Long before I was a doctor I was a mother -- a grandmother, even. So when I set out to learn HIV, I sprang from that healing tradition. Maintaining nutritional competence in those whom we serve plays a very big role in that culture.

What is perhaps most exciting about the role of nutrition in HIV care is that it makes room for a truly holistic approach: one that incorporates the wisdom of many disciplines, including Western medicine, into one comprehensive model; a nutritional model of HIV defense.

The facts speak for themselves. HIV positive people who die tend to do so when they reach a specific point in their wasting. Wasting begins early, is hard to detect until late, and harder to reverse than to prevent. The causes are complex: eating less, absorbing less well, spending nutrients faster or less efficiently. So calories, protein and vitamins are important, as is appetite support. But there's more to nutrition than food.

Immune responses to infection change the way bodies use nutrients. This is critical to an understanding of nutrition in HIV. It means that anything that triggers the immune response triggers the process of wasting.

Thus it makes good sense to support our immune systems: to diagnose and treat infections early; to avoid behaviors which expose us to bacteria or parasites; to avoid alcohol, especially; and to change those stressors in our lives which predispose us to infection.

This is a time of great promise for people with HIV. Every day we learn more about the virus, and the means of its progression. Every day we learn better ways to fight it. And the more we're attuned to our wellness, the longer we'll be here to fight. So we need to attend to nutrition -- all aspects of nutrition -- early.

Get your sleep. Don't worry too much. Eat enough, eat light. Take your vitamins. Wash your hands. Fight the virus, and other infections. Go out and use that body. Wear your rubbers, every time.

If I sound like a mother, I am. But sometimes mothers are right.