In the 80s and early 90s, many people with HIV/AIDS turned toward alternative and complementary medicine to manage their condition. This was due in large part to the fact that no treatment existed for HIV infection until AZT/Retrovir became available in the late 80s. And even then, many people did not see much advantage to the drug. (In hindsight, it’s safe to say that monotherapy with the drug was nearly worthless except for people at death’s door.)
In the mid-90s, with the advent of combinations of different classes of drugs (discussed elsewhere), the apparent need for alternative approaches waned. However, now that people are living longer, they are more likely to see problems arise from long term use of antiretroviral therapy (ARV). Once again, many are turning toward other approaches to manage HIV infection. Some use them to slow progression so they may delay the use of ARV. Others use them to augment their current drug regimen or to deal with the side effects of antiviral agents.
First, let’s clarify some terms. As used here alternative, means something that is used instead of mainstream medicine to produce the same effect. One example might be someone who uses the naturally occurring antidepressants in St. John’s wort to manage mild-to-moderate depression instead of a pharmaceutically-based, antidepressant drug. By contrast, complementary medicine refers to the use essentially of whatever works. Over the past few decades, however, there is an increasing recognition by practitioners of these various arts that each has something to offer. It is a slow revolution, arising in no small degree to the efforts of AIDS activists around the world. Thus, integrative normal holistic medicine endeavors to understand disease from a perspective that looks at what works from any tradition, but maintains its focus on the individual patient at various levels.
There are a wide variety of forms that integrative medicine may take. The so-called allopathic medicine approach utilizes surgery, radiation, psychoanalysis and other “talking” psychotherapies, physical therapy, and pharmacologic or drug-based therapy. Integrative medicine may include such “alternative” methods as the use of vitamins, minerals and amino acids (collectively, micronutrients), often at doses above the minimum necessary to prevent deficiency diseases as well as herbs. In addition, it may also include a variety of “complementary” modalities, including massage therapy, Reiki, meditation, intercession at a distance (or prayer therapy), movement work (such as Qi Gung or Tai Chi), or acupuncture. Some practitioners are trained in the ancient traditions of Tibetan or Chinese medicine, Ayur Vedic medicine (from India) or African traditional medicine. Each of these traditions recognizes the importance of diet, sleep and exercise as critical to maintaining health.
Unfortunately, many of the alternative modalities have somewhat limited data from which to determine efficacy and potency, or on which to base decisions about utility. But this situation is changing. More and more clinical studies are being designed and run that are showing the limitations, benefits and risks of using these types of modalities. The data set is slowly building upon the lore of what may be in some cases thousands of years of tradition.