For a treatment going back two millennia, acupuncture has gotten a lot of attention in recent years -- much of it from the HIV community: Several scientific reports about this treatment's benefits for PWAs have been presented at each International Conference on AIDS. The Office of Alternative Medicine at the National Institutes of Health (NIH) is funding a survey of broad patterns of benefit from nondrug therapies (including Chinese medicine) used by people with HIV. That office has also supported two small HIV-related studies of acupuncture and herbal treatments, one for sinusitis and the other for anemia (now under way). Most important, a crop of HIV-specialized Chinese medical centers has sprung up nationwide, offering acupuncture along with such associated techniques as herbs, massage, heat, diet and exercise.
Acupuncture originated in China and is now used worldwide (in the U.S., 33 states license and regulate the practice). It is the best-known component of a complex medical system whose philosophical foundation holds that the body becomes sick when the life force, called qi (pronounced "chee"), is out of balance. Qi moves along invisible pathways, or meridians, connecting each organ to the others and to surface points on the skin. Through the insertion of solid, very thin sterilized needles at these points -- generally a painless procedure -- acupuncture stimulates the restoration of the balance of qi, and this engenders a gradual and gentle rebuilding of the body's innate healing ability.
Acupuncture users report that it can help with such HIV-related symptoms as peripheral neuropathy (a painful tingling in the limbs), sinusitis, pain-related problems, night sweats, insomnia, dry skin, headache, low energy and fatigue; the treatment has also proved useful for anxiety and depression. Studies have shown it can be a powerful tool to break addictions to drugs, alcohol or cigarettes (its use for drug detox is covered by Medicaid).
"In general, acupuncture is a stress-reduction treatment," says Laura Cooley, an acupuncturist at the Creekside Whole Health Center in Austin, Texas. "Most acupuncturists understand the connection between stress and the immune system. People almost always leave feeling very good."
Cooley says she doesn't think about acupuncture in terms of a balance of esoteric forces: "The doctors I work with don't look at it that way. Acupuncture is about empowerment -- it builds the system in general. When you build the system, you're increasing your resources -- physically, emotionally and mentally."
Acupuncture has been shown to release endorphins -- brain chemicals that lessen pain, induce restfulness and, by stimulating the immune system, may help the body withstand infection. While not everyone with HIV experiences dramatic benefits -- those with advanced AIDS generally have the least physical improvements -- the great majority report an enhanced sense of well-being, helping provide the clarity to make key life-preserving decisions. "Over time, acupuncture influences people to pay attention to their bodies in a deeper way," Cooley says. "This guides patients to become much more active participants in their own diagnoses and treatments."
Traditional Chinese medical clinics across the country have amassed considerable experience using acupuncture to treat HIV. Unfortunately, their shoestring budgets and the medical establishment's hostility to researching non-Western treatments have prevented large-scale studies of acupuncture's effects. The largest study now under way is being conducted through the Community Programs for Clinical Research on AIDS (CPCRA), a unit of NIH. This trial, which since 1994 has enrolled 189 patients at 11 sites, compares acupuncture to amitriptyline, an antidepressant drug, for the relief of peripheral neuropathy. Preliminary results are due in September. Dave Cohn, principal investigator of the Denver CPCRA and co-director of AIDS Services at Denver General Hospital, says, "There is a potential rational, physiological basis for why acupuncture may benefit peripheral neuropathy."
Like Cohn, Renslow Sherer is an M.D. interested in acupuncture. The director of AIDS Services at Cook County Hospital in Chicago, he runs a complementary therapy clinic offering acupuncture and massage to about 100 poor clients a month as a treatment for peripheral neuropathy, detoxification and other problems. "Demand in the community has been high, and acceptance on the part of the hospital has been high," Sherer says, adding: "But with the deep cuts in AIDS funding, we may not be able to sustain the program. In the long run, treatments like acupuncture are cost-effective, because they keep people healthier longer, which reduces the need for expensive combination drug therapies."
Acupuncture's appeal may not be universal, but for many people living with HIV, it has relieved physical and emotional stress. If the outcome of current research is encouraging, acupuncture may become even more popular in the AIDS community.