Complementary and alternative medicine and HIV/AIDS. Part I: Issues and context

doi:10.1016/S1055-3290(97)80035-0

Journal of the Association of Nurses in AIDS Care

Volume 8, Issue 1, January–February 1997, Pages 23-31

https://doi.org/10.1016/S1055-3290(97)80035-0 Get rights and content

This paper reviews the definitions of complementary and alternative medicine (CAM) and adopts the definition, “Complementary and alternative medicine is defined through a social process as those practices that do not form part of the dominant system for managing health and disease” (Jonas, 1996, p. 1). The authors review the literature on CAM usage in the general and HIV/AIDS populations, and the impact of CAM on modern Western medicine and the allied health professions. Host-virus factors in HIV/AIDS are examined from the perspectives of both Western medicine and complementary and alternative medicine. Methodological issues and the historical argument over the relative importance of host and microbe are explored in relation to HIV/AIDS and the CAM and Western approaches to HIV/AIDS care.

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Citation Excerpt :
In populations with chronic or terminal diseases, complementary and alternative medicines (CAM) have been shown to have higher usage than the general population, likely due to the belief that CAM may reduce disease symptoms or side effects from conventional treatments.1–5 In the early HIV-era, CAM usage was high, due to HIV's debilitating effects and a paucity of effective treatment options.6–9 CAM covers a diverse group of treatment and products utilized by many health professionals.
Our goal in this study was to examine how Vitamin C interacts with antiretroviral therapy in individuals with HIV. We specifically evaluated how Vitamin C impacts highly active antiretroviral therapy (HAART) adherence and HAART effectiveness as adjudicated by HIV viral loads and CD4 cell counts. Women served as their own controls, comparing periods of Vitamin C usage with periods of non-usage.
An intra-individual, cross-sectional comparative study ‘nested’ in the WIHS observational cohort study.
Women in the Women's Interagency HIV Study (WIHS).
Adherence, CD4 count and viral load.
Our study population was drawn from 2813 HIV+ participants who contributed 44,588 visits in WIHS from October, 1994 to April, 2009. Among them, there were 1122 Vitamin C users with 4954 total visits where use was reported. In the multivariate model adjusting for age, education, race, income, drug use, Vitamin C use order and depression score, there was a 44% increase in the odds of ≥95% HAART adherence among participants during their period of Vitamin C use compared to when they were not using Vitamin C (OR = 1.44; 95% CI = 1.1–1.9; P-value = 0.0179). There was an association with Vitamin C usage and CD4 counts on viral loads.
Vitamin C usage appears to be associated with improved adherence. Future Vitamin C studies should target specific HAART drugs, and prospective clinical outcomes.
An overlooked majority: HIV-positive gay men who smoke
2012, Journal of Men's Health
Citation Excerpt :
While a meta-analysis of 24 studies has shown that hypnosis is slightly more effective in men for TC [80], more randomized control trials with robust outcome measures are needed [81,82]. CAM is already widely used among PLWH to treat a variety of symptoms and syndromes [83–86]. Perhaps CAM TC interventions might be viable options; however, evidence is limited in relation to CAM acceptability or specific effect among HIV-positive gay men who smoke.
Therapeutic advances have dramatically improved health outcomes and life expectancy among persons living with HIV, but gains in life expectancy achieved by antiretroviral therapy may be mitigated by other health risk behaviours. HIV-positive gay men are especially at-risk for smoking and its adverse health risks. This scoping review summarizes evidence related to HIV and smoking, paying particular attention to gay men's masculinities as a means of providing direction for tailored tobacco cessation interventions for this vulnerable group. HIV-positive gay men face challenges with managing a complex disease and its psychological and social issues require tailored tobacco cessation interventions cognisant of the diverse social contexts in which they live. Although tobacco cessation intervention research among these men is limited, we make some recommendations to guide researchers and health care providers who work with these men.
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2002, The Journal of the Association of Nurses in AIDS Care : JANAC
The objective of this article is to provide a qualitative analysis of the practical concerns that people with HIV/AIDS have with regard to their use of complementary therapies. In-depth semistructured interviews were conducted with a diverse range of people with HIV/AIDS (N = 46). An inductive grounded approach was used to collect and analyze the data. There were five central concerns: (a) selecting which therapies to use, (b) judging which therapies work, (c) combining Western medicine with complementary therapies, (d) assessing the safety of complementary therapies, and (e) dealing with the barriers to the use of complementary therapies. A better understanding of the practical dimensions of complementary therapy use highlights the treatment and care issues that people with HIV/AIDS face and offers insights into the role that nurses might play in addressing some of these issues.
Position of the American Dietetic Association and Dietitians of Canada: Nutrition intervention in the care of persons with human immunodeficiency virus infection
2000, Journal of the American Dietetic Association
Citation Excerpt :
Also, because people with HIV/AIDS may be more medically fragile than the general population, consequences of nutrition-related misinformation may be more severe. Dietitians should offer guidelines for evaluating nutrition-related complementary and alternative therapies so that clients can make informed decisions about their use (99–102). Energy deficits and weight loss continue to be issues for HIV-infected people who experience increased resting-energy expenditure rates (103) despite apparent control of HIV viral load (104).
Human immunodeficiency virus (HIV) targets the immune system, making an infected person susceptible to infection and neoplasm because of an impaired ability to mount an adequate immune response. Malnutrition and its complications can further render an HIV-infected person susceptible to opportunistic infection and reduced effectiveness and tolerance to medications and other therapies. Though effective antiretroviral treatments have dramatically reduced death rates in the United States and Canada, HIV-infected people face a lifetime of vigilant polypharmacy to control HIV and associated complications. Malnutrition, various forms of tissue wasting, fat accumulation, increased lipid levels, and risk of additional chronic disease have become central issues in health care plans.
It is the position of the American Dietetic Association and Dietitians of Canada that efforts to optimize nutritional status, including medical nutrition therapy and nutrition-related education, should be components of the total health care provided to people infected with human immunodeficiency virus HIV. J Am Diet Assoc. 2000;100:708-717.
A review of the use of complementary and alternative medicine and HIV: Issues for patient care
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Complementary and alternative therapies in nursing curricula: A new direction for nurse educators
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Complementary and alternative medicine and HIV/AIDS. Part I: Issues and context

JANAC

Social Science and Medicine

Social Science and Medicine

Dealing with alternative therapies for HIV

Imagery in healing: Shamanism in modern medicine

New picture of HIV pathogenesis

Viral load and clinical outcome: The search for correlation — An interview with Michael Saag, MD

AIDS: More revelations

New African

Acupuncture and Oriental body work: Implications for nursing philosophy and practice

The primacy of caring: Stress and coping in health and illness

Referrals for alternative therapies

The Journal of Family Practice

The status of complementary/alternative medicine in the United Kingdom

Nurse Practitioner Forum

The gravest show on earth: America in the age of AIDS

New perspectives on HIV pathogenesis

JANAC

Acupuncture. A viable medical alternative

Social science theory and methods in the study of alternative and complementary medicine

The Journal of Alternative and Complementary Medicine

A healthy business? Work, health and the pharmaceutical industry

Art and aesthetics in nursing

Early intervention in HIV infection: Where are we?

AIDS Research and Human Retroviruses

Zidovudine resistance and HIV-1 disease progression during antiretroviral therapy

Annals of Internal Medicine

How should alternative therapies be evaluated?

Alternative Therapies

Inventing the AIDS virus

Unconventional medicine in the United States

New England Journal of Medicine

Comparison of nurses and alternative healers

Image

Patients who seek unorthodox medical treatment

Minnesota Medicine

Flying by the seat of our pants & treating HIV and AIDS: A survey of current practices

GMHC Treatment Issues

Current report—HIV antiretroviral strategies revisited

Journal of the American Board of Family Practice