Complementary therapies and HIV treatment in Canada

Here's a simple definition: complementary therapies are those medical practices that fall outside conventional Western medicine.

Complementary therapies include:

• A range of mind–body therapies, such as counselling and meditation, that promote mental health and emotional well-being
• Touch therapies, which involve massage and other forms of physical manipulation performed by practitioners to promote healing and well-being
• Physical agents that are ingested, inhaled or rubbed on the skin

A specific complementary therapy may contain any or all of these elements. For example, massage therapists often use essential oils that are inhaled or rubbed on the skin. The process of inhaling these oils may include a meditative component that many people think of as mind–body therapy.

A brief history

In the early years of the HIV epidemic in North America, before effective antiretroviral treatments were available, people with HIV became active participants in their own healthcare. A tradition of gathering and sharing treatment information began. In Canada, CATIE was at the forefront of this movement as it helped people to understand their role in making decisions regarding their own healthcare.

Many people with HIV began to investigate complementary and alternative therapies in their efforts to stay healthy, boost their immune system, prevent and treat illnesses and delay the onset of HIV-related diseases and AIDS. Such therapies had an immediate appeal because they emphasized a holistic, non-Western approach to health and offered personalized treatment regimens rather than a standardized protocol. We now know that complementary therapies cannot cure HIV infection, but rather are best used to support a holistic approach to health and can make a valuable contribution to the health of people with HIV.

In some ways, the focus on informed decision-making in HIV care and treatment arose because many people who contracted HIV in the early days of the epidemic took the initiative to seek out complementary therapies to address their health needs. These therapies continue to be a valued part of healthcare for people with HIV today.

Complementary therapies and ART

The introduction in the late 1990s of combination antiretroviral therapy (known as ART or HAART) dramatically changed the treatment of HIV. With ART as the cornerstone of their treatment plan, people with HIV can expect to live long and healthy lives. New antiretroviral therapies are convenient, often just one pill a day, and they are associated with fewer side effects than early therapies. The benefits of starting ART sooner rather than later—from an increased life expectancy to preventing the transmission of the virus—are clear.

CATIE has extensive information on HIV treatment, from starting and staying on treatment to managing side effects and how effective treatment prevents passing on HIV to sex partners.

While ART is central to treating HIV, complementary therapies continue to benefit people with HIV: these therapies can improve quality of life, as a person adjusts to living with a chronic health condition that produces ongoing inflammation in the body; they can help people to deal with side effects from medications; and they can help people to live with a disease that is still highly stigmatized and has challenging implications for the most intimate and vulnerable areas of our lives.

It is important to note that combining certain complementary therapies with prescription drugs can potentially cause adverse interactions between them. These interactions can lead to increased side effects and/or toxicity. They may also reduce the effectiveness of ART, potentially leading to drug resistance and treatment failure. It is therefore important to discuss your use of complementary therapies with your healthcare provider and pharmacist and to discuss your use of drug therapies with your complementary therapist.

Many people with HIV today, including those diagnosed in the era of effective treatment, attend to their health in a way that integrates traditional, Western medicine—visits to a healthcare provider, maintenance of an undetectable viral load where possible, regular screening and immunization—with complementary therapies that emphasize stress reduction, support of the organs and body systems most taxed by HIV and its treatment, and management and prevention of conditions where Western medicine has been only partially successful. Integrating complementary therapies into their care enables them to support and maintain their health in ways that go beyond addressing only the physical impact of the virus.

There are a variety of systems of medicine and medical practices that some people use instead of, or in conjunction with, conventional Western medicine. Indigenous and newer immigrant communities have become valuable sources of complementary therapy practitioners for Canadians of all cultural backgrounds. Some people with HIV from within these communities may view the therapies called "complementary" in this guide as simply the expected norms of medical treatment. They may also draw additional strength from using therapies founded on their own spiritual and cultural traditions.