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Complementary Therapies and HIV

February 2013

Table of Contents


Introduction

Decisions about your health care are important -- including deciding what types of therapy to use. Most health care providers will agree that using complementary (also called alternative) therapies with standard medicines can help people living with HIV (HIV+) live longer, healthier lives. Complementary therapies refer to a series of health care treatments that are most often not considered to be part of conventional (Western) medicine. These types of treatments can include acupuncture, aromatherapy, biofeedback, homeopathy, hypnosis, massage therapy, mind-body techniques, and nutritional supplements.

An important note: while it is important for everyone to tell their health care providers about any and all complementary or alternative practices they use, it is especially important for people living with HIV. Since HIV and the drugs used to treat HIV affect the immune system, we recommend talking to your health care provider about any complementary treatments before you use them. This gives your provider a full picture of what you do to manage your health and makes sure the treatments you choose are safe and helpful for you.


What Are Some Common Complementary Therapies?

Acupuncture

Acupuncture is a practice developed in China several thousand years ago. It involves the use of small thin metal needles that are inserted in the skin at particular points on the body. By activating these specific points, acupuncturists look to remove blockages in the flow of one's life force or vital energy, called qi (pronounced "chee"). In Traditional Chinese Medicine (TCM), energy or qi is believed to circulate through the body. Proper circulation or flow of qi promotes health and well-being. Acupressure uses finger-pressure rather than needles to stimulate healing points on the body and achieve proper flow of qi.

There are now many studies that demonstrate the potential benefits of acupuncture. A partial list of conditions for which acupuncture can be helpful includes: pain, headache, nausea, diarrhea, menstrual cramps, and menopausal symptoms. Many states require acupuncturists to be licensed (L.Ac), and an increasing number of insurance plans cover acupuncture. You can find a licensed acupuncturist through the organization that grants the licenses: the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Be sure your acupuncturist uses only disposable, sterile needles.

Aromatherapy

Aromatherapy involves the use of essential oils to improve emotional or physical health. These oils are inhaled or rubbed into the skin, and are generally used to reduce pain, improve mood, and promote relaxation. There is not strong evidence to support the immune-boosting effects of aromatherapy. However, tea tree oil has a demonstrated anti-microbial effect. Any use of essential oils should be discussed with your health care provider.

Biofeedback

Biofeedback is a technique that trains people to control some of the body's operations that usually occur without our having to think about them, such as breathing rate, heart rate, or blood pressure. By being connected to devices that measure these actions and watching these measurements (e.g., heart rate) on a monitor, people can affect the inner workings of their bodies and gain some control over the body's "involuntary" actions. Biofeedback is most often used to help people with headaches and pain.

Homeopathy

Homeopathy aims to activate the body's own healing abilities by giving small doses of very diluted substances. It is based on the idea that "like cures like," or the Law of Similars. This law suggests that diseases can be cured by small amounts of substances that cause similar symptoms in healthy people. Homeopathic remedies are made from small amounts of a variety of plants, minerals, and animal products that are crushed and dissolved in liquid. By adding more and more liquid to the original mixture, the remedy -- a homeopathic 'tincture' -- is diluted.

The results of scientific studies of homeopathy are mixed. Some studies show homeopathy's benefits, while others do not show any difference between homeopathic treatment and placebo (no treatment). People most often use homeopathy to treat allergies, asthma, ear infections, digestive disorders, headaches, and menopausal symptoms. Because homeopathic remedies can include substances that affect your immune system, remember to talk to your health care provider before using them.

Hypnosis

During hypnosis, or hypnotherapy, a trained therapist uses techniques to help you become deeply relaxed and enter a different state of consciousness called a trance. In a trance, your body relaxes while your mind becomes more focused. The hypnotherapist does not control your mind or your actions. Rather, you become very open to suggestion, such as the suggestion to quit smoking. The therapist makes suggestions for changing behaviors or relieving symptoms that are specific to your situation.

Hypnosis can help you relax, reduce stress, relieve anxiety, and ease pain. It is often used before surgical or dental procedures when someone is especially nervous. Hypnotherapy is also used to treat eating disorders, addictions, phobias, insomnia, and digestive problems.

Massage Therapy

Massage involves a trained therapist using her or his hands to physically handle the body's soft tissues and muscles. There are a variety of massage styles ranging from soft stroking to deep muscle kneading. Massage has been practiced as a healing therapy for centuries around the world. Massage therapy affects the whole body, and can relieve muscle tightness, improve circulation, clear waste products, boost the immune system, reduce stress, and help you relax.

Massage therapists become certified after completing their training and passing an exam. Many states recognize the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB; www.ncbtmb.org). You can also find massage therapists in your area by going to the website for the American Massage Therapy Association (www.amtamassage.org/index.html).

Since massage involves direct contact between the therapist's hands and your skin, you will be asked to undress when the therapist leaves the room. Professional therapists should provide plenty of sheets and blankets with which to cover yourself on the massage table. If you feel uncomfortable for any reason, do not hesitate to talk to the therapist or find a different therapist.

It is important for women who are pregnant to be cautious about receiving massages. If you are pregnant and want a massage, make sure you find a massage therapist who is specially trained to massage pregnant women.

Mind-Body Techniques

These activities enhance the mind's ability to affect bodily functions and symptoms. Mind-body techniques often include patient support groups, prayer, and therapies that use creative methods such as art, music, or dance. Practices such as biofeedback, hypnosis, journaling, and meditation are considered mind-body techniques.

Achieving a deep state of relaxation is one way to help ease stress and renew the body. Techniques for deep relaxation include meditation, mindfulness, guided visualization, progressive muscle relaxation, certain types of yoga, or Chinese exercises such as Qigong (Chi Kung), and Tai Chi. You can also use audiotapes or attend classes/workshops to guide you in accessing deep states of relaxation. Recent studies suggest that mindfulness meditation may prevent CD4 cells from decreasing when an HIV+ person is under stress.

Herbs and Dietary Supplements

These therapies may involve the use of herbs such as echinacea, garlic, goldenseal, chamomile, and Chinese herbs. Health professionals may also prescribe foods and vitamins as part of a biological-based therapy. Multivitamins often contain antioxidants, such as vitamins A, C, and E, which combine with particles called free-radicals to make them inactive and unharmful. Free-radicals are natural by-products of the body's functions that can cause damage to cells and lead to disease.

Because echinacea and other supplements affect the immune system, they may interact with your HIV drugs. St. John's Wort, which is an herbal treatment for depression, has been shown to affect how protease inhibitors and non-nucleoside reverse transcriptase inhibitors act. As a result, the US Food and Drug Administration (FDA) recommends that St. John's Wort not be taken by people who also take any types of HIV drugs. It is important for you to discuss any herbs or supplements with your health care provider before taking them. For more details about supplements, please visit our Vitamins and Supplements page.


What Kind of Complementary Treatment May My Health Care Provider Suggest?

When recommending complementary therapies, the health care provider makes decisions based on the patient's condition and other factors such as the patient's strengths, lifestyle, medical history, support systems, and all other factors relating to the patient's health and wellness. This enables the provider to knit together a program tailored for each patient and may involve the following:

Remember, since HIV and the drugs used to treat HIV affect the immune system, it is important to talk to your health care provider about any complementary treatments before you use them. This gives your provider a full picture of what you do to manage your health and makes sure the treatments you choose are safe and helpful for you.

More and more, the medical community recommends complementary therapies for many types of conditions. Since complementary treatments have become more common, The National Institutes of Health has developed a department called The National Center for Complementary and Alternative Medicine (NCCAM) that is dedicated to the study of these treatments. You can learn more about complementary therapy at the NCCAM website, http://nccam.nih.gov.




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