A Cofactor is any issue or influence in your life that has the potential to help or harm your immune system, weaken or reinforce a commitment to safe behavior, and bolster or compromise adherence to health routines. Together, all of these influences can increase or decrease your overall health. The L.I.F.E. Program addresses universal and well-researched cofactors for people living with HIV, and helps build skills for managing them in a way that optimizes immune function, safe behavior, and adherence.

The Cofactor Definitions:
 

		Belief about HIV Disease and Health Progression: Beliefs are a system of related ideas about some issue or circumstance in the world. They can be conscious or unconscious, realistic or inaccurate, and can directly or indirectly influence your emotions and, consequently, the functioning of body systems, including immunity.
		Primary Health Care: Your relationship with a medical provider is a significant dynamic in the state of your health. This relationship can be characterized by poor communication and frustration, or good communication and a collaborative spirit. Different relationship qualities can have an impact on the state of your medical care, and thereby your health.
		Trusted Support and Self Disclosure: Trusted support is an interpersonal experience with a supportive person in which you feel fundamentally safe and can discuss any concerns you have, including issues of sexual identity, drug use, health, HIV status, and other important life concerns that you may have. Trusted support can have a direct and potent influence on immune system functioning.
		Health Risking Behaviors: Risk behavior is anything you do that could expose you, or your sex or injection drug partners, to an infectious disease. Safe behavior is not defined exactly the same by everyone, but you can at least decide what your boundaries are before you are confronted with a sexual decision. Avoiding risk behavior prevents getting a new sexually-transmitted disease (STD).
		Self Assertiveness: Assertiveness is the ability to ask clearly for what you want, and to say no to what you don't want. Assertiveness is not the same as aggressiveness, and does not have to be exercised at the expense of other people's needs. Self-assertiveness is also directly linked to immune system functioning.
		Grief and Depression: Grief is a psychological response to significant loss. Grief can include feelings of sorrow, fear, regret, anxiety, confusion, anger, emptiness, depressed mood and an obsession with the question "why?".   Depression can be a fleeting response to a temporary situation, or a long-lasting, physically debilitating condition needing professional care. It can be characterized by sadness or emotional numbness, lethargy, difficulty concentrating and making decisions, feelings of hopelessness, worthlessness or inappropriate guilt, and lack of pleasure in things that once brought pleasure.   Medical research shows that unresolved grief and significant depression - especially a combination of the two - can have a significant negative impact on immunity.
		Drugs and Alcohol: Toxins - including drugs and alcohol - are substances that we put into our bodies that have little or no nutritional value, may be potentially harmful, and put a strain on the body to process. Germs are microscopic organisms (bacteria, fungi and viruses) that can sometimes cause serious disease.   It is important to be fully aware of what toxins, at what frequency and amount, you regularly put into your body. Reducing exposure to toxins and germs helps optimize immune function.   Body Care:

			Breathing: There is a direct connection between emotions and breathing patterns. Anxiety or fear, for example, can restrict breathing and create a sensation of tightness. Feelings of security and relaxation allow for slow, calm breaths. Full breathing is necessary to deliver oxygen needed by immune cells.
			Water: Water is the universal solvent, and the primary component of our bodies. It is an indispensable element for life, allowing the absorption of nutrients from food, and flushing from the body toxins and waste that could harm your health.
			Food and Nutrition: Along with fresh air and clean water, daily nutrition is at the core of general good health. It must provide minimum requirements of protein, carbohydrates, fat, vitamins and minerals. Immune cells - like all body cells - require adequate nutrition in order to function.
			Exercise: The human body was designed for movement, and exercise is critical for maintaining good circulation and digestion, building lean muscle mass and burning excess calories and fat. Simply put, the body does not do as well physically without regular exercise. The immune system also responds well to exercise - even 30 minutes of moderate exertion (such as a brisk walk) 3 times a week.
			Sleep: Sleep is the period when the body and brain take time to repair and replenish themselves, and it helps the immune system operate at peak efficiency. Regular, sufficient sleep rounds out an integrated body care plan.

		Adherence to Health Routines: A health routine is any activity, done on a regular basis, that helps the body maintain health or heal from sickness. Adherence means "sticking to your schedule" of health routines. Adherence is crucial to the effectiveness of any medical therapy, including prescribed drugs such as antivirals or antibiotics. Sticking to your health plans obviously assists in maintaining or improving health.
		Sustained Survival Stress: Sustained survival stress is different both in intensity and duration from regular stress. Survival stress results when you feel your safety or security is somehow threatened. Sustained survival stressors send repeated alarm signals to your nervous system. The resulting body changes can dampen appetite and libido and interfere with sleep patterns, emotional stability, cognitive judgment and—importantly—immune function.
		Crisis Coping Skills: Crisis Coping skills are strategies for adapting to sudden or distressing events in life. Some coping skills are intuitive and habitual, others can be learned. Research shows that an active and optimistic coping strategy is beneficial to immunity, while a passive and negative coping strategy dampens immunity.
		Life Purpose and Goals: Life goals are specific experiences or objectives to be accomplished that grow out of a sense of personal purpose, interest, or curiosity. Goals motivate you to engage in life and cherish being alive. Research shows that long-term survivors of an AIDS diagnosis typically have clear life goals and pursue them with action.
		Altruism and Spirituality: Altruism is concern and action for the well being of others, without inherent self-interest. Altruism can benefit entire communities as well as individuals. Spirituality is an appreciation of the interconnectedness of life and a desire to be part of something larger than yourself. Research shows that long-term survivors of HIV/AIDS typically are involved in some altruistic activity—often volunteering.

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Client Testimonials "I was so depressed I didn't want to live. I had trouble taking my meds—I just didn't have any energy. I realized that I didn't really believe that there was any hope. The L.I.F.E. Program® put my life back into focus. My counselor helped me get into a regular exercise program and weekly counseling sessions to talk out my fears. I realized that if I could stay with my treatment, I had every chance of living a long, productive life."          — Sean