What does a 4,000-year-old form of Chinese exercise -- which combines slow, elegant movement, meditation and deep breathing -- offer PWAs in an era of state-of-the-art drug regimens? Growing numbers of people with HIV who practice chi kung (also spelled qigong and pronounced chee-goong) and tai chi (pronounced tie-chee) say the therapeutic techniques reduce stress, boost immune function and improve strength, energy and mental clarity. Some scientists, doctors and even HMOs are beginning to agree.

Based on the concept of chi or qi -- vital life energy that flows along pathways in the body called meridians -- chi kung translates as "the cultivation of chi," or simply "energy work." It stimulates and balances the flow of chi using a wide variety of methods or schools -- everything from standing meditation to martial arts techniques such as tai chi.

For many PWAs seeking healing and health maintenance, chi kung exercises can easily be learned in a few classes. They often combine simple meditative postures and movements with breathing and concentration techniques. Tai chi, on the other hand, involves complex, dynamic martial arts exercises that can also be used to promote healing and concentration. Students of tai chi often spend months learning the basic 108 moves.

Fifty-nine-year-old Emilio Gonzalez of Occidental, California, knows all the moves. He should. HIV positive since 1985, he has taught martial arts for 20 years, leading free tai chi classes for more than 2,000 students, many of whom are HIV positive. Gonzalez points out that not everyone needs to practice the "grand ultimate" long form of tai chi to get results. For many PWAs, he says, the gentle, self-hypnotic and dance movements of basic chi kung are usually "more accessible than tai chi and often just as effective in promoting relaxation, reducing negative emotions and improving overall health."

"This is preventive medicine," Gonzalez says. "Chi kung is like acupuncture without the needles, and it's much less expensive. Interestingly, it's not the doctors as much as the profit-oriented insurance companies and giant HMOs like Health Net and Kaiser Permanente that are beginning to embrace -- and pay for -- chi kung."

George Wedermyer, who co-teaches chi kung classes with Gonzalez, agrees that chi kung is powerful preventive medicine. Thirteen years ago, after learning that he was HIV positive, Wedermyer refused AZT monotherapy. "The doctors treated me like I was crazy," he says. "I was sliding downhill, but traditional Chinese medicine -- including chi kung, herbs and acupuncture -- stabilized things a bit. It kept me going." In 1996, Wedermyer added triple antiretroviral therapy, and now reports, "I not only feel centered and emotionally balanced, I'm much stronger -- I'm pumping iron!"

Two-year tai chi student Steve Fleming, a 43-year-old San Francisco PWA recovering from cancer, combines daily tai chi practice with an eclectic mix including a quadruple anti-HIV cocktail, antioxidants, Native American-style drumming and prayer. "There's no therapy I've shut out," he says. HIV positive for at least 13 years, Fleming's inclusive regimen appears to be working. His CD4 count increased from 150 to 400 in the two years since beginning tai chi, and his stress levels have plummeted. Of the various tai chi movements, Fleming says, "The 22 self-massage techniques are the most rewarding. It's a nice escape from the stress of the city. I can retreat to a private place in my mind."

While students like Fleming extol the mental and emotional benefits of chi kung, studies performed with HIV negative individuals in both China and the United States confirm that the exercises can enhance immune function, increase strength and confidence, and reduce stress and pain.

Chi kung is important for other reasons. Once learned, "you can do it anytime, anyplace," says Gonzalez. Accessible as it is, the responsibility to practice is yours. "Chi kung is a way of taking charge of your own health," Wedermyer says.

To skeptics and the curious alike, longtime students and practitioners offer this advice: Genuinely try it. If it doesn't work, then stop. Wedermyer tells fellow PWAs to "keep it simple and find something you're comfortable with. Then practice. Continue your exercises, because the benefit is cumulative."

For those who cannot attend classes, Gonzalez and Wedermyer have produced an instructional videotape set called Qigong for Health. Wedermyer says, "AIDS is not a death sentence if you know how to take care of yourself."