HIV-Related Belly Fat: More Than Just an Appearance Issue

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

Excess belly fat, known in medical circles as VAT (visceral adipose tissue), is a type of hard fat that can affect people living with HIV-infection. Research has shown that between 20% and 30% of HIV-positive patients are experiencing excess VAT. For years, there’s been a common misconception that this belly fat is just a physical cosmetic issue that is a side effect of earlier HIV treatments – something that must be accepted as a reality of now living longer with HIV-infection. Recent research dispels that myth so that even with newer anti-retro viral regimens this condition continues to exist.

Photo Source: Don't Take VAT

"Don’t Take VAT" is an educational initiative supported by the ADAP Advocacy Association, that is shedding light on excess belly fat and the medical complications it can potentially create in order to help people living with HIV-infection learn about the condition, how to identify it, and what questions to ask their doctor. Since VAT is a type of hard fat that can surround a person’s organs and make it difficult for people to do things like bend over to tie their shoes or breath normally, the ramifications of this type of belly fat go far beyond the emotional strain caused by the stigma of carrying VAT. Excess abdominal VAT is also associated with a variety of health concerns, including diabetes and cardiovascular disease, which is why it’s important for patients to talk to their doctor about it.

Far too often, people with HIV believe the doughy fat around one’s midsection can be addressed by a healthy diet and exercise alone. But VAT doesn’t work that way. It can be challenging to reduce VAT with exercise and healthy living alone. The "Don’t Take VAT" website – www.DontTakeVAT.com – includes fact sheets about VAT and healthy living with HIV, as well as a video that provides a deeper look at VAT and tips about what to ask your doctor.

A doctor can determine if a person has excess abdominal VAT by assessing the individual’s medical history and HIV therapy regimen and by measuring around a patient’s waist and hips and calculating waist-to-hip ratio. But this often requires a patient’s willingness to make such a request, as often even doctors mistake VAT for regular belly fat and don’t always conduct this type of assessment during routine medical appointments.

While having excess HIV-related belly fat can cause physical, medical and emotional difficulties, nobody should feel ashamed or embarrassed about it. It is important that you take ownership of your own health and take the first step toward talking to your doctor and examining your treatment option.

Taking STEPS (Social, Treatment, Education, Physical, Spiritual)

By: Darnell Ferrell, STEPS Coordinator, Priority Health Care

Priority Health Care’s (PHC) “STEPS” (Social, Treatment, Education, Physical, and Spiritual) program is a new initiative in Louisiana, assisting young men living with HIV/AIDS. The program provides participants obtainable resources to enhance their quality of life through linkage to job readiness and employment training. This approach enables participants to become self sufficient by means of gainful employment.

The Office of Minority Health is funding STEPS it for a term of three years. It is being carried out through the Louisiana Public Health Institute with eleven collaborative partners – including PHC.

In Louisiana, underserved communities have faced numerous challenges among young racial and ethnic minority men ages 20-29. In response, STEPS focuses on five strategy areas:

• Corrections
• HIV stigma reduction
• Employment creation/protection
• Housing discrimination
• Asset building 

STEPS provides holistic support and guidance through linkage to job readiness and employment training, thereby enhancing the program participant’s quality of life in these areas:

• Social – Psychosocial and mental health counseling/treatment. 

• Treatment – Primary medical care services to address chronic diseases, STI’s, and general preventive healthcare services.

• Education – Educate participants on preventive health; assist with personal goals in educational attainment, job readiness training, and financial planning (Life Skills).

• Physical – Promoting healthy eating habits/diets for specific illnesses conditioning of the body.

• Spiritual – Motivate and encourage participants to have a positive attitude and outlook on life by helping them find their purpose despite any health disparities

PHC has leveraged relationships with community stakeholders and other partners to guarantee the program participants job interviews. STEPS project partners include: Job One Career Center (Resume Building, Employment Referrals), Goodwill Industries (Culinary Arts, C-Tech Broadband Communications, Hospitality), STRIVE NOLA (Job Readiness Training), Adult Literacy Learning (GED), and Delgado Community Collage.

After only one-year into the program, STEPS has already demonstrated its successful bridge to better link participants to their communities. For example, take the experience with John Doe (name changed for privacy), who is an African-American male. At age 24, John Doe was homeless for 6 months living under the New Orleans Bridge with his seven-year old son. The Movement at Crescent Care (NOAIDS Task Force) referred him to STEPS.

After two months, John Doe obtained employment at a local restaurant. A local housing program secured transitional housing for three months; followed by assistance with identifying an apartment for him and his son to receive permanent supportive housing. He was subsequently promoted to shift manager at his job, and also transitioned into more permanent housing.

Equally important, John Doe remains virally suppressed, healthy, compliant, and self sufficient by means of gainful employment. STEPS allowed him to create a pathway of opportunities for himself by way of hard work and dedication to being proactive in his progress in every way.

Throughout the AIDS epidemic, local community programs have provided the building blocks for successfully combatting the disease, and the stigma surrounding it. Programs, such as STEPS, leverage resources, relationships, and partnerships within the community to better serve people otherwise underserved. STEPS helps to create a community of people living healthy lives through education, treatment, and support.    

Learn more at http://priorityhealthcare.org/main/?#steps.

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Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.