Your doctor or primary health provider isn’t just there to run your HIV numbers and send you on your merry way. If they’re worth their salt, then they’re also there to discuss every aspect of your health—physical, mental and spiritual—and to give you advice and options. 

“It’s super important to have a sense of trust and comfort with your provider so that together you can look at all your health concerns holistically,” says Antonio Urbina, MD, who’s been an HIV doc for 25 years and currently heads the HIV- and LGBTQ-specializing Comprehensive Health Center within New York City’s Mount Sinai Health System.

Before your next provider visit, take some time to list all your health and wellness concerns on a sheet of paper—and not just the ones pertaining to HIV. Are you eating too much processed or junk food but don’t know how to make a change? Would you like to exercise more to lose weight and feel better but don’t know where to start? Are there stressors in your life—work, family, relationship, etc.—you just don’t know how to deal with? Are you worried that your meds—including, perhaps, your HIV meds—are causing you to gain weight? 

Once you’ve made that list, says Urbina, show it to your provider and ask for some help! “A list like that helps give me insight into your priorities,” he says. Overwhelmed? Ask a trusted loved one to accompany you to your visit.

Increasingly, says Urbina, “patients on current HIV regimens come to me with concerns about weight gain. They say that despite no changes to their diet, they’ve noticed they’re adding on the pounds. So I’ll show them recent data showing that their current HIV regimen could be the issue, then I’ll suggest that we switch to a different med for a few months and see what happens.”

In many patients, he says, that’s led to positive results.

Of course, regardless of meds, diet and exercise play a huge role in maintaining not a healthy weight but also overall physical and mental health. “A lot of strong data ties exercise to overall happiness,” says Urbina. “So if someone is not exercising at all, I’ll suggest they start with something as gentle and simple as a daily walk.” You can always do a triathlon later!

What about diet? Start by keeping a food diary and showing it to your provider, says Urbina. “You have to know what you’re eating to make an intervention.” Again, start simple. Replace sugary soda with water or flavored seltzer. If you must eat fast food, “take one or both buns off the hamburger” to reduce empty carbs, he says. Swap out that morning cereal for a hard-boiled egg with tomato and avocado. Replace the lunchtime sandwich with a salad.

And what about life? Are you having good sex? Do you feel safe in your home with your domestic intimates? Do you feel connected to the outside world and enjoy a sense of community? Do you have some kind of spiritual or meditation practice to ground you amid stress?

Guess what, says Urbina. All those things are fair game to discuss with a good provider. And if they don’t seem to have the time or interest to address the whole you? Then try to find a new provider, if your region and/or health plan allows.

“Think of your provider as someone you’re going to check in with regularly on your wellness journey,” says Urbina. “Let’s do this together!”