When you’re living with the human immunodeficiency virus (HIV), it’s normal to wonder if your everyday activities are helping or harming your health. Some people are curious about whether HIV is affected by diet, alcohol consumption, and more.

One issue that people on myHIVteam often ask about is caffeine intake. One person put it clearly when they said, “I am wondering if coffee is good for people living with HIV and what effect it has on CD4 count and viral load.”

If you’re curious about the effects of caffeine on HIV, this article offers key facts to consider. Armed with this information, you can decide whether to consume caffeinated beverages and how much you’re comfortable with.

Caffeine for People Living With HIV

There have been a few relatively small studies looking into how caffeine affects people living with HIV. Although they offer hints at the relationship between caffeine and HIV, they’re more useful to tell researchers what they should study next.

One small study done in 2017 focused on 130 people diagnosed with HIV. The results showed that drinking higher amounts of caffeine was associated with higher CD4 counts and a lower HIV viral load. An HIV viral load refers to the amount of HIV in a person’s bloodstream and shows how fast the virus is multiplying. This study, however, was for a short period and in a specific group of individuals, so the results may not apply to a variety of people living with HIV. Although one study isn't enough to formulate a theory, the researchers noted that more studies are necessary to find the effect of caffeine on viral load and CD4.

Another study in 2017 in France looked at more than 1,000 people diagnosed with both HIV and the hepatitis C virus (HCV), although some people had already overcome HCV. In this study, drinking at least 3 cups of coffee every day was associated with a lowered risk of death by about half. However, this study included people who also used other substances such as alcohol or nicotine, and the researchers based their study on self-reported surveys, which were not standardized. Although this study was larger, it also didn’t take into account genetic differences and other caffeine sources, and it wasn’t specific about the amount of caffeine consumed (for example, how strong or weak each cup of coffee was). This study also did not tie caffeine to anything specific, like viral load or CD4 levels.

Yet another study tested 139 people diagnosed with HIV and HCV. It found that people performed better on cognitive tests when they had 3 or more cups of coffee. Once again, this study did not isolate HIV. Instead, it looked at people living with both HIV and HCV. It also did not test to see if viral load decreased or CD4 increased when people had caffeine.

If you're interested in the results of these studies and how they might apply to you, talk to your doctor. Your health care team should be able to guide you regarding caffeine consumption and how it might affect HIV or interact with any medications you’re taking.

Caffeine, Sleep, and Viral Load

Sleep can be a big problem for people living with HIV. Many people living with HIV have severe problems when it comes to falling asleep, staying asleep, or getting good rest.

Poor sleep in people with HIV can occur for many reasons, including:

• Stress due to HIV diagnosis
• Sleep changes possibly related to having HIV
• Medications taken to fight HIV
• Other infections a person gets because of HIV
• Situations unrelated to HIV, like substance abuse or other life stress

One study showed that drinking caffeine could make sleep worse for people living with HIV. This 2017 study looked at 130 people who were HIV-positive. Those who drank more caffeine were more likely to feel greater distress, experience a lower quality of life, and have worse insomnia. Interestingly, this study also had an association with negative outcomes related to CD4 count and viral load. The researchers concluded that caffeine can make it harder to sleep, negatively affecting the overall health of people with HIV. They also highlighted the need for larger studies to confirm the findings of their research.

This study doesn’t provide definite answers. The researchers even phrase their conclusions as possibilities, not facts. If you’re struggling to sleep and you drink caffeine, it’s worth talking to your doctor to find out what they think you should do.

Caffeine and Other Medical Conditions

Although caffeine is generally considered safe in the amounts found in coffee and tea, it may not be the best choice for some people with certain medical conditions. These include pregnancy, substance use, and mental health conditions, as well as certain sleep and cardiovascular disorders, such as high blood pressure. A 2022 study in the U.K. involving the general population found that many health conditions seem to improve when you drink caffeine. There were, however, some study participants who didn’t experience any health benefits at all.

If you’re living with other health issues in addition to HIV, talk to your doctor about using caffeine. This is especially important if you have conditions that fall into the categories listed above. Your health care professional will be able to help you weigh the potential benefits and risks of caffeine. Then, you can come up with a plan that feels right for you.

Caffeine Guidelines

Unless you get directions from your doctor that are more specific, follow the guidelines issued by the U.S. Food and Drug Administration (FDA) for the general population. These indicate that many people can drink up to 400 milligrams of caffeine every day without negative side effects, but this can vary depending on the person.

People vary in their sensitivity to caffeine. Some medical conditions and certain medications can increase sensitivity to caffeine. It may be safer to consume smaller amounts or none at all, depending on the situation.

You'll need to figure out how much caffeine you can have before you experience negative side effects. These can include:

• Anxiety
• Shakiness or jitteriness
• Nausea or upset stomach
• Faster heart rate
• Headache
• Inability to sleep at bedtime

It also helps to know about how much caffeine is in your favorite beverages. A cup of coffee can have anywhere between 95 and 200 milligrams of caffeine, while an energy drink can have 70 to more than 300 milligrams. When in doubt, you can look up your specific beverage so you’ll know how much caffeine you’re drinking.

If you want to avoid caffeine, consider switching to decaffeinated coffee or tea. These options still contain very small amounts of caffeine, but they can satisfy your desire to drink something warm without the side effects of caffeine.

Talk With Others Who Understand

On myHIVteam, the social network for people with HIV and their loved ones, more than 41,000 members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Are you wondering whether your coffee consumption or morning energy drink is affecting your HIV? Share your experience in the comments below, or start a conversation by posting on your Activities page.