I’ve always had sinus problems, but HIV made them much worse. Itchy eyes, headaches, and my nose alternating from dripping to totally blocked -- it drives you nuts," says San Francisco PWA Glenn Jenkins. And Jenkins has plenty of company, since two thirds of PWAs suffer from chronic sinus problems that can make life miserable.

Infections, often bacterial, are the most common cause of sinusitis and may require aggressive medical treatment, including both antibiotics and frequent saline spraying to keep the area clean. Natural anti-inflammatories such as fish oil or flaxseed oil, vitamin C, ginger and quercitin or other bioflavonoids can also help.

Not all sinus problems come from infections. Environmental and food allergies are often involved. Most practitioners have reservations about using traditional desensitizing allergy injections, which may increase viral load and are probably ineffective in PWAs with decreased immune function. Luckily, other approaches exist.

First, reduce exposure to allergens. Keeping your living space clean and free of pollen, dust and mold is a must. Air filters can help, although effective ones are fairly expensive. Food allergies -- especially to dairy products -- cause mucus buildup and nasal dripping in some PWAs: Try eliminating milk products.

Next, consider stinging nettle, an herb that prevents full-blown allergy symptoms by stabilizing the body’s histamine reaction -- the cause of the itchy eyes, dripping nose and frequent sneezes. Dr. Mary Bove, a naturopathic physician in Brattleboro, Vermont, recommends taking two capsules of stinging nettle three times per day.

Long-term use of standard decongestants can lead to dependence, so Bove suggests three to six cups daily of an herbal tea made with one-third teaspoon each of eyebright, elderflower and fenugreek. Also useful are aromatic steam treatments: Put five or six drops of essential oils in a bowl, add two to three cups of boiling water, and sit with a towel tent over your head, inhaling the steam for five to 10 minutes. And if you can take it, Bove suggests horseradish as a very powerful decongestant. She recommends eating a quarter teaspoon initially, then gradually increasing the dose to a full teaspoon once or twice every day.

Traditional Chinese Medicine practitioners recommend herbal formulas for sinus problems, and many PWAs swear by them. Misha Cohen, a doctor of Oriental medicine at the Quan Yin Healing Arts Center in San Francisco and author of The Chinese Way to Healing: Many Paths to Wholeness (Perigee/1996), recommends combining frequent nasal saline washes with Pe Min Kan Wan (the Plum Flower-brand is sugar-free and contains no ma huang, a potentially dangerous chemical). For best results, combine this with sinus acupressure-massage and acupuncture. Cohen prefers individual fine-tuning the approach but has seen great success with this combo. Shortly after beginning the saline wash, acupuncture and herbs recommended by Cohen, Jenkins’ sinus problems were dramatically decreased: “It’s simple: Life’s better when you can actually breathe!”

With all these options, there’s no need to drip your way through the day. You may even be able to go back to smelling the roses along the way.