Good nutrition is a key to overall health and can help you live long and well with HIV. Nutrients from food provide the raw material for cells and organs and support optimal functioning of all body systems. A well-balanced diet improves energy and strength, helps maintain a healthy weight, promotes good immune function and improves quality of life.

A healthy diet is especially important for people living with HIV, as the virus can increase nutritional requirements, and poor nutrition can worsen disease progression. What’s more, HIV-positive people are more likely to have coexisting health concerns, and eating well reduces the risk for heart disease, diabetes, fatty liver disease and several types of cancer.

How does HIV affect nutrition?

Even among people with well-controlled HIV, chronic viral infection triggers ongoing immune activation and inflammation, which can affect metabolism and energy expenditure. The virus can also cause persistent damage to the gut. People with advanced HIV—or any serious illness—may burn calories faster and may not absorb nutrients as well.

Opportunistic infections, as well as the side effects of some antiretroviral medications, can cause vomiting and diarrhea, which can lead to dehydration and nutrient loss. In addition, nausea, fatigue, changes in the sense of smell or taste, and mouth or throat problems can reduce the desire and ability to eat.

In the early years of the epidemic, wasting syndrome, or the overall loss of both fat and lean muscle mass, was a hallmark of AIDS. Today, overweight and obesity are more common among people living with HIV in the United States, and some antiretrovirals have been linked to weight gain. For some HIV-positive people, food insecurity, or lack of consistent access to affordable healthy food, is a concern.

What is a healthy diet?

Diet recommendations can be confusing, as food fads come and go, and guidelines change based on the latest nutrition research. The guidance you remember from childhood may no longer reflect current thinking about what and how much to eat. For example, current U.S. government dietary guidelines no longer include a food pyramid with a set number of servings per day from each food group but rather recommend a more flexible approach.

HIV-positive people who are on antiretroviral treatment with viral suppression and an adequate CD4 T-cell count can generally follow the same nutrition guidelines as the population at large. Those who have trouble getting enough calories and nutrients from food can try liquid supplement products.

Instead of struggling to follow complex dietary rules, most people find it easier to look at the overall picture and try to choose healthful foods most of the time. Focus on whole foods that have not been heavily processed. Ultra-processed foods that contain a lot of sugar, salt and unhealthy fats have been linked to obesity and a host of health problems.

Experts recommend getting most of your nutrients from a balanced diet, which usually provides an ample supply of vitamins, minerals, amino acids, essential fatty acids and antioxidants. A healthy diet contains a wide variety of foods, including the following:

Fruits and vegetables contain many vitamins and minerals as well as phytochemicals with health-promoting properties. Many also contain fiber that promotes good digestion. When shopping for produce, select fruits and vegetables with a variety of colors: Green, yellow, orange, red and purple ones contain different nutrients. But consider the fact that many fruits are high in sugar when budgeting your daily calories.

Carbohydrates are the body’s main source of fuel and help you maintain energy. When choosing bread, pasta or rice, opt for brown whole-grain varieties instead of white ones, as the refining process removes nutrients along with color.

Protein provides essential building blocks for making muscles, bones and other tissues. A healthy diet should include plant-based protein sources, like beans, lentils, nuts and tofu, in addition to lean meat and poultry, seafood, eggs and dairy products.

Fats and oils are essential for everyone—and they are a rich source of calories for people who want to gain weight—but the type of fat matters. Choose monounsaturated fats (found in olive oil and avocados, for example) and polyunsaturated fats (found in nuts and seafood) while limiting saturated fats (found in meat, cheese and whole milk) and trans fats (often found in fast food and processed commercial products).

Sugar has pluses and minuses. It supplies essential energy for the body and brain and provides extra calories for people who want to gain weight. But too much can contribute to obesity and diabetes. Try to get most sugar from fruit and other whole foods rather than from sugary drinks and processed foods.

Salt, or sodium, is an essential mineral. Modern American diets are seldom deficient in sodium, but you can lose salt if you sweat heavily when you exercise. Too much salt can cause bloating, or fluid buildup, and can worsen high blood pressure.

 

Water and other fluids are an important part of your diet. Water is a major component of the body’s cells and is necessary for proper digestion. Most experts recommend drinking about eight glasses of water per day. If you have a fever, vomiting or diarrhea, increase your fluid intake. Other fluids can help fulfill your daily needs, but go easy on sweet beverages, even natural fruit juices. Coffee and tea contain healthful bioflavonoids, but cut back on caffeine if it makes you jittery or interferes with your sleep.

Vitamins and minerals keep the body—including the immune system—working properly. Some act as antioxidants that prevent cell damage. A balanced diet generally provides adequate vitamins and minerals, but some people can benefit from supplements. People who eat a vegan diet, for example, may need extra vitamin B-12. More is not necessarily better, however, and too much can be harmful. A daily multivitamin supplement is safe for most people and can help fill in gaps in your diet.


How can I improve my nutrition?

The latest dietary guidelines recommend developing a customized healthy eating plan that incorporates personal preferences, cultural traditions and budget constraints. Standard dietary recommendations might need to be modified based on your individual needs and circumstances. For example, it’s difficult to make a general recommendation about how many calories people need each day, as this will vary according to age, size, individual metabolism and activity level. Recommended dietary allowances for nutrients set by the federal government are the minimum levels needed to avoid deficiencies—but you may need more.

Track changes in your food intake, weight and measurements over time. Have your blood sugar and lipid levels checked regularly. Talk to your health care provider if you are having trouble eating, are unintentionally losing or gaining more weight than you want or if you feel like you’re not getting necessary nutrients. Discuss risk factors for other health problems besides HIV, such as cardiovascular disease, as these might influence your diet. A registered dietitian can help develop a personalized diet plan that meets your individual needs.

How can I ensure that food is safe?

People living with HIV, especially those with a low CD4 count, are more susceptible to infections and should take precautions to make sure the food they eat is free of food-borne bacteria and other pathogens.

Here are some food safety tips:

  • Wash your hands with soap and water before and after handling food.
  • Wash fruits and vegetables well, even those you can peel.
  • Meat, seafood and eggs should be well cooked.
  • Use separate utensils and cutting boards for vegetables and meat.
  • Serve cold foods cold and hot foods hot—germs grow at room temperature.
  • Avoid unpasteurized dairy products.
  • Be cautious about foods from bulk bins, deli counters and salad bars.
  • Check expiration dates on food packages.
  • Throw out anything that looks, smells or tastes funny.
  • Use filtered or bottled water if you’re not sure the tap water supply is safe.

Last Reviewed: August 6, 2025