Temporary Disabled. :) please Go back Alternative and Traditional Medicine for HIV www.fgks.org » Address: [go: up one dir, main page] Include Form Remove Scripts Accept Cookies Show Images Show Referer Rotate13 Base64 Strip Meta Strip Title Session Cookies International HIV & AIDS charity DonateFundraising About Us Our Partners Help & Advice Contact Us Facebook Linked in Twitter Newsletter Copyright © AVERT skip to menu Alternative and Traditional Medicine for HIV back to top Introduction Alternative and complementary medicine is quite popular among people living with HIV. In America, for example, around half of HIV positive people have reported use of this type of treatment.1 2 Many HIV positive people say they feel better after using alternative and complementary medicine, and it is likely that some of these treatments are indeed beneficial, although unproven according to conventional Western medicine. back to top What are alternative and complementary medicines? Alternative and complementary medicine is the name generally given to those medical and health care systems, practices, and products that are not presently considered to be part of conventional Western medicine. Well known examples include herbal and other nutritional supplements, acupuncture, aromatherapy, homeopathy and yoga. Alternative medicine is used in place of conventional medicine Complementary medicine is used together with conventional medicine. The more ancient forms of alternative and complementary medicine are also known as traditional medicine. back to top What are these therapies used for? Aromatherapy blends In relation to HIV, alternative therapies are most commonly used in areas where it is difficult to access Western medicine. In the absence of antiretroviral treatment, people may seek other ways to delay the onset of AIDS, or to treat opportunistic infections. In sub-Saharan Africa, for example, traditional healers outnumber medically qualified doctors eighty-to-one.3 Traditional healers also usually provide immediate treatment, whereas clinics may have lengthy waiting lists and tests for eligibility. Most people living with HIV in developed countries have ready access to antiretroviral therapy and conventional treatments for opportunistic infections. Because these treatments are so effective, there is less demand for alternative HIV medicine, except perhaps for addressing relatively minor infections, or when antiretroviral treatment cannot any longer be taken, for example because of drug resistance. Many instead look to complementary medicine as a way to prevent or relieve aids treatment side effects, some of which are not easily treatable with conventional medicine. There is also demand for complementary therapies that might boost immunity, relieve stress, or improve general health and wellbeing. The people who distrust and avoid Western medicine for HIV include not only individuals, but also some governments. For example, senior politicians in South Africa have promoted unproven therapies while at times disparaging antiretroviral drugs. In Gambia, the president himself has treated patients with a herbal mixture he claims is an AIDS cure. back to top Do alternative and complementary therapies for HIV and AIDS work? Western medicine embraces all approaches shown to be safe and effective in rigorous scientific trials. By definition, complementary and alternative medicine consists of therapies that are unproven, at least by the standards of Western medicine. Given the many therapies in existence, there can be little doubt that some of them do what they are supposed to. Many others are likely to be ineffective or can even be harmful. In the absence of good scientific trials, it is impossible to be certain which is which. Acupuncture Still it can be argued that, from a scientific point of view, some treatments are more likely to work than others. Acupuncture, for example, appears to alter brain activity,4 and there is quite good evidence that it can help relieve post-operative nausea.5 6 Herbal medicines, too, are scientifically plausible: a number of modern drugs were derived from plants first used traditionally. Scientists have already identified one plant extract that acts like an antiretroviral drug;7 it is entirely possible that there are others. At the other end of the scale are therapies that are not considered credible by the scientific community at large. The most notorious of these is homeopathy, which the World Health Organization recommends should not be used to treat HIV.8 Yet even if a medicine has no specific effects on an illness, this doesn’t necessarily mean it is worse than nothing. It is widely accepted that patients’ beliefs about a treatment, and the quality of the doctor-patient relationship, can influence health outcomes. This is what is known as the placebo effect. For example, one trial9 divided irritable bowel syndrome sufferers into three groups: the first received no treatment, the second underwent sham acupuncture (placebo), and the third received fake acupuncture plus a 45-minute consultation with a friendly doctor. The proportions of patients reporting moderate or substantial improvement were 3% (no treatment), 20% (placebo only) and 37% (placebo plus interaction). This effect may well account for some of the reported benefits of alternative and complementary medicine, as suggested in an editorial that accompanied the study: “Is it possible that the alternative medical community has tended historically to understand something important about the experience of illness and the ritual of doctor-patient interactions that the rest of medicine might do well to hear? … The meanings and expectations created by the interactions of doctors and patients matter physically, not just subjectively.”10 Even if it fails to ease symptoms, the treatment experience may have non-specific effects such as boosting self-confidence and relieving anxiety. Group therapies – such as yoga – are particularly good for meeting new people, who may be able to share knowledge of other treatment options. back to top Why is there such a lack of evidence? Supporters of complementary and alternative medicine propose a number of reasons why their therapies have not been subjected to thorough testing. For one thing, major medical trials are highly expensive; if there is no prospect of a patent then there is less of an incentive to invest in research. Reliable, ethical trials also require a considerable amount of expertise. Many scientists with the necessary skills are reluctant to investigate therapies they think are implausible. Yet it is misleading to suggest that no research takes place. The US government has an agency (NCCAM) dedicated to complementary and alternative medicine, and in 2010 the National Institutes of Health (NIH) allocated nearly around $520 million to this field11 (around 1.5% of all federal funding for medical research).12 Potential HIV therapies investigated in government-sponsored trials include acupuncture, yoga, Reiki and distant healing.13 Although practioners of complementary and alternative medicine generally voice support for scientific research, they are often unwilling to accept negative findings. In 2005, medical journal The Lancet published the most thorough review of homeopathy trials ever conducted.14 Having analysed more than one hundred trials related to a wide range of illnesses, the authors concluded, “there was no convincing evidence that homeopathy was superior to placebo.” Homeopaths united in objecting to the methodology of both the trials and the review.15 Some even suggested that placebo-controlled randomised trials (regarded as the gold-standard of medical science) were inappropriate for testing their system of healing.16 back to top Potential for harm Some forms of complementary and alternative medicine can cause harmful side effects. Words like “natural” and “traditional” are certainly no guarantee of safety. Herbal or nutritional therapies (notably St John’s Wort) may also interact with other medications, making them less effective or worsening their side effects. In general, herbal remedies and dietary supplements are not covered by the strict regulations that govern pharmaceutical drugs. Quality is inconsistent even among popular commercial formulations; tests have shown that the concentrations of active ingredients can vary greatly from the amounts listed on the packaging.17 The standard of complementary and alternative practitioners is similarly uneven. Although some countries regulate certain types of practitioners (such as osteopaths in the US and UK), many people practise without any formal qualifications. Even if a therapy carries little risk of direct physical harm, it may still turn out to be a waste of time and money. Relying on alternative medicine instead of scientifically proven treatment can have very serious consequences. Once HIV has severely weakened the immune system, antiretroviral drugs are less likely to be life-saving. back to top Advice for those seeking complementary medicine HIV positive people have a long history of taking control of their own healthcare decision-making. Those interested in complementary medicine can take steps to maximise their chances of success. The Canadian AIDS Treatment Information Exchange (CATIE) suggests ten questions for assessing a new therapy:18 What am I hoping to get out of this therapy? Do other HIV positive people use it? Am I able to talk to any of these other people about their experiences? Is there any research or additional information about this therapy? What are the side effects, if any? What sort of commitment do I have to make to use this treatment? Where can I get this treatment, and will it be regularly available? How much of this treatment is too much and what are the early signs of taking too much? Does this treatment interact with anything else I’m taking? How much does it cost? Careful research is needed to answer these questions. Good sources of information include reference books on complementary medicine (available in many libraries), medical journals (which can be searched using the PubMed website), and the publications of reputable health organisations. The National Center for Complementary and Alternative Medicine (NCCAM) provides information intended to help people make sense of web-based health resources on complementary medicine.19 Many AIDS organisations and other bodies, including NCCAM, will answer enquiries over the phone or online. As already discussed, all forms of complementary medicine are unproven according to Western conventional medicine; each individual must make their own assessment of likely risks and benefits based on the available data. The most reliable evidence comes from large human trials – preferably randomised trials in which the treatment is compared to a placebo. Personal testimonies and laboratory findings should be given less weight, especially if they appear only in promotional material. Anyone who makes sensational claims (such as being able to cure many unrelated diseases with a single therapy), or who attacks conventional treatment, is probably best avoided. If you have done your research and wish to try a complementary therapy, the next step is to talk to your personal doctor or HIV specialist. This is important because there may be a risk of interactions with other medications. Some medical doctors have received training in complementary medicine. If your doctor lacks such expertise then it may be sensible to also find a complementary practitioner, ideally one with experience in treating people with HIV. Help finding a practitioner may be obtained from your doctor, an AIDS service organisation, or a professional body such as the Institute for Complementary Medicine in the UK, or the American Holistic Medical Association in the US. There are many practitioners available; it is worth taking the time to find one you trust and feel comfortable with. Look for experience, qualifications and references you can verify. When purchasing a herbal medicine or nutritional supplement, try to choose a reputable seller and manufacturer. Large, long-established companies are generally the most trustworthy because they have more to lose from selling poor quality goods. If possible, look for a company that submits its products for independent quality testing. Having started a new treatment, it is a good idea to keep a diary of your symptoms. This will help you assess whether the therapy is having the desired outcome, or whether it may be causing unwanted side effects. back to top List of common complementary and alternative therapies Complementary and alternative therapies can be divided into five main categories. The list below contains a few of the most popular examples. Whole medical systems Naturopathic medicine (mostly practised in the West; includes diet modification, herbal medicine, acupuncture and massage) Traditional Chinese medicine (includes herbal medicine, acupuncture and massage) Ayurveda (ancient Indian healing system; includes diet modification, herbal medicine, cleansing therapies, massage, meditation and yoga) Homeopathy (most commonly prescribes extremely diluted solutions of natural substances) Mind-body medicine Relaxation techniques, meditation and visualization Spirituality and prayer Yoga (may incorporate spirituality, meditation and body postures) Tai Chi (a Chinese martial art incorporating meditation and breathing exercises) Qi gong (includes meditation, body postures and breathing exercises) Aromatherapy (uses remedies derived from plants that are inhaled, applied to the skin or used internally) Biologically based practices Vitamins and minerals Herbal remedies Animal-derived extracts Prebiotics and probiotics (aim to encourage the growth of beneficial microbes) Manipulative and body-based practices Massage Chiropody (invented in America; manipulates the spine) Osteopathy (invented in America; manipulates the spine, joints and muscles; American osteopathic physicians are also trained in conventional medicine) Shiatsu (traditional form of Japanese massage therapy) Reflexology (invented in America; applies pressure to the feet, hands or ears) Rolfing (named after American Ida Pauline Rolf; manipulates soft tissue) Energy medicine Acupuncture (involves inserting fine needles into the body) Reiki (practitioners claim to channel healing energy through their palms) Therapeutic touch and distant healing (practitioners claim to manipulate energy “biofields” with their hands) Bioelectromagnetic-based therapies (involve unconventional use of sound, light, magnetism, and other forms of electromagnetic radiation) back to top African traditional healers and HIV Traditional medicine for sale in Malawi Sub-Saharan Africa is the region worst affected by AIDS; it is also a region in which most people turn first to traditional healers when they fall ill. There is potential for traditional healers to play an important role in responding to the epidemic. Although few have been scientifically tested, there can be little doubt that some of the remedies given by traditional healers are effective in treating HIV-related opportunistic infections and drug side effects. However, in common with all forms of medicine, these therapies may also do harm through side effects, drug interactions, or delaying use of conventional treatment. In addition, the reuse of implements for rituals such as scarification, tattooing and circumcision can transmit infections, including HIV. Some African healers blame illness on witchcraft, which can lead to ostracism of those accused. Collaboration between traditional healers and Western doctors has the potential to improve safety, for example by encouraging better hygiene. Training can also assist traditional healers in identifying illnesses beyond their capacity to treat, hastening referral to a clinic when necessary. In South Africa, The Traditional Health Practitioners Act includes a council to oversee and provide training to traditional health practitioners to protect the interests of the patient. As yet, the Act has not been fully enforced; there have been calls to implement the Act alongside a robust system of scientific testing of 'remedies'.20 Traditional healers are respected within their communities, and know how to convey health information in a culturally appropriate manner.21 They are ideally placed to teach HIV prevention, distribute condoms, conduct counselling, encourage HIV testing, and set up support groups for affected people. Yet although traditional healers are generally eager to learn from other health workers, experience has shown it is not necessarily easy to establish successful collaboration.22 Traditional theories of disease causation are very different to those of Western science. Traditional healers – suppressed during the colonial era, and often demonised in the media – are understandably suspicious of authority. Many are reluctant to reveal details of their remedies for fear that their ideas will be stolen. Likewise, conventional doctors are inclined to be prejudiced against treatments that lack scientific foundation. These are not the only difficulties: “How can healers give their clients a diagnosis of AIDS when it means possibly losing their business? How can a traditional healer – the traditional advocate of a clan’s fertility – counsel an HIV-positive woman who wants to have a child? And how can a traditional healer turn away a sick patient who has become dependent on his or her care and support?”23 It may take months or even years to establish mutual trust, confidence and respect. Success depends on being sensitive to the local context, and cooperation must be on equal terms, regardless of level of education. Rather than trying to change traditional belief systems, research has shown it is better to stress what is common to both forms of medicine, and to establish a common language.24 The best way to maximise the reach of training is to first identify and train a group of the most influential and respected healers, who can each then train many others. This method, however, requires ongoing support if it is to be sustainable.25 Despite the challenges, a number of organisations – such as THETA in Uganda, TAWG in Tanzania, PATF in Zambia, and the Iteach Programme in South Africa – have demonstrated the benefits of collaborating with traditional healers in HIV prevention and care.26 27 28 Much could be gained from replicating these programmes more widely. email print tweet more Where Next? AVERT.org has more about: Palliative care Learning you are HIV positive Recent history of HIV and AIDS Back to top Sign up to our Newsletter Donate References back to top Hsaio HF, et al (2003 June) 'Complementary and alternative medicine use and substitution for conventional therapy by HIV-infected patients' 33(2):157-65 Felise B. Milan, M.D., et al (2008 October) 'Use of Complementary and Alternative Medicine in Inner-City Persons with or at Risk for HIV Infection' 22(10): 811–816 Mills E. et al (17 June 2006) “The challenges of involving traditional healers in HIV/AIDS care” Int J STD & AIDS 17(6) Lewith G.T. et al (September 2005) “Investigating acupuncture using brain imaging techniques: the current state of play” Evidence-based complementary and alternative medicine 2(3) Lee A and Done M.L. (2004) “Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting” Cochrane Database of Systematic Reviews Lee A et al (September 2006) “Publication bias affected the estimate of postoperative nausea in an acupoint stimulation systematic review” Journal of Clinical Epidemiology 59(9) Eiznhamer D.A. et al (November-December 2002) “Safety and pharmacokinetic profile of multiple escalating doses of (+)-calanolide A, a naturally occurring nonnucleoside reverse transcriptase inhibitor, in healthy HIV-negative volunteers” HIV Clinical Trials Mashta, O (2009, 24th August), 'WHO warns against using homeopathy to treat serious diseases' British Medical Journal 339(b3447). Kaptchuk T.J. et al (3 May 2008) “Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome” BMJ 336(7651) Spiegel D. and Harrington A. (3 May 2008) “What is the placebo worth?” BMJ 336(7651) NIH 'Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC)' NIH 'NIH Budget' NCCAM: All Clinical Trials Shang A. et al (27 August 2005) “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy.” Lancet 366(9487) Faculty of Homeopathy (2009) “We Answer the Critics” Chatfield K. and Relton C. (September 2005) “Are the clinical effects of homeopathy placebo effects? - A full critique of the article by Shang et al” Harkey M.R. et al (June 2001) “Variability in commercial ginseng products: an analysis of 25 preparations” American Journal of Clinical Nutrition 73(6) CATIE (2004) “A Practical Guide to Complementary Therapies for People Living With HIV” NCCAM 'Evaluating Web-Based Health Resources' TAC (Dec 2009) 'Equal Treatment Magazine' Ssali, A. (2005, December) 'Traditional healers for HIV/AIDS prevention and family planning, Kiboga District, Uganda: evaluation of a program to improve practices' AIDS Behaviour 9(4):485-93 Kayombo E.J. et al (26 January 2007) “Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania” Journal of ethnobiology and ethnomedicine 3:6 UNAIDS (2000) “Collaboration with traditional healers in HIV/AIDS prevention and care in sub-Saharan Africa – A Literature Review” [PDF] UNAIDS (2006) “Collaborating with Traditional Healers for HIV Prevention and Care in sub-Saharan Africa: suggestions for Programme Managers and Field Workers” [PDF] Mills E. et al (June 2006) “The challenges of involving traditional healers in HIV/AIDS care” Int J STD & AIDS 17(6) UNAIDS (2000) “Collaboration with traditional healers in HIV/AIDS prevention and care in sub-Saharan Africa – A Literature Review” [PDF] AllAfrica (2010, August 27th) 'Zambia: Traditional Healers And HIV/Aids' The Witness, (2012, 24th September), ‘Sangomas: certified to hand out condoms to fight HIV’ english español back to content home pageHIV & AIDS Topics Treatment & CareEpidemicGlobal EpidemicAIDS & HIV Around the WorldAIDS : What is AIDS? What causes AIDS?HIV & AIDS NewsHIV : The virus that causes AIDSReflections on the Epidemic World AIDS DayMoney for HIV/AIDSFunding for HIV and AIDS Money for HIV/AIDSPEPFARThe Global Fund How different people are affected by HIV and AIDS Men Who Have Sex with Men (MSM)Children orphaned by HIV and AIDSChildren, HIV and AIDSHIV/AIDS and Vulnerable Groups Prisons, Prisoners and HIV/AIDSTransgender People and HIV/AIDSWomen and HIV/AIDSIssuesHIV & Injecting Drug Users HIV & AIDS Stigma and DiscriminationHIV and AIDS IssuesHIV and Sex WorkHistoryHIV and AIDS HistoryAIDS TimelineHistory of AIDS Up to 1986History of AIDS: 1987-1992History of AIDS: 1993-1997History of AIDS: 1998-2002History of AIDS: 2003-2006History of AIDS: 2007 OnwardsAVERT History History of the HIV and AIDS Charity AVERT AVERT: Early 1990s to the start of the InternetAVERT: Overseas projects & developing AVERT.orgAVERT: Southern African projects and AVERT.orgAVERT: The First Five YearsLiving with HIVLiving with HIV and AIDSAm I going to die?Emotional Needs and SupportHIV and PregnancyLearning You Are HIV PositiveLiving with HIV StoriesWhat is living with HIV?PreventionOverview of HIV preventionHIV Prevention Around the WorldIntroduction to HIV PreventionPrevention of HIV transmission from mother to childHIV Transmission from Mother-to-childPreventing Mother-to-child Transmission (PMTCT) in PracticePreventing Mother-to-child Transmission of HIV WHO Guidelines for PMTCT & BreastfeedingPrevention of HIV transmission through bloodBlood Safety and HIVNeedle Exchange and Harm ReductionPrevention of HIV Transmission through BloodAIDS and sex educationAbstinence and Sex EducationHIV Prevention through Sex EducationHIV/AIDS Education and Young PeopleIntroduction to HIV and AIDS EducationLessons and Activity PlansSex Education That WorksPrevention of sexual transmission of HIVCircumcision & HIVCondoms: Effectiveness, History and AvailabilityHIV Prevention StrategiesPrevention of Sexual Transmission of HIVSex Workers and HIV PreventionThe Female CondomUsing Condoms, Condom Types and SizesHIV treatment as preventionHIV Treatment As PreventionHIV Treatment for PreventionPost-exposure Prophylaxis Pre-exposure ProphylaxisScienceHIV scienceA Cure for AIDSA World Free from HIVHIV and AIDS VaccineHIV Causes AIDSHIV Drugs, Vaccines and Animal TestingHIV Structure and Life CycleHIV Types, Subtypes Groups and StrainsMicrobicidesThe Origin of HIV and AIDS StatisticsWorldwide HIV & AIDS StatisticsUnderstanding HIV and AIDS StatisticsWorldwide HIV & AIDS StatisticsWorldwide HIV & AIDS Statistics CommentaryAmerican HIV & AIDS StatisticsUnited States of America HIV & AIDS Statistics Canadian HIV & AIDS StatisticsCanada AIDS Statistics by Year and AgeCanada HIV Statistics SummaryLatin American & Caribbean HIV & AIDS StatisticsCaribbean HIV & AIDS StatisticsLatin America HIV & AIDS StatisticsAfrican HIV & AIDS StatisticsSouth Africa HIV & AIDS StatisticsSub-Saharan Africa HIV & AIDS StatisticsAsian HIV & AIDS StatisticsIndia HIV & AIDS StatisticsSouth East Asia HIV & AIDS StatisticsAustralian HIV & AIDS StatisticsAustralia HIV & AIDS StatisticsEuropean HIV & AIDS StatisticsEuropean HIV and AIDS StatisticsUK HIV and AIDS Statistics Transmission & Testing HIV transmissionAIDS: Fear and AnxietyCan You Get HIV From. . . ?Criminal Transmission of HIVHIV & AIDS SymptomsHIV and BreastfeedingHIV Transmission Questions & AnswersHIV testingHIV TestingHIV Testing Frequently Asked QuestionsTreatment & Care HIV and AIDS treatmentHIV and AIDS TreatmentHIV and AIDS Treatment & CareHIV Treatment for ChildrenStarting, monitoring & switching HIV treatmentHIV and AIDS care HIV and AIDS CareHIV and AIDS Home Based CareHIV/AIDS and PainPalliative CareHIV and AIDS drugsAntiretroviral Drug Side EffectsAntiretroviral Drugs TableHIV and AIDS DrugsNew Antiretroviral DrugsTreatment accessAIDS, Drug Prices and Generic DrugsTreatment AccessUniversal Access to HIV/AIDS TreatmentAIDS-related infectionsHIV Opportunistic Infections: Prevention and TreatmentHIV/AIDS & related InfectionsStages of HIV InfectionTuberculosisOther treatment and careAlternative and Traditional Medicine for HIVHIV and NutritionHIV & AIDS Around The World AfricaThe HIV & AIDS epidemic in AfricaGay Men in Africa and HIV/AIDSHIV and AIDS in AfricaHIV and AIDS in Africa QuestionsThe Impact of HIV & AIDS in AfricaAfrican countriesHIV & AIDS in BotswanaHIV & AIDS in MalawiHIV and AIDS in KenyaHIV and AIDS in NigeriaHIV and AIDS in South AfricaHIV and AIDS in SwazilandHIV and AIDS in TanzaniaHIV and AIDS in UgandaHIV and AIDS in ZambiaHIV and AIDS in ZimbabweHIV and AIDS in LesothoHistory of HIV & AIDS in AfricaHistory of HIV & AIDS in AfricaHistory of HIV & AIDS in South AfricaTimeline of AIDS in AfricaAmericasHIV & AIDS in the United StatesHistory of HIV & AIDS in the United States of AmericaHIV & AIDS in the United States of AmericaHIV & AIDS Treatment in the United States of AmericaHIV and AIDS Among African AmericansHelp and advice for HIV and AIDS in AmericaUSA HIV & AIDS Help and AdviceHIV & AIDS in Latin America and the CaribbeanHIV & AIDS in BrazilHIV and AIDS in Latin AmericaHIV and AIDS in the CaribbeanAsia & EuropeHIV & AIDS in AsiaHIV & AIDS in ChinaHIV & AIDS in ThailandHIV and AIDS in AsiaOverview of HIV and AIDS in IndiaTimeline of AIDS in AsiaWho is Affected by HIV and AIDS in India?HIV & AIDS in EuropeHistory of HIV & AIDS in the UK 1981-1995History of HIV & AIDS in the UK 1996 OnwardsHIV and AIDS in Russia, Eastern Europe & Central AsiaHIV and AIDS in the UKHIV and AIDS in Western and Central EuropeHIV and AIDS Treatment in the UKHelp and advice in the UKHelp and Advice for HIV/AIDS in the UKWho Has to Pay for NHS Treatment in the UK?Sex, Sexuality & Relationships Gay & LesbianGay & LesbianAm I Gay? Are You Born Gay? Can You Stop Being Gay?Coming outGay and LesbianGay SexHomophobia, Prejudice & Attitudes to Gay Men & LesbiansHomosexual or Gay?How Many Gay People Are There?Lesbians, Bisexual Women and Safe SexYoung & GayBeing Gay at SchoolHIV, AIDS and Young Gay MenGay & LesbianAm I a Lesbian?Am I Gay?Young Gay Men & LesbiansResources & helpResources for people who are gay, lesbian or unsure'Young Gay Men Talking' booklet [PDF]STDsCommon STDsChlamydia Genital Warts HPVGonorrhea Hepatitis A, B & CHerpes STD PicturesSTIs or STDsSyphilisSTD StatisticsSTD Statistics WorldwideSTDs in AmericaSTDs in the UKSexInformation about sex Condoms & Spermicides questionsContraception questionsHow to Have SexOral SexPregnancy QuestionsSex QuestionsWorldwide Ages of ConsentYoung PeopleRelationships & SexAm I Ready for Sex?Being Gay, Sexuality and Attraction Having SexHaving Sex for the First TimeRelationships and FeelingsRelationships and Sex Your Body and PubertyPuberty and Boys' BodiesPuberty, Periods and Girls' BodiesYour Body, Puberty and Sexual Organs Having Safer SexAbout HIV/AIDS for Young PeopleAbout STIs & STDs for Young PeopleBirth Control and Contraception for Young PeopleCondom Tips for Young PeopleDrink, Drugs & SexHaving Safer SexSex, the Internet and TechnologySex, the Law and Young PeopleHIV-positive LifeBeing HIV-positive and HealthyFinding Out That You're HIV-positiveFriends, Attitudes and HIVSex and Relationships for HIV-positive Young PeopleFAQ about sexQuestions About Sex for Young PeopleOther WebsitesGo Ask Alice!Sex, Etc.BBC - The SurgeryPhotos, Videos, Games & Stories Games Play our games to test your knowledge and skills, while learning new facts. See how much you know about HIV/AIDS and sexual health, with our AIDS Game, Sex Education Game, Pregnancy Game and Condom Game. Use your mouse to collect the right letters while avoiding the baddies for a chance to appear on our HI-scores table. Give our games a try now, and see how well you can do! AIDS Game Pregnancy Game Sex Education Game Condom Game Photos & Videos Our media gallery contains hundreds of HIV and AIDS related photos, videos and graphics. You can have a look around, use the search feature, or take a look at some photo selections. Photo Selections Photos & Videos Gallery Media Types Photos Graphics Videos Search the Media Gallery Latest media: Quizzes Try our quizzes to test your knowledge on all aspects of sexual health and HIV and AIDS. We have a Sex Quiz, Pregnancy Quiz, Condom Quiz and an HIV and AIDS Quiz. Just a beginner? Then try the quizzes' easy levels. Think you're an expert? Well try the hard quizzes. AIDS Challenge HIV and AIDS Quiz Pregnancy Quiz Sex Education Quiz Condom Quiz StoriesLesbian and gay storiesComing out StoriesYoung Bisexual and Gay Men: Personal StoriesYoung Lesbian and Bisexual: Personal StoriesHIV and AIDSHIV and AIDS in the FamilyPersonal Stories of Men Living with HIVPersonal Stories of Women Living with HIVPersonal Stories of Young People Living with HIVStories From Around the WorldTalking about sex First Time Sex StoriesStories of Sex EducationSubmit a storyFeatured Story I went through kind of a phase shift from just getting feelings towards this one guy, to be being confused and feeling kind of bi... - Submitted by Wesley Read more >> InternationalYouth Day 2013 Involving youth in the HIV response Giving young people a platform to share their thoughts and experiences raises awareness among their peers and gives an invaluable insight into the needs of this high-risk group. More than 2,400 young people are newly infected with HIV every day, accounting for 40% of new adult infections. Involving youth in the HIV response is key to lowering new HIV infections among the next generation and the role of technology in doing this is now clearer than ever. A sneak preview of results from an AVERT survey, due to be released on International Youth Day 2013 - 12 August, show that most young people prefer to get their sexual health and HIV/AIDS information online or via mobile, as it's quicker, confidential and cheap. But not all youth are the same, we've found regional variations in the type of technology young people prefer - with 67% of respondents from Africa using mobile phones for health information, compared to just 31% in Europe. To commemorate International Youth Day 2013 - 12 August, share your experiences with others by sending AVERT your story. Raise HIV awareness among youth, check out the hints, tips and quizzes below and share them with your friends. Young People Zone Quizzes 'Can't Explain' home pageTemas sobre el VIH y el SIDA ¿Puede Contraer SIDA De. . . ?Síntomas Del VIH Y Del SIDASIDAVIHPruebas De Detección Del VIHVIH, Embarazo, Madres Y BebésVisión General De La Prevención De VIHIntroducción Al Tratamiento De VIH Y SIDALa Evidencia De Que El VIH Causa El SIDALas Estadísticas Del SIDA Y VIH En El MundoSexo, sexualidad y las relaciones ¿Cómo Se Tiene Sexo?Preguntas Generales Sobre SexoUso De Condones, Tipos Y Tamaños De Condones¿Soy Gay? ¿Se Nace Gay? ¿Se Puede Dejar De Ser Gay?Enfermedades De Transmisión Sexual Y Síntomas De ETSMedia, juegos y concursos Fotos y VideosJuegos (en Inglés) Search Avert.org Click to search site search back to content
Alternative and complementary medicine is quite popular among people living with HIV. In America, for example, around half of HIV positive people have reported use of this type of treatment.1 2 Many HIV positive people say they feel better after using alternative and complementary medicine, and it is likely that some of these treatments are indeed beneficial, although unproven according to conventional Western medicine.
Alternative and complementary medicine is the name generally given to those medical and health care systems, practices, and products that are not presently considered to be part of conventional Western medicine. Well known examples include herbal and other nutritional supplements, acupuncture, aromatherapy, homeopathy and yoga.
The more ancient forms of alternative and complementary medicine are also known as traditional medicine.
In relation to HIV, alternative therapies are most commonly used in areas where it is difficult to access Western medicine. In the absence of antiretroviral treatment, people may seek other ways to delay the onset of AIDS, or to treat opportunistic infections. In sub-Saharan Africa, for example, traditional healers outnumber medically qualified doctors eighty-to-one.3 Traditional healers also usually provide immediate treatment, whereas clinics may have lengthy waiting lists and tests for eligibility.
Most people living with HIV in developed countries have ready access to antiretroviral therapy and conventional treatments for opportunistic infections. Because these treatments are so effective, there is less demand for alternative HIV medicine, except perhaps for addressing relatively minor infections, or when antiretroviral treatment cannot any longer be taken, for example because of drug resistance. Many instead look to complementary medicine as a way to prevent or relieve aids treatment side effects, some of which are not easily treatable with conventional medicine. There is also demand for complementary therapies that might boost immunity, relieve stress, or improve general health and wellbeing.
The people who distrust and avoid Western medicine for HIV include not only individuals, but also some governments. For example, senior politicians in South Africa have promoted unproven therapies while at times disparaging antiretroviral drugs. In Gambia, the president himself has treated patients with a herbal mixture he claims is an AIDS cure.
Western medicine embraces all approaches shown to be safe and effective in rigorous scientific trials. By definition, complementary and alternative medicine consists of therapies that are unproven, at least by the standards of Western medicine. Given the many therapies in existence, there can be little doubt that some of them do what they are supposed to. Many others are likely to be ineffective or can even be harmful. In the absence of good scientific trials, it is impossible to be certain which is which.
Still it can be argued that, from a scientific point of view, some treatments are more likely to work than others. Acupuncture, for example, appears to alter brain activity,4 and there is quite good evidence that it can help relieve post-operative nausea.5 6 Herbal medicines, too, are scientifically plausible: a number of modern drugs were derived from plants first used traditionally. Scientists have already identified one plant extract that acts like an antiretroviral drug;7 it is entirely possible that there are others.
At the other end of the scale are therapies that are not considered credible by the scientific community at large. The most notorious of these is homeopathy, which the World Health Organization recommends should not be used to treat HIV.8
Yet even if a medicine has no specific effects on an illness, this doesn’t necessarily mean it is worse than nothing. It is widely accepted that patients’ beliefs about a treatment, and the quality of the doctor-patient relationship, can influence health outcomes. This is what is known as the placebo effect. For example, one trial9 divided irritable bowel syndrome sufferers into three groups: the first received no treatment, the second underwent sham acupuncture (placebo), and the third received fake acupuncture plus a 45-minute consultation with a friendly doctor. The proportions of patients reporting moderate or substantial improvement were 3% (no treatment), 20% (placebo only) and 37% (placebo plus interaction). This effect may well account for some of the reported benefits of alternative and complementary medicine, as suggested in an editorial that accompanied the study:
“Is it possible that the alternative medical community has tended historically to understand something important about the experience of illness and the ritual of doctor-patient interactions that the rest of medicine might do well to hear? … The meanings and expectations created by the interactions of doctors and patients matter physically, not just subjectively.”10
Even if it fails to ease symptoms, the treatment experience may have non-specific effects such as boosting self-confidence and relieving anxiety. Group therapies – such as yoga – are particularly good for meeting new people, who may be able to share knowledge of other treatment options.
Supporters of complementary and alternative medicine propose a number of reasons why their therapies have not been subjected to thorough testing. For one thing, major medical trials are highly expensive; if there is no prospect of a patent then there is less of an incentive to invest in research. Reliable, ethical trials also require a considerable amount of expertise. Many scientists with the necessary skills are reluctant to investigate therapies they think are implausible.
Yet it is misleading to suggest that no research takes place. The US government has an agency (NCCAM) dedicated to complementary and alternative medicine, and in 2010 the National Institutes of Health (NIH) allocated nearly around $520 million to this field11 (around 1.5% of all federal funding for medical research).12 Potential HIV therapies investigated in government-sponsored trials include acupuncture, yoga, Reiki and distant healing.13
Although practioners of complementary and alternative medicine generally voice support for scientific research, they are often unwilling to accept negative findings. In 2005, medical journal The Lancet published the most thorough review of homeopathy trials ever conducted.14 Having analysed more than one hundred trials related to a wide range of illnesses, the authors concluded,
“there was no convincing evidence that homeopathy was superior to placebo.”
Homeopaths united in objecting to the methodology of both the trials and the review.15 Some even suggested that placebo-controlled randomised trials (regarded as the gold-standard of medical science) were inappropriate for testing their system of healing.16
Some forms of complementary and alternative medicine can cause harmful side effects. Words like “natural” and “traditional” are certainly no guarantee of safety.
Herbal or nutritional therapies (notably St John’s Wort) may also interact with other medications, making them less effective or worsening their side effects.
In general, herbal remedies and dietary supplements are not covered by the strict regulations that govern pharmaceutical drugs. Quality is inconsistent even among popular commercial formulations; tests have shown that the concentrations of active ingredients can vary greatly from the amounts listed on the packaging.17
The standard of complementary and alternative practitioners is similarly uneven. Although some countries regulate certain types of practitioners (such as osteopaths in the US and UK), many people practise without any formal qualifications.
Even if a therapy carries little risk of direct physical harm, it may still turn out to be a waste of time and money. Relying on alternative medicine instead of scientifically proven treatment can have very serious consequences. Once HIV has severely weakened the immune system, antiretroviral drugs are less likely to be life-saving.
HIV positive people have a long history of taking control of their own healthcare decision-making. Those interested in complementary medicine can take steps to maximise their chances of success.
The Canadian AIDS Treatment Information Exchange (CATIE) suggests ten questions for assessing a new therapy:18
Careful research is needed to answer these questions. Good sources of information include reference books on complementary medicine (available in many libraries), medical journals (which can be searched using the PubMed website), and the publications of reputable health organisations. The National Center for Complementary and Alternative Medicine (NCCAM) provides information intended to help people make sense of web-based health resources on complementary medicine.19 Many AIDS organisations and other bodies, including NCCAM, will answer enquiries over the phone or online.
As already discussed, all forms of complementary medicine are unproven according to Western conventional medicine; each individual must make their own assessment of likely risks and benefits based on the available data. The most reliable evidence comes from large human trials – preferably randomised trials in which the treatment is compared to a placebo. Personal testimonies and laboratory findings should be given less weight, especially if they appear only in promotional material. Anyone who makes sensational claims (such as being able to cure many unrelated diseases with a single therapy), or who attacks conventional treatment, is probably best avoided.
If you have done your research and wish to try a complementary therapy, the next step is to talk to your personal doctor or HIV specialist. This is important because there may be a risk of interactions with other medications.
Some medical doctors have received training in complementary medicine. If your doctor lacks such expertise then it may be sensible to also find a complementary practitioner, ideally one with experience in treating people with HIV. Help finding a practitioner may be obtained from your doctor, an AIDS service organisation, or a professional body such as the Institute for Complementary Medicine in the UK, or the American Holistic Medical Association in the US. There are many practitioners available; it is worth taking the time to find one you trust and feel comfortable with. Look for experience, qualifications and references you can verify.
When purchasing a herbal medicine or nutritional supplement, try to choose a reputable seller and manufacturer. Large, long-established companies are generally the most trustworthy because they have more to lose from selling poor quality goods. If possible, look for a company that submits its products for independent quality testing.
Having started a new treatment, it is a good idea to keep a diary of your symptoms. This will help you assess whether the therapy is having the desired outcome, or whether it may be causing unwanted side effects.
Complementary and alternative therapies can be divided into five main categories. The list below contains a few of the most popular examples.
Whole medical systems
Mind-body medicine
Biologically based practices
Manipulative and body-based practices
Energy medicine
Sub-Saharan Africa is the region worst affected by AIDS; it is also a region in which most people turn first to traditional healers when they fall ill. There is potential for traditional healers to play an important role in responding to the epidemic.
Although few have been scientifically tested, there can be little doubt that some of the remedies given by traditional healers are effective in treating HIV-related opportunistic infections and drug side effects. However, in common with all forms of medicine, these therapies may also do harm through side effects, drug interactions, or delaying use of conventional treatment. In addition, the reuse of implements for rituals such as scarification, tattooing and circumcision can transmit infections, including HIV. Some African healers blame illness on witchcraft, which can lead to ostracism of those accused.
Collaboration between traditional healers and Western doctors has the potential to improve safety, for example by encouraging better hygiene. Training can also assist traditional healers in identifying illnesses beyond their capacity to treat, hastening referral to a clinic when necessary. In South Africa, The Traditional Health Practitioners Act includes a council to oversee and provide training to traditional health practitioners to protect the interests of the patient. As yet, the Act has not been fully enforced; there have been calls to implement the Act alongside a robust system of scientific testing of 'remedies'.20
Traditional healers are respected within their communities, and know how to convey health information in a culturally appropriate manner.21 They are ideally placed to teach HIV prevention, distribute condoms, conduct counselling, encourage HIV testing, and set up support groups for affected people.
Yet although traditional healers are generally eager to learn from other health workers, experience has shown it is not necessarily easy to establish successful collaboration.22 Traditional theories of disease causation are very different to those of Western science. Traditional healers – suppressed during the colonial era, and often demonised in the media – are understandably suspicious of authority. Many are reluctant to reveal details of their remedies for fear that their ideas will be stolen. Likewise, conventional doctors are inclined to be prejudiced against treatments that lack scientific foundation. These are not the only difficulties:
“How can healers give their clients a diagnosis of AIDS when it means possibly losing their business? How can a traditional healer – the traditional advocate of a clan’s fertility – counsel an HIV-positive woman who wants to have a child? And how can a traditional healer turn away a sick patient who has become dependent on his or her care and support?”23
It may take months or even years to establish mutual trust, confidence and respect. Success depends on being sensitive to the local context, and cooperation must be on equal terms, regardless of level of education. Rather than trying to change traditional belief systems, research has shown it is better to stress what is common to both forms of medicine, and to establish a common language.24
The best way to maximise the reach of training is to first identify and train a group of the most influential and respected healers, who can each then train many others. This method, however, requires ongoing support if it is to be sustainable.25
Despite the challenges, a number of organisations – such as THETA in Uganda, TAWG in Tanzania, PATF in Zambia, and the Iteach Programme in South Africa – have demonstrated the benefits of collaborating with traditional healers in HIV prevention and care.26 27 28 Much could be gained from replicating these programmes more widely.
english español
Play our games to test your knowledge and skills, while learning new facts. See how much you know about HIV/AIDS and sexual health, with our AIDS Game, Sex Education Game, Pregnancy Game and Condom Game. Use your mouse to collect the right letters while avoiding the baddies for a chance to appear on our HI-scores table.
Give our games a try now, and see how well you can do!
Our media gallery contains hundreds of HIV and AIDS related photos, videos and graphics. You can have a look around, use the search feature, or take a look at some photo selections.
Try our quizzes to test your knowledge on all aspects of sexual health and HIV and AIDS. We have a Sex Quiz, Pregnancy Quiz, Condom Quiz and an HIV and AIDS Quiz.
Just a beginner? Then try the quizzes' easy levels. Think you're an expert? Well try the hard quizzes.
I went through kind of a phase shift from just getting feelings towards this one guy, to be being confused and feeling kind of bi... - Submitted by Wesley Read more >>
Giving young people a platform to share their thoughts and experiences raises awareness among their peers and gives an invaluable insight into the needs of this high-risk group. More than 2,400 young people are newly infected with HIV every day, accounting for 40% of new adult infections.
Involving youth in the HIV response is key to lowering new HIV infections among the next generation and the role of technology in doing this is now clearer than ever.
A sneak preview of results from an AVERT survey, due to be released on International Youth Day 2013 - 12 August, show that most young people prefer to get their sexual health and HIV/AIDS information online or via mobile, as it's quicker, confidential and cheap. But not all youth are the same, we've found regional variations in the type of technology young people prefer - with 67% of respondents from Africa using mobile phones for health information, compared to just 31% in Europe.
To commemorate International Youth Day 2013 - 12 August, share your experiences with others by sending AVERT your story. Raise HIV awareness among youth, check out the hints, tips and quizzes below and share them with your friends.