Many HIV Patients Turn to Alternatives

Medically Reviewed by Annie Finnegan
From the WebMD Archives

Oct. 10, 2000 -- Many people infected with HIV, the virus that causes AIDS, are turning to alternative treatments -- in addition to conventional ones -- to help alleviate symptoms including pain. But just how many people are trying things like herbs, massage, or acupuncture and, more importantly, do they work? Two new studies appearing in a recent edition of the journal Alternative Therapies say they do -- to a certain extent.

In one study of nearly 1,000 HIV patients in Australia, researchers not only wanted to know how many people were using alternative therapies but why they were using them. "The aim of the research was to determine the extent to which people use alternative therapies" instead of or in conjunction with traditional ones -- especially antiretroviral treatments commonly used to halt the spread of the disease, researcher Richard de Visser tells WebMD. De Visser is a doctoral candidate and project officer at the Australian Research Centre in Sex, Health, and Society at La Trobe University in Melbourne.

The researchers found subjects were using alternative treatments including nutritional supplements, diet modification, herbal remedies, massage, and meditation and prayer. The study did not include acupuncture. De Visser says the two major findings were that more than half of all those studied -- 56% -- use alternative therapies, and they're usually used along with antiretroviral drugs. "It is therefore not surprising that [HIV patients] had favorable attitudes to both antiretroviral drugs and alternative therapies," de Visser says.

De Visser also says they found most people do not make an either/or choice between alternative therapies and antiretroviral drugs. Instead, they choose therapies that will best enable them to minimize the side effects of both their disease and medications, and enhance their general well-being. "Taking a holistic approach and being actively involved in health care decision making appears to be important for [these patients], and may be important for people with other chronic conditions," de Visser says.

At the Yale School of Nursing, researchers studied 11 people with HIV to see if acupuncture helped relieve symptoms -- such as pain -- and improve their quality of life as a result. Researcher Margaret W. Beal, PhD, says it did. Typically, acupuncture involves penetration of specific locations on the skin -- called acupuncture points -- by thin, sterilized needles.

Beal, an associate professor at the Yale School of Nursing, says since the study was so small, people shouldn't jump to conclusions about the effectiveness of acupuncture to relieve HIV symptoms. "However, since all of our patients in this study who had gastrointestinal symptoms had some relief, there's good reason to think there's potential for acupuncture to be effective for people with [gastrointestinal] problems either from HIV or their medicines they take for HIV." In fact, Beal says Yale researchers have applied for a grant from the NIH's National Center for Complementary and Alternative Medicine to study acupuncture relief of gastrointestinal symptoms in people with HIV.

Health care professionals overwhelmingly agree that patients should consult their doctor before using alternative treatments, says Beal, whether it's acupuncture, changes in diet, or herbs. "There are numerous reports of people trying things on their own. I understand their desperation, but if they are unaware of the risks, they may just make matters worse."

Take the herb St. John's wort, a popular herb used to treat mild-to-moderate depression. In the U.S., herbs are categorized as food supplements and can be sold without approval from the FDA. Last February, two studies in the British medical journal The Lancet showed the herb interferes with HIV drug therapies. At the time, Georg Noll, MD, an author of one report, said many doctors and patients are not aware that herbs bought at the corner pharmacy may be dangerous, especially since they can interfere with other medications. "I tell patients they shouldn't take any over-the-counter drug without informing the treating doctor," he told WebMD. Noll is a cardiologist at University Hospital in Zurich, Switzerland.

As a result of The Lancet studies, the FDA did act. It quickly issued an advisory letter to health care providers warning about combining St. John's wort with other medications. Specifically, that it can stunt HIV treatment and reduce the effectiveness of many drugs or lead to drug-resistant viruses. "People suffering want relief," Noll says. "But instead, they may just make matters worse if they don't seek sound medical advice."

De Visser says the results of the Australian study and other research reveals that many people living with HIV want to be, and are, very active in decision making about their health care. In Australia, he says, these patients have free access to many antiretroviral treatments, but they also have access to a range of alternative therapies. "Although they have to meet the full cost of alternative therapies, it appears that many [of them] believe that use of alternative therapies improves their quality of life."