AEGiS-GMHC: Alternative Therapies for AIDS: An Historical Review

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Alternative Therapies for AIDS: An Historical Review

Gay Men's Health Crisis: Treatment Issues, Volume 7 no. 11/12 - Winter, 1993/94
Carola Burroughs

The use of unconventional, "alternative," natural, or complementary therapies for AIDS, as for any other illness, has often been founded in a frustration with the lack of safe or effective conventional treatments: many people seek out unconventional therapies not out of any intent to be different, but simply to find relief from problems which conventional service providers either do not address or seem unable to deal with adequately. In the case of AIDS, since for years few drugs were even available, some PWAs sought out alternative treatments from the earliest years of the epidemic. Although advocates of alternative therapies for AIDS have continued to push for wider availability of and research into such treatments, they have been very much a minority within the AIDS service community until quite recently, when the vital role played by nutrition and oxidative stress has finally begun to receive greater recognition, and the results of the Concorde study, as well as the paucity of other promising AIDS drug treatments seen at the last International Conference in Berlin, have called into question the value of conventional antiretroviral drugs.

The recent growth of interest in alternative therapies within the AIDS community reflects an increase in attention on the part of the public as a whole, as demonstrated by the results of the Eisenberg[1] study which appeared in the January 1993 issue of The New England Journal of Medicine. This study concluded that "the frequency of use of unconventional therapy in the U.S. is far higher than previously reported": a full 34 percent of the survey respondents reported using at least one "unconventional" therapy in the preceding one-year period, and the number of visits made to alternative practitioners was estimated at 425 million, exceeding the number made to all U.S. primary care physicians. The establishment of an Office of Alternative Medicine at the National Institutes of Health in June 1992, by Congressional mandate, is another indicator of the heightened interest in investigating and validating alternative therapies. However, not surprisingly, there remains a significant amount of resistance and skepticism on the part of the medical establishment to many unconventional therapies, whether for AIDS or any other disorder.

The term "alternative medicine" is a catch-all phrase which includes therapeutic nutrition, chiropractic, homeopathy, structural and energetic therapies and mind-body interventions, traditional ethnomedicinal systems such as Chinese medicine and Ayurveda which combine botanical medicine with other applications, other uses of non-Western and Western herbs, and various treatments which simply have not been accepted by the medical establishment. Alternative medicine has been variously called "natural," "complementary," "holistic," and numerous other terms which refer to elements of a particular modality or tradition. "Complementary" is the preferred term in Europe. The traditional ethnomedicinal systems are by nature holistic, meaning that they aim to treat the whole individual, rather than a specific disease or symptom, and that they address not only the physical aspect of the patient but also mind and spirit. It is assumed that each individual possesses an innate healing capacity (the "immune system" in the broadest sense), and the goal generally is to reinforce this capacity and restore strength and balance to weakened systems using a variety of natural modalities: foods, herbs and other botanicals, body work, detoxification, etc., tailored as much as possible to the individual's specific constitution and condition.

The use of alternative therapies for AIDS grew out of this same eclectic mix. Traditional Chinese Medicine (TCM) and acupuncture, in particular, became available for AIDS treatment early on in a number of cities. At Lincoln Hospital in the Bronx, Dr. Michael Smith and others who had participated in the development of the Lincoln Hospital acupuncture project for drug treatment during the 1970s, were in the forefront of AIDS treatment as well. In 1984 a number of clinics and acupuncture centers in San Francisco and the Boston area began to treat PWAs, and others followed. The Chicago AIDS Alternative Health Project, founded in 1986, was the world's first acupuncture clinic dedicated exclusively to the treatment of AIDS. The Institute for Traditional Medicine in Portland, Oregon developed a series of Chinese herbal formulas (the best known of which is Composition A) which have been extensively followed since 1986 at ITM, at the Immune Enhancement Project in San Francisco, and at the University of Miami. Other aspects of TCM such as Qigong and Taiji (or T'ai Chi), are also used for their proposed therapeutic benefits.

The Zen macrobiotic diet was another popular approach, particularly for people with Kaposi's Sarcoma, and its use led to the 1982 founding in New York of Health Education AIDS Liaison (HEAL), the oldest support and resource organization promoting the use of natural and non-toxic therapies for AIDS. The development of a Western-based version of Ayurvedic medicine, the traditional medicine of India, and the Transcendental Meditation program, resulted in the founding of Ayurveda Resources of New York, a resource and support group for people with AIDS which employed meditation, herbal and purifying massage therapies to enhance immune function.

Throughout the U.S., during the second half of the 1980s, holistically-oriented MDs, OMDs (Doctor of Oriental Medicine), chiropractors, and naturopaths, developed AIDS protocols combining nutrition, Western and Asian herbology, acupuncture, homeopathy, exercise, and mind-body approaches. Publications such as the Healing AIDS newsletter, People with AIDS (PWA) Coalition Newsline, and John James' AIDS Treatment News provided information and resource listings about the growing body of treatment information. Among other widely-used treatment approaches, mind-body therapies were recognized early on as an important aspect of immune enhancement. This area includes therapies such as meditation, imagery/visualization, biofeedback, hypnosis, psychotherapy, expressive therapies (music, art, and dance/movement), therapeutic and healing touch, and spiritual healing. Organizations such as the PWA Coalition, Northern Lights Alternatives, Body Positive, and the Center for Attitudinal Healing offered workshops and seminars. The Manhattan Center for Living, a companion organization to the Los Angeles Center for Living founded in 1987 to offer support groups, body work, and other life-supportive services for people dealing with any life-challenging illness, but PWA/HIVs make up the bulk of their clientele. Based on the principles of A Course in Miracles, a channeled book which has been called "a self-study course in spiritual psychotherapy," the Los Angeles and Manhattan Center workshops and support groups emphasize the healing power of meditation, love, and spiritual development.

Within the field of homeopathy, some practitioners and theorists began early to consider the challenges presented by AIDS, but within the homeopathic community as a whole, unfortunately, little progress has been made in achieving consistently beneficial results. Effective treatment with classical homeopathy depends to a great degree on the skill and experience of the practitioner. Since there is no standard licensing and hence no protection for homeopaths nationally, many fear legal reprisals.

In Seattle, Bastyr College of Naturopathic Medicine's Healing AIDS Research Project (HARP), begun in October 1988, is assessing the results of protocols combining Chinese and Western botanicals or classical homeopathy with nutrition, hyperthermia, and other therapies. The earlier-mentioned research efforts of projects affiliated with the Institute for Traditional Medicine continue, in San Francisco, Chicago, Santa Fe, and Los Angeles. There have been and continue to be a number of small, community-based clinical trials of single substances such as lentinan (shiitake mushroom) and St. John's wort (hypericin).

As for research efforts at the fledgling Office of Alternative Medicine, with its miniscule $2 million budget, two out of the initial thirty grants awards are for AIDS projects, both to look at the potential immune-boosting effects of massage, on preterm newborns of HIV-infected mothers and on patients with advanced AIDS. In addition, the OAM has initiated another non-funded research track in the form of field investigations of alternative practitioners. Two of the practitioners who are being considered for this program are doing work in AIDS, Dr. Charles Simone with shark cartilage for KS, and Dr. Jon Kaiser with a multiple-modality nutritionally-based protocol for HIV/AIDS generally. An historical review of alternative approaches to AIDS treatment would not be complete without mentioning issues of access. Alternative medicine, despite its roots in traditional ethnomedicine, has the not-undeserved reputation of being new age and only for the elite or middle-class. This, however, is due to its fringe status, which makes it mainly unreimbursable by insurance and entitlement programs, rather than to any lack of interest on the part of low-income people. As alternative medicine gains wider acceptance among the medical and insurance industries, as for example in the case of Dr. Dean Ornish's program for cardiovascular disease, it will also become more available to the population at large.

1. Eisenberg et al, "Unconventional Medicine in the United States; Prevalence, Costs and Patterns of Use," NEJM, 1/28/93, 246-252.

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