Acupuncture in the Global Village: A Report From the 15th International AIDS Conference
By Kristen E. Porter, PhD, MS, MAc, LAc and Elizabeth Sommers, PhD, MPH, LAc
Acupuncture and traditional medicine from around the world were uniquely highlighted at the 15th International AIDS Conference, held in Toronto in August. More than 26,000 delegates from 170 countries attended the gathering.
Featured speakers and guests included President Bill Clinton, Melinda and Bill Gates, and singer Alicia Keys. The theme of this year's event revolved around promoting access to treatment and prevention. Almost 10,000 oral and poster presentations were made on all aspects of HIV/AIDS, including clinical work, social issues and the global response to the pandemic.
The role and importance of women in the epidemic received higher recognition than in past conferences. More workshops and conference offerings centered on educating and empowering women worldwide, and resounding support came from participants and presenters who said it's time to end women's invisibility in the epidemic. Representatives from the United Nations described work in progress to design a specific arm for women's issues. New and developing prevention technologies, such as microbicides, can give women a greater level of control in HIV prevention. The treatment principle of promoting the child by nourishing the mother, familiar to practitioners of Asian medicine, clearly is beginning to be appreciated and implemented. A new organization called Granny to Granny discussed international connections for resource sharing. The group works like a sister-city project, pairing women from developed countries such as the U.S., Canada and Europe, with women from developing or underdeveloped countries.
Although the focus of the conference included updates on new medications, status of vaccine prevention trials and management of medication side effects, the role of traditional medicine was recognized in a number of innovative ways. A section of the Global Village, the conference venue dedicated to networking and cultural issues, was devoted to traditional healing. Organizers of this section included Prometra International, a group that promotes African forms of healing; advocates from the U.S. and Canada for the use of medicinal cannabis; and Pathways to Wellness, from Boston, who represented acupuncture and Asian medicine.
In Africa, it's estimated that three-quarters of medical personnel are traditional healers. Prometra representatives gave demonstrations of drumming, chanting, dancing and other techniques drawn from traditional practices.
Free sample auricular acupuncture treatments were offered each afternoon of the conference; more than160 treatments were provided to individuals of all ages and backgrounds. Many health-care providers, such as physicians, nurses and physical therapists, received treatment and were curious and enthusiastic to experience the process. Many were receiving acupuncture for the first time in their lives; about one-third of a sample of 55 individuals surveyed reported they had previously tried acupuncture.
Of the approximately 50 presentations dealing with complementary and alternative medicine, several were specific studies related to acupuncture, Chinese herbs and other Asian healing practices. Investigators from Bastyr University, led by J. Leonard, discussed a pilot study of Ganoderma lucidum (reishi) that examined the safety of the immunomodulatory botanical, as well as selected effects on lymphocytes.1 In the 10 participants reported on, supplementation was safe and well-tolerated. Further study will continue to examine these issues, as well as other clinical indicators.
Dr. J. Wang from the Chinese Academy of Traditional Chinese Medicine in Beijing described a randomized clinical trial of 72 individuals using Zhongyan-4; this herbal mixture is designed to supplement qi, nourish yin, clear heat and provide detoxification to the body.2 This group of participants included individuals at early and middle stages of HIV/AIDS. Favorable results of decreased viral load, increased body weight and symptom improvement were reported.
Investigators in Hong Kong and at the Yale School of Medicine surveyed individuals with HIV/AIDS who were using traditional Chinese medicine (TCM).3 Almost 30 percent used both TCM and antiretroviral therapy for health maintenance and symptom control. This same group of investigators reported on a survey conducted to examine the relation of medication adherence and the use of TCM.4 Respondents reported the use of herbal prescriptions, over-the-counter TCM preparations and herbal teas.
The use of acupuncture in rural Thailand was discussed by L. Louie and Thai researchers, and colleagues from Canada, the Albert Einstein College of Medicine and Columbia University.5 A hospital-based acupuncture clinic was developed in 2004 to offer adjunctive treatment and examine the effects of treatment on quality of life and symptom reduction. After six months of follow-ups, patients reported decreases in pain, relief of symptoms and improved sense of wellness and emotional well-being. Almost half of the 32 patients surveyed reported an increased ability to work, which impacted financial concerns and related stress.
Misha Cohen and colleagues from the University of California at San Francisco reported on the use of TCM in treating individuals with high-grade squamous intraepithelial lesions; these types of lesions are sometimes precursors to cervical or anal cancer.6 Using a combination of acupuncture, moxibustion and herbal ointments, these investigators developed a protocol that examined the safety and feasibility of this type of treatment. Although the study is still in progress, four out of nine participants have experienced complete or partial regression of their lesions.
Carla Wilson presented the results of a survey of 150 clients at Quan Yin Healing Arts Center in San Francisco.7 The purpose of the survey was to assess attitudes about access to education and risk reduction in the context of complementary medicine. Sixty percent of those surveyed reported that the clinic offered a safe environment conducive to well-being; 85 percent reported that having access to acupuncture and other modalities such as massage, herbal medicine, yoga and qigong helped them to manage depression and anxiety, decrease their substance use and improve their decision-making capabilities.
Kristen Porter presented a poster on Pathways' experience with integrating complementary care into six HIV/AIDS clinical settings in greater Boston, including three hospitals, a community clinic specializing in medical and mental health for homeless and street youth, and residential facilities, including a Latino agency.8 The successful strategies were related to location, culturally appropriate care, improving utilization through outreach and fostering strategic partnerships.
This array of varied presentations represents significant advancement in TCM and Asian medicine's contributions to health-care issues related to HIV/AIDS. There clearly is a place at the table for acupuncturists and other practitioners to offer our expertise, vision, compassion and creativity to address this global epidemic. More information about the conference and presentations can be accessed at www.aids2006.org.
Leonard J, Majd I, Kassermann JP, Wenner C. Safety and effect of an extract from ganoderma lucidum (reishi) on NK cell numbers in HIV+ individuals not taking antiretroviral therapy. MOPE0220.
Wang J. Randomized double-blinded controlled clinical trial on treatment of HIV/AIDS with Zhongyan-4. CDB0878.
Kwong SVC, Wong KH, Lee SS, et al. Prevalence of use of TCM in Chinese patients on HAART. CDB0879.
Ma K. Use of TCM and its prevalence related to adherence to HAART in people with HIV in Hong Kong. CDB0770.
Louie L, Pathanapornpandh N, Pultajuk U, et al. Acupuncture as a strategy for HIV symptom relief and improved quality of life in rural Thailand. MOPE0222.
Jay N, Cohen M, Darragh T, et al. A traditional Chinese medicine treatment for anal high-grade squamous intraepithelial lesions (HSIL) in HIV-positive men and women. TUPE0051.
Wilson C. Alternative and complementary medicine: a pathway to HIV prevention. WEPE0535.
Porter K, Sommers E. Delivering integrative care: highlights of integrating complementary practice into six HIV/AIDS clinical institutional settings. TUPE0160.
Click here for more information about Kristen E. Porter, PhD, MS, MAc, LAc.
Click here for more information about Elizabeth Sommers, PhD, MPH, LAc.
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