Health Tips for Positive Riders & Crew

Are you HIV+ and Riding or Crewing the Red Ribbon Ride?  To learn more about Red Ribbon Ride Positive Pedalers, contact Joe Ede at


  • Eat 2-3 times a day, even if you're not hungry
  • HIV+ participants need more protein- take a supply of supplement bars and drinks, especially if keeping weight on is a challenge
  • No food restrictions with meds except:
    • DDI/Videx on empty stomach
    • No fat with Crixivan, unless taken with Norvir.
    • Grapefruit juice and Fortovase form of Saquinavir: grapefruit juice increases saquinavir blood levels, so people exercising 8 to 12 hours should increase fluids to 4 to 5 liters each day. To avoid the problem, don't drink grapefruit juice during the cycling event.


  • Drink a balance of water and electrolyte replacement fluids.
  • Be sure to ask camp and pit stop volunteers if ice is filtered.
  • Drink water all day and all evening long! Dehydration can continue while you sleep, so keep a full water bottle with you at night to drink.
  • Adequate fluids are especially important with Septra/Bactrim, or any other antibiotic.
  • If you take Crixivan, keep a close watch on your fluid intake to avoid problems with your kidneys (sludge or stones). You need to add an additional 1.5 liters above your replacement fluid requirement (which is already increased from exercise/exposure).

Side Effects

  • The big ones are diarrhea, nausea, indigestion, and headache.
  • Diarrhea: expect to get it! Many things can contribute to diarrhea during the ride: heat, stress, change in foods, etc. As all these things can add to existing GI side effects. Be prepared! Take Imodium or lamotil with you!
  • Nausea and indigestion: Before the ride, think about what upsets your stomach. Vitamins? Certain vegetables? Spices? Some of your meds? Avoid foods that do this.
  • Taking meds with food can help reduce nausea and indigestion.
  • Tips: cool foods help calm your stomach. Hard candies sometimes help. Get out of the sun- rest as much as you can. A cool rag on head and/or wrist can help to alleviate heat.
  • Headache: dehydration can cause headache, take some ibuprofen or acetaminophen with you. Also, stopping caffeine abruptly can cause headache, so if you drink coffee regularly, drink it on the ride.
  • Besides the meds, the sun, the new food, and the stress can contribute to existing side effects.
  • Bottom line: if you're not feeling right, tell somebody and get help. Talk to other Positive Pedalers, your tent mate or riding partner. Nothing is more important than staying well.
  • Have a low threshold to use the medical personnel for questions and concerns.


  • You're out of your normal setting- how will you remember to take your meds? Make a plan before you leave. Discuss treatment options and tips for adherence with your medical provider and/or other Positive Pedalers.

Medical Tips

  • Keep a list of all your medications and doses with you.
  • Talk with your doctor about the Ride! Do a check-in about any special needs before you leave.
  • Make sure you have your medical provider's telephone numbers.

    During the ride:

    • Best not to start new regimen within 1 month before the ride.
    • Keep medications out of direct sunlight, as much as possible.
    • Medication sets may be easier to deal with on rides than individual pill bottles. These are readily available at pharmacies or often from medical providers.
    • No antiretrovirals need to be refrigerated if they'll be used within one month.
    • If you have special needs or feeling "off", always check in with medical personnel in camp or at rest stop.
    • The First Aid Crew is sophisticated with HIV related questions and medications, so don't hesitate to engage the First Aid Crew with your questions or concern.


  • Sun causes dehydration-drink water & electrolyte replacement fluids!
  • Septra/Bactrim and some antibiotics, such as doxycycline and tetracycline, cause sun sensitivities- wear high SPF sunscreen on all exposed body parts and reapply regularly- you're sweating the sunscreen off too.
  • Use plenty of sunscreen with SPF even if you're not taking antibiotics.
  • Sunscreen an exposed head bring along caps and bandanas if there's not much hair up there.


  • If you have the opportunity to wash your hands, use warm water and wash for 15 seconds.
  • Wash hands or use Purell/antibiotic lotion/sanitizer after using the porta potties and bathroom whenever possible- carry your own supply in case it is not available at your stop. Sanitizers should be available at camp and pit stops.
  • Wash hands in camp before all meals.


Courtesy of Positive Pedalers of California