Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

360 Abstracts 22483-22487

12th World AIDS Conference

anguish the process may cause. Breakdown of trust between children and their
parents can be avoided if honest, open communication is possible. Programmes
are potentially more successful if adequate research is undertaken and the
responses are tailored to meet the specific needs of the different target groups.
22483 Traditional Chinese medicine increasing in popularity as
complementary therapy in HIV/AIDS
Carla J. Wilson1, M.R. Cohen2. 11748 Market Street, Suite 202 San Francisco
California; 2Quan Yin Healing Arts Ctr San Francisco CA, USA
Issue: People with HIV/AIDS require complementary medicine, including Traditional Chinese Medicine.
Project: Quan Yin Healing Arts Center is a non-profit community-based complementary medicine clinic which has delivered Chinese medicine treatment for
over 13 years in San Francisco. The clinic is the largest of five HIV acupuncture
clinics in San Francisco funded by the Department of Public Health through the
federally-funded Ryan White CARE program. Quan Yin provides acupuncture,
electro-acupuncture, moxibustion (an herbal heat therapy), massage therapy, Qi
Gong (Chinese exercise/meditation) classes, and Chinese and Western herbal
medicine, along with Western medical consults.
Results: In 1990, Quan Yin provided treatment to 75 unduplicated HIV/AIDS
clients. By 1995, Quan Yin treated 465 unduplicated HIV/AIDS clients. In 1996,
Quan Yin treated 533 unduplicated clients. From 1990 to 1996, this was a 711%
increase. Since 1990, the demographics in the clinic have changed to reflect the
changing nature of the AIDS epidemic in the Bay Area. For example, in 1990,
98% of the people receiving acupuncture were gay men, with 90% white. In 1996,
the clinic's demographics changed to reflect the emerging populations in need of
treatment for HIV. While 23.4% of the SF population with AIDS is people of color,
36% of Quan Yin's HIV+ clients are people of color. Latinos are 11% of the HIV+
clients, 9% are African Americans, 4% are Native Americans, 3% are Asian/PI,
and other 9%. Quan Yin's client base exceeds the percentages for all people of
color populations with HIV. In addition, women account for 6% of unduplicated
HIV+ clients, compared to 2.6% of the SF AIDS population. 81% are gay men.
Lessons Learned: People with HIV in the San Francisco Bay Area, including
the emerging populations, are actively seeking and receiving complementary
medicine, especially Chinese medicine treatment. Government support has provided an increase in access for the emerging populations.
22484 Effect of holistic approach on the progression of HIV
disease (8 years follow-up)
Geeta Bhave, U.D. Wagale, B. Ghanasavant, P.M. Pai. Seth G S Medical
College and Kem Hospital, Parel Mumbai 400012, India
Objective: To observe the effect of holistic approach on the progression of HIV
disease.
Methods: Total 2760 HIV positive patients were given post test counselling
and healthy lifestyle education at our centre singe 1989.460 (17%) patients attended regularly followup counselling sessions where they were motivated to
adopt healthy lifestyle which included positive attitude, yogic exercises, balanced
vegetarian diet with vitamin support and minimum medicines. None of the patients
received antiviral therapy. Patients were motivated to stop drinking, smoking &
tobacco chewing. Date of seroconversion in heterosexual transmission was calculated by taking out average of first exposure and date of recruitment. Detailed
clinical history & monthly weight chart was maintained. As per WHO staging
system patients were classified into 4 stages: 1) Asymptomatic stage, 2) Mild,
3) Moderate & 4) Severe HIV disease. In the year 1997, count was done in 114
cases using immunofluorescence technique & CD4 monoclonal antibody.
Results: Out of 460 patients analysed 91% belonged to 15-45 age group, 18
(4%) were children, 82% were males and 18% were females. 55% were married,
42% unmarried & 3% were widowers and divorcee. 65% were educated and 35%
were illiterate. Duration of infection was more than 10 years in 10 (2%) cases. 9
out of these 10 are infected through blood transfusion and all of them are in stage
I. 95% of the patients with less than 5 years HIV infection and between 5 to 9
year infection are in stage I. All 18 children are in stage I. 50% of children have
infection more than 5 years. 75% of the patients had weight gain between 2 -
8 kg, only 4% developed tuberculosis. 85% of the patients had CD4 count more
than 500 cells/cumm. Out of six deaths only two were related to HIV disease, two
were accidental & two patients committed suicide.
Conclusion: On going counselling and adoption of healthy lifestyle has delayed
the progression of AIDS. This is probably the best alternative for the developing
countries where patients cannot afford costly antiviral therapy.
64* /22485 Humour in AIDS nursing care is no taboo!
Iren Bischofberger, P. Lenzin. Anker-Huus, Beckenhofstrasse 45 8006 Zurich,
Switzerland
Background: Humour is known as a human phenomenon which has been stud
ied quite extensively in health care settings during the past two decades (Fry
1994, Buxman and LeMoine 1995). Cousins (1989, 1991) demonstrated, that
systematically planned humour has the potential of many positive effects such
as pain reduction in chronic terminal illness. Therefore, the authors urge, that
humour must not be excluded from HIV/AIDS care. However, a sound relationship
between patients and nursing staff is needed in order not to offend or intimidate
patients or their relatives.

Objectives: - Increased awareness and appreciation of humour among nursing
staff working in HIV/AIDS care
- Evaluation of attitudes towards humour in various AIDS care institutions
Interventions: - Survey of the importance of and attitudes towards humour in
AIDS care institutions during a half day continuing education programme including
discussion of case studies
- Follow-up questionnaire to participants about impacts on their nursing practice
- Availability of literature and other relevant humour resources in the AIDS care
institutions
Discussion: It is assumed, based on prior experiences and continuing education programmes (Bischofberger 1996), that the participants and the whole care
team in the AIDS institutions will feel more confident in dealing with humour among
colleagues and patients. In addition, misunderstandings about the humour style
and various humour interventions are avoided based on the common baseline
information exchanged.
[1] Bischofberger I., (1996), Humour and AIDS - a conflict in nursing practice?, Key Note
Presentation at the Annual Conference of the Swiss Special Interest Group of Nurses in
HIV/AIDS Care
[2] Buxman K. und LeMoine A. (eds.), (1995), Nursing perspectives on humor, Power Publications Staten Island, New York
[3] Cousins N., (1989), Head First, Penguin New York
[4] Cousins N., (1991), Anatomy of an illness as perceived by the patient, Bantam New York
[5] Fry W.F, (1994), The biology of humor, International Journal of Humor Research, Vol. 7,
No. 2, pp. 111-126
S22486 Local government response: Homeward Haven at Ospital
ng Maynila Medical Center, an HIV/AIDS service center of
Manila
Victoria Ching. Ospital ng Maynila Medical Center Pres Quirino Ave Malate,
Manila, Philippines
Issues: There is a need to disseminate health education to reduce HIV transmission at a local government setting.
Project: The project started in 1993 under the Mayorship of the City of Manila
where an old building was renovated within the hospital compound to house
Homeward Haven. The Haven provides temporary shelter for People With AIDS
(PWA) and health maintenance including medicine are given for free.
Results: Since its inception, the project was able to involve families of HIV/AIDS
cases. Counseling, care and treatment were given to patients and even seek job
for them to regain their morale. To date, seventy-two (72) HIV seropositives were
admitted to the Haven and they continue to patronize its services.
Lessons Learned: As the first local government-sponsored HIV/AIDS Center
in the Philippines, there is an apparent need to sustain financial and human
resources if only to adequately respond to the dreaded disease. Assistance from
the private sector within the City of Manila should be sustained.
22487 Use of herbal and holistic therapy for treatment and care
for PWAs in the Asia Pacific region - A PWA perspective
Paul Toh1, Seri Phongphit2. 1 Third Floor, United Nations Building Rajadamnern
Nok Ave., Bangkok 102000, 2UNAIDS, Asia Pacific Intercountry Team, Bangkok,
Bangkok, Thailand
Objectives: (1) Explore and share experiences of success and failures of holistic
and herbal treatments and care in Asia with other developing regions eg. Africa,
Latin America.
(2) Promote and enhance the use of herbal/holistic in view of limited access to
triple combination for 90% of PWAs in the developing countries.
(3) Lobby for governments to approve and support the use of these therapie.
Types and Methods of Application: Herbal: Experiences in using Bitter
Momordica (karela) and Bellyache Bush (Thailand); Experiences in using "Saboo Daeng" (Princess Chulaborn Institute, Thailand); Experiences in using
"Lingzhi/851" (Taiwan, HK, Singapore); Traditional healing through the use of
herbs (the Cambodian experience)
Holistic: Treating AIDS through the power of meditation (Phra Acharn Rat
Rattanayano experiences at Wat Doi Kerng in Mae Hong Son, Thailand); Use
of massage, exercise and herbs as alternative treatments (the Thai experience);
Use of "Chi Kong", a blood circulation exercise (the Singapore experience)
Results: 1. Successful use in herbal treatments in Thaialnd, Singapore, Taiwan
and Hong Kong 2. Failures of Lingzhi, Bitter Momordica and herbals. 3 Success
stories of meditation at Wat Doi Kerng. 4. Success stories of "chi Kong" exercise
with herbs in Singapore
Actions: 1. Recognition by governments for use in developing countries.2 Availability and access. 3. Twinning programmes to share experiences and conduct
trials.
Conclusion: Herbal and holistic therapy are hardly named alternative therapies because it is the main source of treatment in developing countries. With
the current economic downturn in Asia, Herbal and holistic treatment is the only
answer to about 90% of PWAs living in the Asia Pacific region.