Smoking can also increase your risk of developing various types of cancer, especially lung cancer. For people living with HIV, cancer risk is already higher. If you want to try and quit smoking, speak to a healthcare worker for advice.