References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
People living with HIV, particularly those with weakened immune systems (CD4 count below 200), are more susceptible to foodborne infections that a healthy immune system would normally handle. Cryptosporidium, Salmonella, Listeria, and other food-borne pathogens can cause more severe and prolonged illness in immunocompromised individuals.
If your CD4 count is well controlled on antiretroviral therapy, your food safety risk is similar to the general population. These precautions are most important for people with low CD4 counts or those not yet on treatment.
Foods to Be Cautious With
| Food | Risk | Advice |
|---|---|---|
| Raw or undercooked eggs | Salmonella | Cook eggs until solid. Avoid raw egg in mayonnaise, mousse, etc. |
| Raw or undercooked meat | Salmonella, E. coli, Toxoplasma | Cook meat thoroughly. Avoid rare steak and raw mince |
| Unpasteurised dairy | Listeria, Salmonella | Use pasteurised milk and cheese. Avoid soft mould-ripened cheese (brie, camembert) |
| Raw shellfish | Vibrio, norovirus, hepatitis A | Cook shellfish thoroughly. Avoid raw oysters |
| Unwashed fruit and vegetables | Various bacteria, parasites | Wash thoroughly under running water before eating |
| Deli meats and pate | Listeria | Heat until steaming hot before eating, or avoid |
Water Safety
- UK tap water: Generally safe. UK mains water is treated and monitored
- Travel: In countries with unreliable water treatment, drink bottled water, avoid ice, and use bottled water for brushing teeth
- Cryptosporidium: This parasite can survive chlorine treatment. People with very low CD4 counts (<100) may benefit from using a water filter that removes Cryptosporidium, though this is rarely necessary in the UK
General Food Safety Tips
- Wash hands before preparing and eating food
- Use separate chopping boards for raw meat and ready-to-eat food
- Refrigerate leftovers within 2 hours and eat within 2 days
- Reheat food until steaming hot throughout
- Check use-by dates
Read more: What is HIV? | Healthy eating with HIV | Travel with HIV
Frequently Asked Questions
Do I need to follow these rules if my CD4 count is normal?
If your CD4 count is above 200 and your viral load is undetectable, your food safety risk is similar to the general population. Standard food hygiene practices (which everyone should follow) are sufficient. These extra precautions are mainly for people with low CD4 counts.
Can I eat sushi if I have HIV?
If your immune system is well controlled (CD4 > 200, undetectable viral load), the risk from sushi is the same as for anyone else. If your CD4 count is low, it’s best to avoid raw fish until your immune system recovers with treatment.
Related reading
- Can You Catch an STI From a Toilet Seat?
- Can You Get Chlamydia From Kissing?
- Can You Get Herpes From a Toilet Seat?
- Can You Get Herpes From Kissing?
- Can You Get an STI if You're Both Virgins?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
