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

12th World AIDS Conference

Abstracts 42254-42379 849

biofeedback on physiological measures of relaxation, training on cognitive behavioral management skills, problem-solving, anxiety, anger, and depression management, coping skills, and educational classes. Control subjects received a standard
treatment regimen. The sample was composed of 29 Caucasians (72%), six AsianAmericans (15%), and five Hawaiians/Part-Hawaiians (12%). The mean age of
all subjects was 37 years. Two of the subjects in each condition were females.
Results: The study found various measures of emotional and psychological
distress to be significantly related to the number of physical HIV-related symptoms
reported by subjects. Treatment significantly reduced anxiety (p <.05), depression (p -.05) and anger (p -.01) for subjects with a higher number of physical
symptoms, as well as reducing their reliance on emotional coping strategies (p <.05). Treatment also improved these subjects' sense of both physical (p <.01)
and psychological (p <.01) well-being.
Conclusion: The present results demonstrate that a training program of cognitive/behavioral management, and problem-solving and coping skills, in conjunction with biofeedback on physiological measures of relaxation, can effectively: (1)
reduce a cluster of symptoms of emotional distress common among HIV-positive
individuals, and; (2) promote a sense of physical and psychological well-being.
42375 The success of the vitamin service at the AIDS Council of
New South Wales
Leighton Cheal. AIDS Council of New South Wales, Darlinghurst, New South
Wales 2010, Sydney, Australia
Issues: The placement of complementary therapy services within mainstream
HIV/AIDS organisations in Australia has improved access for positive people and
consequently improved relationships with that community. Project: A service offering vitamins and nutritional supplements at near wholesale prices to to people
living with HIV/AIDS has been established in the client service area of the AIDS
Council of NSW. This was done in consultation with 2 other community organisations representing the positive community. Special relationships were established
with suppliers which have enabled us to offer the products at prices substantially
lower than elsewhere and in some cases, at half of cost price.
Results: The program has been extremely well received by it's target group,
having been recognised third highest out of all services offered by the AIDS
Council in a recent community survey. The program being offered in the same
location as other services enables clients to attend to different needs without extra
travel/cost. The involvement of other community organisations and the positive
community in running the service has enabled us to build close relationships with
these groups. We have been able to pass on these relations (particularly with
suppliers) to other organisations contemplating similar services, domestically and
in some cases internationally.
Lessons Learnt: Intergrating complementary therapy services with other more
mainstream HIV/AIDS services has not only benefited clients but has improved
relationships with the positive community.
42376 Massage therapy for the treatment of painful peripheral
neuropathy in HIV+ individuals
Alberto M. Acosta1,2, Ri Sau Kuen Chan2, J. Jacobs2. 1595 Madison Avenue
#1200, New York, N. Y 10022; 2The New York Hospital, Cornell Medical Center,
New York NY, USA
Issue: HIV+ individuals may present with complaints of painful peripheral neuropathy which may not adequately respond to pharmacologic therapy.
Project: HIV+ individuals with painful peripheral neuropathy of the feet who
had partial or no improvement in pain after pharmacologic therapy (i.e. narcotic
analgesics, tricyclic antidepressants and/or serotonin reuptake inhibitors) were
referred to occupational therapy (OT) for pain management and treatment from
09/11/95 to 10/24/96. OT treatment consisted of 8 sessions of massage therapy
and instruction on a self performed home massage program. No changes in medications were made during the duration of the project. The Brief Pain Inventory
(BPI) was used to measure quality and intensity of pain (scale: 1-10 points) prior
to initiating OT massage therapy and after 8 treatment sessions.
Results: Seven HIV+ individuals (4 males; 3 females) with an age range of
28 to 49 years (mean 39.1) received 8 OT massage therapy treatments over an
average of 58 days (range 25 to 126 days). Five patients reported improvement
with a mean decrease in pain of 3.2 (range: 1 to 7). The mean CD4 count in the
responder group was 183 (range 17-336). One female reported no response to
therapy (CD4 = 114) and one male reported worsening pain (CD4 = 247). Both
non-responders were diabetic. None of the responders had diabetes.
Lessons Learned: OT massage therapy decreased the intensity of painful
peripheral neuropathy of the feet in 5 of 5 non-diabetic, HIV+ individuals who had
previously had little or no response to pharmacologic therapy. Two diabetic HIV+
individuals did not report improvement. OT massage therapy may be beneficial
in the treatment of painful peripheral neuropathy in some HIV+ individuals.

42377 Use of homeopathy for delaying progression of HIV
disease
Govind Bhave. B-1/5 Narayan Pujari Nagar, Worli Mumbaee 400018, India
Objective: With 30 years experience in homeopathy, an attempt was made to
study the effect of homeopathic treatment on the progression of HIV disease
Methods: Total 62 patients were referred for homeopathic treatment in last
5 years. All the patients had confirmed Western Blot report for HIV infection

& were given post test counselling. Detailed case history was recorded as per
homeopathic principles. The broad outline of the treatment included in chronological orders, medicines for psychological trauma & shock, for purification of the
body, constitutional medicines & medicines for the prevention of opportunistic
infections. Any other major or minor illnesses were treated with indicated homeopathic medicines. Two patients who developed tuberculosis were referred to
chest physician. Date of infection was taken as year of first exposure to virus
due to risk behaviour or due to blood transfusion. Only 26 patients could afford
CD4 count and were referred to private laboratory. Method used was immunofluorescence. Patients were classified into three groups: 1) Asymptomatic 2) AIDS
related conditions 3) AIDS.
Results: Majority of the patients, 91% were males & 9% were females. All the
patients were between 25 to 44 age group. All the patients were educated. Four
patients had HIV infection for more than 7 years and are asymptomatic. 88% of
the patients with 5 to 7 years infection are asymptomatic. 80% of the patients
gained weight from 2 to 6 kg. 78% of the patients had CD4 count more than
500 cells/cumm. 6 (10%) patients had ARC. One patient had severe diarrhoea,
one had Herpes zoster and two had stomatitis and all of them responded well to
homeopathic treatment. Two patients developed TB, one patient died due to TB.
Conclusion: People from developing countries cannot afford costly antiviral
therapy. Homeopathic medicines are easily available in India at a reasonable
price and hence could be used for treatment of HIV disease.
42378 SIDARTHA (Studio Italiano Delle Associazioni - Ricerca
su Terapie complementari in HIV/AIDS): Patterns of
complementary treatments use
Vittorio Agnoletto1, Lital Hollander2, G. Calvi3, R. Pascale4, L. Serragli5,
G. Leaci6, J. Leaci7, C. Bassani2. 1c/o Lila Viale Tibaldi 41 20136 Milano;
2Centro Studi Lila Nazionale Milano; 3RCS Milano; 4ASA Milano; 5Alfaomega
Mantova; 6ALA Milano; 7Gruppo Abele Torino, Italy
Background: A previous pilot investigation (430 respondents), revealed a frequent use of complementary therapies (48.1%) among PLWHA in Italy. The
present study, funded by the Istituto Superiore di Sanita of the Italian Health
Ministry, aimed at better defining the use of these therapies in relation to: demographic, clinical and treatment profile of users, therapies used, safety and efficacy
on specific indications or QoL parameters.
Methods: An anonymous, self-compilated questionnaire with structured answers, distributed to Italian PLWHA by volunteers of 5 Italian NGOs. Study
sample was stratified according to geographical distribution, age, and sex on the
basis of official statistics regarding the AIDS population.
Results: In summer 1997, 1312 questionnaires were obtained, of which 50.1%
were collected in healthcare structures and 34.7% in NGOs. Demographic and
clinical characteristics of the study sample (geography, sex distribution: 64.4%
males, 34.4% females, -50% infected by IV drug-use etc.) were revealed as
reflecting the Italian cohort of people living with HIV. Quality of care parameters:
58.3% of respondents were treated with antiretroviral drugs although 8% still used
NRTI monotherapy and 61% were unaware of their current viral loads. 36.1%
of respondents were users, ex-users or potential users of complementary therapies; this use was accentuated among symptomatic subjects (39.9%), women
(40.5%) and University graduates (52.5%). The therapies most utilised included:
vitamins/antioxidants - 19.2%, homeopathy - 17.9%, mental techniques - 12.5%,
herbal remedies - 11.5%. Reports on efficacy were collected from individuals in all
stages of infection and regarded mainly: sense of well-being (39%), reduction of
stress (26.9%), improvement of fatigue (23.5%), appetite (23%), sleep (20.9%),
rash (13.5%), diarrhoea (12.6%), fever (11%). Safety results were satisfactory.
Conclusions: Complementary therapies are a tool regarded valid by Italian
PLWHA in all stages of disease. The range of therapies utilised is vast and often
more then one therapy is used. Efficacy reports reveal that use is substantially
complementary to antiretroviral therapies and focus mainly on HIV-related symptoms, adverse events of conventional treatment and on parameters of quality of
life.
|42379 Complementary therapy (CT): Changes in patterns of use
among HIV clinic patients
Virginia Waring, A. Tseng, I.E. Salit. G331 101 College Street, The Toronto
Hospital, Toronto, Ontario, Canada
Objectives: To identify and compare current (HAART-era) and past (pre-HAART)
patterns of CT use in an HIV clinic population.
Methods: Structured interview, questionnaire and chart data were obtained
from 96 clinic patients (pts) in a tertiary-care hospital setting between December
1997 and February 1998.
Results: The pts were predominantly male (97%), homosexual (88%), with a
mean age of 41, mean CD4 count 285, and mean viral load 3.5 logs. CT is currently being used by 88% of pts (mean of 5.7 products/pt, range 1-25) compared
to 63% who had used CT in the past (mean of 3.7 products/pt, range 1-14).
Of current users, 86% take >1 vitamin product, 60% take >1 herbal product,

and 35% consult a CT practitioner. The most common currently used products
include: multivitamins, marijuana, and chiropractic while beta-carotene, selenium
and garlic were most frequently used in the past. The most prevalent reason
cited for current CT use is for general health and well-being (37%) whereas in
the past, CT was most often used to increase immunity and prevent progression
of HIV (32%). The majority of pts rate their current use of CT therapy as "very
effective" (43%). CT was most commonly discontinued because of perceived