While people with HIV are living longer, healthier lives because of advances in testing and treatment, some might be experiencing new relationships with their bodies.

Body image challenges can be a common experience, especially if you face stigma surrounding HIV and mental health conditions, such as depression or anxiety.

There are many ways to address mental health and HIV while improving body image. Small steps can often make a big difference in supporting people as they live fulfilling lives with HIV.

Living with HIV can change the way the body looks and functions. Sometimes this is the result of HIV or medications for treatment.

Some common body changes with HIV include:

  • HIV-associated wasting: an extreme type of weight loss most often seen in people who receive a late diagnosis
  • Lipoatrophy: fat loss in the face, arms, legs, and buttocks; cheeks may appear sunken, and veins may protrude from extremities
  • Lipohypertrophy: fat accumulation in the neck and shoulders, breasts, and belly, or lipomas, movable lumps of fat under the skin

Advances in treatment options mean it’s more common to grow older with HIV, so some people may experience body changes common with aging, such as weight gain.

Other people may experience weight loss due to depression, infections, or mouth and teeth problems. These are also experiences you may have with HIV.

Many people living with HIV experience changes in body image. A 2022 study of 16 people with HIV-related lipodystrophy reported changes in self-esteem and concerns about physical appearance. Eighty-seven percent of participants had body dissatisfaction, and 88% reported reduced libido.

Research from 2011 found a connection between poor body image, HIV stigma, and depression. Of a group of 451 people with HIV on antiretroviral therapy, 47% reported negative body image.

People who experienced high stigma and lived with depressive symptoms were more likely to have poor body image than those who did not experience depression or stigma.

According to the Centers for Disease Control and Prevention (CDC), people with HIV often internalize the stigma that is sometimes associated with HIV. This can lead to a negative self-image, shame and isolation, and delays in testing and treatment.

Caring for your mental health can help you handle life challenges while making it easier to manage other aspects of HIV, such as remembering to take medications on time. It may also help you manage changes in the body, and body image.

Mental wellness can often improve with steps you take on your own, or by joining other people living with HIV.

Spending time with others living with HIV who may also experience body image challenges can be helpful. An HIV treatment center may be able to recommend support groups that take place in-person or online.

In addition to an HIV support group, you may feel more at home in a support group for people living with a mental health condition such as depression. A caseworker or healthcare professional may be able to discuss options with you.

Support from a psychiatrist, psychologist, or therapist may help you manage mental health-related symptoms and to improve your body image.

While all of these professionals may offer mental health support, only a psychiatrist can prescribe medications.

Many people use journal writing to process emotions and personal feelings. Your journal is a private place where you can write about anything in your life.

There’s no need to stick to a particular structure, topic, or schedule. The practice may help you manage depression, anxiety, and stress symptoms.

Exercise and quality sleep can help you manage your mental health while living with HIV.

If you’re experiencing changes in body image, moderate exercise may help you find a positive association with your body, especially if you do an activity you enjoy. Exercise can be a pleasant walk in a place you love or a sport you enjoy.

Mindfulness is often described as attention to the present moment. Although definitions and practices vary, a frequent objective of mindfulness meditation is to focus on the present without judgment, which can increase feelings of acceptance.

For some people who experience changes to the body from HIV, meditation may help them manage negative feelings associated with body image.

Seemingly small acts can have a big impact, especially when managing a condition like HIV. Review your to-do list to find tasks you’ve been putting off. Learn to cook a new meal, clean a closet, or get in touch with old friends.

A sense of accomplishment can result from a completed task or even the preliminary stages of a task. If you can’t cook that healthy meal right now, find self-confidence and satisfaction in what you can do. This may look like making a list of ingredients, shopping for food, or prepping your kitchen.

Volunteering might shift your focus from a negative self-image to supporting others.

Offering time or skills to a nonprofit could be a step in this direction. Consider a charity that serves others living with HIV, which could deepen your connections to the community.

Negative body image is a common experience of people living with HIV. Caring for your mental health can help manage conditions like depression.

Some techniques, such as mindfulness meditation and exercise, can help change a negative body image. Support groups and personal journaling are other ways to cope.