An HIV carrier from Guangdong Province, who received burns to 85 percent of her body during an agricultural accident, is fighting for her life after local hospitals refused to treat her injuries.
The case illustrates the difficulties HIV-positive patients face in receiving non-related treatment in China since general hospitals usually transfer them to infectious disease hospitals, which are not equipped to treat other conditions such as severe burns.
Wang Biwen, 30, suffered the burns in May when doing farm work with her husband, Deng Zerun.
Wang was rushed to the local Yingde People's Hospital, which later transferred Wang to Yuebei People's Hospital in Shaoguan.
After doctors tested Wang's blood and found her to be HIV-positive they sought to move her to another facility, Deng told the Global Times.
"Xiao Yong, a doctor in the Yuebei Hospital, told me at that time that my wife only had 20 days left to live. He asked me to bring her back if she could survive for a while and noted that the surgery costs would be cheaper later on," Deng said.
He took Wang back to the Yingde People's hospital, where she was also refused treatment.
Deng eventually brought his wife home where he was forced to use herbs to treat her wounds.
However, after Wang survived for 20 days, the Shaoguan hospital still refused to treat Wang, claiming the herbs had caused her condition to worsen.
These remarks could not be verified with the Yuebei People's Hospital by press time.
A desperate Deng called several larger hospitals in Guangzhou to no avail.
In late August, Deng appealed to the Yingde health bureau, which ordered the Yingde People's Hospital to temporarily accommodate Wang. But without a burns unit, the Yingde hospital was powerless to do more.
Deng's story was then published in the Yangcheng Evening News.
Liao Xinbo, a vice director of the Guangdong's Department of Health, told the newspaper Thursday that qualified hospitals have no right to reject patients without proper reasons.
"Any local hospital with a burn department should accommodate such a patient immediately. If the hospital needs support to treat HIV-carriers, they can invite doctors from designated infectious disease hospitals to help. Patients can report any unreasonable refusal to our department," Liao said.
"I am still hoping that the hospitals will change their minds and save my wife," Deng said.
http://english.peopledaily.com.cn/90882/7597330.html
Friday, October 7, 2011
Interview with HIV doctors
HIV Doctors
What type of medical specialist do I need if I am HIV positive?
The research shows that if your doctor has experience with HIV treatment, significant experience, you will tend to live longer and better. So when you seek out medical advice and you're beginning HIV treatment, it's important to ask your doctor if he has experience with treating HIV and how many patients he's treated with HIV. The type of doctor that you need is an infectious disease specialist, preferably someone who has significant experience in treating HIV patients.What should I look for in an HIV doctor?
A good HIV doctor should have significant experience in treating HIV patients, but should also be in tune with who you are as a person. Do they understand your lifestyle? Do they understand your habits and your situations? Can you speak freely with your doctor? Are you comfortable telling your doctor about potentially drugs or alcohol or sexual situations that you found yourself in? If you find yourself not being honest with your doctor, chances are very good that you don't have the right doctor.How do I find an HIV doctor?
The first step to finding an HIV doctor is to call your state's AIDS hotline. Get the number of an AIDS service organization in your area or city. Step two: call the AIDS service organization and ask for a list of HIV specialists whom they recommend. Step three: talk to friends, support group members, counselors or other knowledgeable people about who among the list they have experience with, and who might be a best fit with you. Step four: interview HIV doctors like you would anyone else. See if they're a good fit for you. When you get the list down to two or three doctors, go through some of the financial realities. Is your insurance carried by this specialist? Are you comfortable with that person? Finally, make the decision, but always know that you can change HIV doctors at any time.When should I make my first HIV appointment?
When you first test HIV positive, the first thing you need to understand is how healthy is your immune system and how far or how aggressive is the HIV that you have. I think, right away after testing HIV positive, people should visit an HIV doctor. You need to get a CD4 test, which measures the health of your immune system, and an HIV viral load test, which measures the amount of HIV virus in your blood. With the results of those two tests you can make further decisions. If you have a healthy immune system, perhaps you can wait longer before seeing another doctor about your HIV. With an immune system that is not as healthy, you should be in regular contact with your HIV doctor.What should I expect at the first appointment with my HIV doctor?
The first appointment with an HIV doctor can be uncomfortable because the subject of HIV, in itself, can be uncomfortable. So you can expect that an HIV doctor will ask you a whole series of questions about your health and your life, and some of your habits. You'll most likely be tested for a variety of other conditions, such as Hepatitis B and or Hepatitis C. In an appointment with an HIV doctor, you can expect questions about drugs and alcohol, questions about sexual practices, the use of condoms, your overall health in general, and you can expect a physical examination where the HIV doctor will literally touch and feel you to determine the health of your body. You can also expect probably a short speech about safe sex practices and substance abuse interventions, and that would be what you should expect from a visit to an HIV specialist.What questions should I ask my HIV doctor during my first appointment?
The questions to ask your doctor during your first appointment include the number of patients or experience that that doctor has in treating people. The research shows that people that doctors who treat substantial number of HIV patients tend to do a better job treating them. So one of the first questions to ask is; How many other patients that that doctor has treated? Other questions would include; What's the health of my immune system? How are my T-Cells or CD4 cells? How much virus is in my body? How is the viral load, is it high or is it low? How's the general sense of my health? Is my liver in good shape? Is my blood pressure high? So there's HIV questions and then there's general health questions that people need to keep in mind.Will my HIV doctor put me on medication immediately?
The time to go on HIV medication really depends upon the health of your immune system, also called a CD4 or T-cell count, weighed along with the HIV viral load test, which is the amount of HIV that's in your blood. If you have a high viral load and a low T-cell, the time to start medicine is much sooner. If you have a very healthy and strong immune system, and very little virus in your blood, it may be months or years before you need treatment.http://www.videojug.com/interview/hiv-doctors
HIV Doctors
HIV Doctors: Video : Brett Grodeck (Author, The First Year - HIV) gives expert video advice on: What should I expect at the first appointment with my HIV doctor?; What questions should I ask my HIV doctor during my first appointment? and more. HIV Treatment.
How to find a doctor?
In general there are two categories of doctors, those that practice medicine and those that do surgery—some do both. If you are seeking the help of a doctor, either a general medical doctor, a specialist, or a surgeon, the following medical specialty list will help you with what type doctor you need. Some of these specialist may be MDs (medical doctors) or DOs (doctors of osteopathy).
More Information: What Kind of Surgeon Do I Need?
http://healthpages.org/health-care/what-kind-of-doctor-do-i-need/
More Information: What Kind of Surgeon Do I Need?
- Allergist
- An allergist is a doctor that specializes in the diagnosis and treatment of allergies and asthma. Allergies are when the body’s immune system overreacts to something it’s not used to causing a “reaction.” Allergens—things that irritate the body, like pollen, foods, mold, smoke, or medicine—can cause an allergic reaction or allergy. Symptoms of allergic reaction can include sneezing, rash, tears in the eyes and runny nose. Shortness of breath, chest tightness and trouble breathing are symptoms of a severe reaction, and often need emergency treatment. An allergist specializes in identifying the causes of these reactions and recommends treatment. Treatment can include avoiding the allergen, shots to decrease symptoms (called desensitization shots) or pills.
- Anesthesiologist
- An anesthesiologist is the doctor that administers anesthesia when you have surgery. The provide either local or general anesthesia and monitors your condition while you are in surgery. Some anesthesiologist manage pain after surgery.
- Cardiologist
- A cardiologist is a doctor that specializes in caring for the heart including heart failure, heart attack, cardiomyopathy, and high blood pressure. Reasons to see a cardiologist include chest pains (angina), heart attack (myocardial infarction), irregular heart beats (arrhythmias), heart murmurs, high blood pressure (hypertension), abnormal EKG’s, cardiomyopathy, heart failure, coronary artery disease, or pre-operative medical clearance.
Cardiologist do test such as
- electrocardiogram
- Doppler echocardiogram
- stress test including nuclear stress test
- cardiac catheterization
- Dermatologist
- A dermatologist is a doctor that specializes in dermatology— the branch of medical science that deals with the structure, function, and disorders of the skin, hair and nails.
- A dermatologist evaluates and treats skin rashes, growths, infections, hair loss, and nail problems. Dermatologists remove warts, biopsy skin for skin cancers, and treat skin cancer. Diseases a dermatologist treats include nail fungus, psoriasis, dermatitis, eczema, acne, scabies, herpes zoster, ring worm, hives, dandruff, and fungal infections.
- Emergency Medicine
- The doctor who provides emergency care in an emergency clinic or hospital emergency room is an emergency medicine specialist. These specialists treat sudden illnesses, accidents or injuries such as gun shot wounds or auto accidents that may be life threatening.
- Endocrinologist
- An endocrinologist diagnoses and treats disorders of glands and hormones. Specific organs in the endocrine system include the thyroid (which regulates the body’s metabolism and energy level), the parathyroid (which regulates calcium and vitamin D), the adrenal glands (which regulates water and mineral balance and produces steroids, amines, epinephrine and norepinephrine), the ovaries (which regulates female hormones), the testes (which regulates male hormones), the pancreas (which secretes insulin to regulate blood sugar and glucagon), and the pituitary gland (produces oxytocin and ADH and secretes precursor hormones for other glands to work). The endocrinologists also treats disorders due to the over- or under-production of gland hormones such as hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), Hashimoto’s Thyroiditis, hypoglycemia (low blood sugar), diabetes (high blood sugar), Addison’s disease, Cushing’s Syndrome, and goiter.
- Family Practitioner
- For most of us, it is a family practice doctor that we know best. They are the ones that coordinate our health care and often called “primary care doctors.” A Family Practice doctor specializes in family medicine, and does not practice surgery. A family doctor can give care, preventive care services, as well as treat disorders and diseases regardless of age, sex, or type of problem. Sometimes, family doctors may sew up minor cuts, open small abscesses or remove warts.
- Gastroenterologist
- An gastroenterologist is a doctor who specializes in the diagnosis and treatment of disorders (diseases) of the gastrointestinal tract (GI tract), including the esophagus, stomach, small intestine, large intestine, pancreas, liver, gallbladder, and biliary system.
- Disorders of the GI tract include difficulty swallowing, appendicitis, cirrhosis of the liver, gallstones, diverticulitis, diverticulosis, GERD (gastroesophageal reflux disease), hepatitis, hiatal hernia, cholecystitis, inflammatory bowel disease, enlarged liver or spleen, chronic pancreatitis, irritable bowel syndrome, bloody stools, ulcerative colitis, Crohn’s Disease, bowel obstruction, peptic ulcer and heartburn.
- Gastrointestinal tract tests, such as endoscopy (looking for tumors, bleeding, ulcers and cancer) and colonoscopy (looking for tumors, polyps, inflammation, bleeding, ulcers and cancer in the colon) are preformed or interpreted by a gastroenterologist.
- Geriatrician
- Specializes in the care of older adults (health for seniors) called geriatrics.
- Gynecologist/Obstetrician
- A gynecologist specializes in women’s health and medicine including prenatal care and fertility. Obstetricians deliver baby’s and can do surgeries such as c-section (cesarean), episiotomy, and hysterectomy. Gynecologists treat disorders such as uterine bleeding, painful periods, endometriosis, pelvic inflammatory disease, fibroids, and breast changes. A perinatologist also cares for pregnant women, but specializes in care for women with problem pregnancies such as gestational diabetes, preeclampsia, and preterm birth.
- Hematologist/Oncologist
- A hematologist specializes in disorders of the blood such as anemia, AIDs, hemophilia, thrombocytopenia, leukemia, sickle cell disease and cancers of the lymph node glands (lymphoma). An oncologist is a doctor that specializes in oncology, the branch of medicine that deals with the diagnosis and treatment of tumors. Tumors can be benign (non-cancerous) or malignant (cancerous). An oncologist specializes in the diagnosis, treatment and management of cancer. Treatment can include bone marrow biopsy or chemotherapy.
- Hospitalist
- A hospitalist is a hospital-based general physician, medical sub specialist (pediatrician) or family practitioner who assume the care of hospitalized patients in the place of patients’ primary care doctor in acute care or intensive care units. The hospitalist acts as a consultant on surgical patients and has limited outpatient care responsibilities.
- Infectious Disease Specialist
- An infectious disease specialist specializes in the diagnosis and treatment of infections caused by bacteria, viruses, fungi or unknown origin. They treat infections that have not responded to treatment by your regular doctor or other life threatening infections like HIV, tuberculosis and MRSA.
- Internist
- An internist is a doctor that specializes in internal medicine for adolescents and adults, and does not practice surgery. Internal medicine is the branch of medicine that deals with the diagnosis and treatment of non surgical diseases. Today, a general internist is often called a “primary care doctor” and treats adults and adolescents. The internist’s training includes emergency medicine, hospital medicine, geriatrics, and critical care medicine. Internists do physical exams.
- Nephrologist
- A nephrologists specializes in the diagnosis and treatment of kidney and urinary tract diseases. Any abnormalities in diagnostic kidney tests or urine tests are referred to a nephrologist. They also monitor patients on dialysis, consult with surgeons for kidney transplants and surgeries, and do endoscopy of the renal system. Nephrologists treat acute and chronic renal failure, glomerulonephritis, neurogenic bladder, kidney stones, and urinary tract infections.
- Neurologist
- A neurologist diagnoses, treats and manages nervous system disorders and injuries which include the brain, nerves, and spinal cord. They also specialize in brain disorders such as Alzheimer’s, Parkinson’s, seizure disorders, multiple sclerosis, meningitis, epilepsy, stroke, Guillain-Barré, myasthenia gravis, brain tumors, and brain infections. A neurologist also treats brain injuries, coma, and hypoxia.
- Ophthalmologist/Optometrist
- An ophthalmologist or optometrist is a doctor that specializes in disorders of the eye and vision correction such as nearsightedness, farsightedness. They also treat eye problems caused by high blood pressure and diabetes. Ophthalmology is the branch of medicine that deals with the structure, function and diseases of the eye and do surgery.
- Orthopedist
- An orthopedist is a doctor that specializes in orthopedics – the field of medicine that deals with the correction or prevention of skeletal deformities. Orthopedists usually have a specialty interest (sub-specialty) and focus their practice on a certain part of the skeletal system such as the hand, foot, or spine. Orthopedist not only treat medical conditions, they also do surgery such as hip, knee and shoulder replacements, knee arthroscopy and spinal fusion. Orthopedists treat musculoskeletal disorders such as osteoarthritis (degenerative joint disease). Orthopedists treat carpal tunnel syndrome, chronic low back pain, degenerative disc disease, fractures, osteoporosis, osteomyelitis, scoliosis, kyphosis, lordosis, Herbeden’s notes, Bouchard’s nodes, ganglions, gout, plantar fasciitis, Morton’s neuroma, Achilles Tendonitis, rhabdomyolysis, and sports injuries such as strains and sprains.
- Otolaryngologist
- An otolaryngologist specializes in diagnosis and treatment of disorders of the ears, nose and throat.
- These disorders include: ear infections (otitis media), hearing loss, earache, perforated ear drum, middle ear cysts, sinus infection, and nosebleeds.
- Pain Management Specialist
- Pain management specialists treat all types of pain. These doctors are usually anesthesiologists with special training in pain management. Chronic pain—pain that lasts more than 3 months—is managed by pain care specialist on an outpatient basis. Treatments include medicine, injections, and referrals to physical therapy, massage and acupuncture.
- Pediatrician
- A pediatrician is a doctor that specializes in pediatrics – the branch of medicine that deals with the development and care of newborns, infants, children and adolescents. There are also sub-specialties of pediatrics such as psychiatry and cardiology.
- Podiatrist
- Foot disorders are diagnosed and treated by a podiatrist. A podiatrist can also do surgery on the foot and ankle and treat problems such as ingrown toenails, bunions, plantar fasciitis, Morton’s neuroma, hammertoe, achilles tendon tear, achilles tendonitis, and rupture, corns, heel pain, heel spurs, stress fractures, toe nails, tendon injuries in the foot and leg, tarsal tunnel syndrome, foot numbness, shin splints, ankle sprains, and physical deformities of the foot and ankle. Podiatrist also treat sports injuries to the feet and ankle. Podiatrist also recommend and fit orthotics such as sock liners and arch supports.
- Psychiatrist
- A psychiatrist is a doctor that specializes in the branch of medicine that deals with the study and treatment of mental, emotional, and behavioral disorders.
- Psychologist
- A psychologist is a doctor that specializes in the branch of medicine that deals with the study and treatment of behavior.
- Pulmonologist
- A pulmonologist specializes in pulmonary medicine and treats disorders of the lungs and chest (respiratory disorders) like chronic obstructive pulmonary disease (COPD), ARDS, acute respiratory failure, pneumonia, asbestosis, asthma, atelectasis, bronchitis, cor pulmonale, emphysema, tuberculosis, pulmonary edema, SARS (severe acute respiratory syndrome), pulmonary embolism, pleural disorders, and pneumothorax. Pulmonologists also do test such as bronchoscopy.
- Radiologist
- Interpretation of x-rays and other diagnostic studies such as MRI, CT scans, mammograms, and sonograms are done by a radiologist. Interventional radiologist can perform biopsies and angiograms as well as inject chemotherapy into tumors.
- Radiation Oncologist
- A urologist specializes in the treatment of cancer using radiation and works closely with the oncologist. They determine where the radiation goes, the type needed, and the dosage for the type of cancer.
- Rheumatologist
- A rheumatologist specializes in the diagnosis and treatment of the joints, muscles and connective tissue. They treat arthritis, fibromyalgia, lupus, and symptoms of rheumatism.
- Urologist
- A urologist specializes in urology – the branch of medicine that deals with the urinary tract, ureters, kidneys, bladder and disorders of the prostate. These disorders include prostate cancer, benign prostatic hyperplasia (BPH), and erectile dysfunction.
- Surgeon
- For more information about the different types of surgeons and what operations they perform.
http://healthpages.org/health-care/what-kind-of-doctor-do-i-need/
HIV part 1
http://www.tibotec-hiv.com/bgdisplay.jhtml?itemname=treatment_and_drug_classes
What are alternative and complementary medicines?
Alternative and complementary medicine is the name generally given to those medical and health care systems, practices, and products that are not presently considered to be part of conventional Western medicine. Well known examples include herbal and other nutritional supplements, acupuncture, aromatherapy, homeopathy and yoga.
Most people living with HIV in developed countries have ready access to antiretroviral therapy and conventional treatments for opportunistic infections. Because these treatments are so effective, there is less demand for alternative HIV medicine, except perhaps for addressing relatively minor infections, or when antiretroviral treatment cannot any longer be taken, for example because of drug resistance. Many instead look to complementary medicine as a way to prevent or relieve aids treatment side effects, some of which are not easily treatable with conventional medicine. There is also demand for complementary therapies that might boost immunity, relieve stress, or improve general health and wellbeing.
The people who distrust and avoid Western medicine for HIV include not only individuals, but also some governments. For example, senior politicians in South Africa have promoted unproven therapies while at times disparaging antiretroviral drugs. In Gambia, the president himself has treated patients with a herbal mixture he claims is an AIDS cure.
Still it can be argued that, from a scientific point of view, some treatments are more likely to work than others. Acupuncture, for example, appears to alter brain activity,4 and there is quite good evidence that it can help relieve post-operative nausea.5 6 Herbal medicines, too, are scientifically plausible: a number of modern drugs were derived from plants first used traditionally. Scientists have already identified one plant extract that acts like an antiretroviral drug;7 it is entirely possible that there are others.
At the other end of the scale are therapies that are not considered credible by the scientific community at large. The most notorious of these is homeopathy, which the World Health Organization recommends should not be used to treat HIV.8
Yet even if a medicine has no specific effects on an illness, this doesn’t necessarily mean it is worse than nothing. It is widely accepted that patients’ beliefs about a treatment, and the quality of the doctor-patient relationship, can influence health outcomes. This is what is known as the placebo effect. For example, one trial9 divided irritable bowel syndrome sufferers into three groups: the first received no treatment, the second underwent sham acupuncture (placebo), and the third received fake acupuncture plus a 45-minute consultation with a friendly doctor. The proportions of patients reporting moderate or substantial improvement were 3% (no treatment), 20% (placebo only) and 37% (placebo plus interaction). This effect may well account for some of the reported benefits of alternative and complementary medicine, as suggested in an editorial that accompanied the study:
Yet it is misleading to suggest that no research takes place. The US government has an agency (NCCAM) dedicated to complementary and alternative medicine, and in 2010 the National Institutes of Health (NIH) allocated nearly around $520 million to this field11 (around 1.5% of all federal funding for medical research).12 Potential HIV therapies investigated in government-sponsored trials include acupuncture, yoga, Reiki and distant healing.13
Although practioners of complementary and alternative medicine generally voice support for scientific research, they are often unwilling to accept negative findings. In 2005, medical journal The Lancet published the most thorough review of homeopathy trials ever conducted.14 Having analysed more than one hundred trials related to a wide range of illnesses, the authors concluded,
Herbal or nutritional therapies (notably St John’s Wort) may also interact with other medications, making them less effective or worsening their side effects.
In general, herbal remedies and dietary supplements are not covered by the strict regulations that govern pharmaceutical drugs. Quality is inconsistent even among popular commercial formulations; tests have shown that the concentrations of active ingredients can vary greatly from the amounts listed on the packaging.17
The standard of complementary and alternative practitioners is similarly uneven. Although some countries regulate certain types of practitioners (such as osteopaths in the US and UK), many people practise without any formal qualifications.
Even if a therapy carries little risk of direct physical harm, it may still turn out to be a waste of time and money. Relying on alternative medicine instead of scientifically proven treatment can have very serious consequences. Once HIV has severely weakened the immune system, antiretroviral drugs are less likely to be life-saving.
The Canadian AIDS Treatment Information Exchange (CATIE) suggests ten questions for assessing a new therapy:18
As already discussed, all forms of complementary medicine are unproven according to Western conventional medicine; each individual must make their own assessment of likely risks and benefits based on the available data. The most reliable evidence comes from large human trials – preferably randomised trials in which the treatment is compared to a placebo. Personal testimonies and laboratory findings should be given less weight, especially if they appear only in promotional material. Anyone who makes sensational claims (such as being able to cure many unrelated diseases with a single therapy), or who attacks conventional treatment, is probably best avoided.
If you have done your research and wish to try a complementary therapy, the next step is to talk to your personal doctor or HIV specialist. This is important because there may be a risk of interactions with other medications.
Some medical doctors have received training in complementary medicine. If your doctor lacks such expertise then it may be sensible to also find a complementary practitioner, ideally one with experience in treating people with HIV. Help finding a practitioner may be obtained from your doctor, an AIDS service organisation, or a professional body such as the Institute for Complementary Medicine in the UK, or the American Holistic Medical Association in the US. There are many practitioners available; it is worth taking the time to find one you trust and feel comfortable with. Look for experience, qualifications and references you can verify.
When purchasing a herbal medicine or nutritional supplement, try to choose a reputable seller and manufacturer. Large, long-established companies are generally the most trustworthy because they have more to lose from selling poor quality goods. If possible, look for a company that submits its products for independent quality testing.
Having started a new treatment, it is a good idea to keep a diary of your symptoms. This will help you assess whether the therapy is having the desired outcome, or whether it may be causing unwanted side effects.
Whole medical systems
Although few have been scientifically tested, there can be little doubt that some of the remedies given by traditional healers are effective in treating HIV-related opportunistic infections and drug side effects. However, in common with all forms of medicine, these therapies may also do harm through side effects, drug interactions, or delaying use of conventional treatment. In addition, the reuse of implements for rituals such as scarification, tattooing and circumcision can transmit infections, including HIV. Some African healers blame illness on witchcraft, which can lead to ostracism of those accused.
Collaboration between traditional healers and Western doctors has the potential to improve safety, for example by encouraging better hygiene. Training can also assist traditional healers in identifying illnesses beyond their capacity to treat, hastening referral to a clinic when necessary. In South Africa, The Traditional Health Practitioners Act includes a council to oversee and provide training to traditional health practitioners to protect the interests of the patient. As yet, the Act has not been fully enforced; there have been calls to implement the Act alongside a robust system of scientific testing of 'remedies'.20
Traditional healers are respected within their communities, and know how to convey health information in a culturally appropriate manner.21 They are ideally placed to teach HIV prevention, distribute condoms, conduct counselling, encourage HIV testing, and set up support groups for affected people.
Yet although traditional healers are generally eager to learn from other health workers, experience has shown it is not necessarily easy to establish successful collaboration.22 Traditional theories of disease causation are very different to those of Western science. Traditional healers – suppressed during the colonial era, and often demonised in the media – are understandably suspicious of authority. Many are reluctant to reveal details of their remedies for fear that their ideas will be stolen. Likewise, conventional doctors are inclined to be prejudiced against treatments that lack scientific foundation. These are not the only difficulties:
The best way to maximise the reach of training is to first identify and train a group of the most influential and respected healers, who can each then train many others. This method, however, requires ongoing support if it is to be sustainable.25
Despite the challenges, a number of organisations – such as THETA in Uganda, TAWG in Tanzania and the Copperbelt Province AIDS Task Force (PATF) in Zambia – have demonstrated the benefits of collaborating with traditional healers in HIV prevention and care.26 27 Much could be gained from replicating these programmes more widely.
http://www.avert.org/alternative-medicine-hiv.htm
What are alternative and complementary medicines?
Alternative and complementary medicine is the name generally given to those medical and health care systems, practices, and products that are not presently considered to be part of conventional Western medicine. Well known examples include herbal and other nutritional supplements, acupuncture, aromatherapy, homeopathy and yoga.
- Alternative medicine is used in place of conventional medicine
- Complementary medicine is used together with conventional medicine.
back to top What are these therapies used for?
In relation to HIV, alternative therapies are most commonly used in areas where it is difficult to access Western medicine. In the absence of antiretroviral treatment, people may seek other ways to delay the onset of AIDS, or to treat opportunistic infections. In sub-Saharan Africa, for example, traditional healers outnumber medically qualified doctors eighty-to-one.3 Traditional healers also usually provide immediate treatment, whereas clinics may have lengthy waiting lists and tests for eligibility.
Most people living with HIV in developed countries have ready access to antiretroviral therapy and conventional treatments for opportunistic infections. Because these treatments are so effective, there is less demand for alternative HIV medicine, except perhaps for addressing relatively minor infections, or when antiretroviral treatment cannot any longer be taken, for example because of drug resistance. Many instead look to complementary medicine as a way to prevent or relieve aids treatment side effects, some of which are not easily treatable with conventional medicine. There is also demand for complementary therapies that might boost immunity, relieve stress, or improve general health and wellbeing.
The people who distrust and avoid Western medicine for HIV include not only individuals, but also some governments. For example, senior politicians in South Africa have promoted unproven therapies while at times disparaging antiretroviral drugs. In Gambia, the president himself has treated patients with a herbal mixture he claims is an AIDS cure.
back to top Do alternative and complementary therapies for HIV and AIDS work?
Western medicine embraces all approaches shown to be safe and effective in rigorous scientific trials. By definition, complementary and alternative medicine consists of therapies that are unproven, at least by the standards of Western medicine. Given the many therapies in existence, there can be little doubt that some of them do what they are supposed to. Many others are likely to be ineffective or can even be harmful. In the absence of good scientific trials, it is impossible to be certain which is which.Still it can be argued that, from a scientific point of view, some treatments are more likely to work than others. Acupuncture, for example, appears to alter brain activity,4 and there is quite good evidence that it can help relieve post-operative nausea.5 6 Herbal medicines, too, are scientifically plausible: a number of modern drugs were derived from plants first used traditionally. Scientists have already identified one plant extract that acts like an antiretroviral drug;7 it is entirely possible that there are others.
At the other end of the scale are therapies that are not considered credible by the scientific community at large. The most notorious of these is homeopathy, which the World Health Organization recommends should not be used to treat HIV.8
Yet even if a medicine has no specific effects on an illness, this doesn’t necessarily mean it is worse than nothing. It is widely accepted that patients’ beliefs about a treatment, and the quality of the doctor-patient relationship, can influence health outcomes. This is what is known as the placebo effect. For example, one trial9 divided irritable bowel syndrome sufferers into three groups: the first received no treatment, the second underwent sham acupuncture (placebo), and the third received fake acupuncture plus a 45-minute consultation with a friendly doctor. The proportions of patients reporting moderate or substantial improvement were 3% (no treatment), 20% (placebo only) and 37% (placebo plus interaction). This effect may well account for some of the reported benefits of alternative and complementary medicine, as suggested in an editorial that accompanied the study:
“Is it possible that the alternative medical community has tended historically to understand something important about the experience of illness and the ritual of doctor-patient interactions that the rest of medicine might do well to hear? … The meanings and expectations created by the interactions of doctors and patients matter physically, not just subjectively.”10Even if it fails to ease symptoms, the treatment experience may have non-specific effects such as boosting self-confidence and relieving anxiety. Group therapies – such as yoga – are particularly good for meeting new people, who may be able to share knowledge of other treatment options.
back to top Why is there such a lack of evidence?
Supporters of complementary and alternative medicine propose a number of reasons why their therapies have not been subjected to thorough testing. For one thing, major medical trials are highly expensive; if there is no prospect of a patent then there is less of an incentive to invest in research. Reliable, ethical trials also require a considerable amount of expertise. Many scientists with the necessary skills are reluctant to investigate therapies they think are implausible.Yet it is misleading to suggest that no research takes place. The US government has an agency (NCCAM) dedicated to complementary and alternative medicine, and in 2010 the National Institutes of Health (NIH) allocated nearly around $520 million to this field11 (around 1.5% of all federal funding for medical research).12 Potential HIV therapies investigated in government-sponsored trials include acupuncture, yoga, Reiki and distant healing.13
Although practioners of complementary and alternative medicine generally voice support for scientific research, they are often unwilling to accept negative findings. In 2005, medical journal The Lancet published the most thorough review of homeopathy trials ever conducted.14 Having analysed more than one hundred trials related to a wide range of illnesses, the authors concluded,
“there was no convincing evidence that homeopathy was superior to placebo.”Homeopaths united in objecting to the methodology of both the trials and the review.15 Some even suggested that placebo-controlled randomised trials (regarded as the gold-standard of medical science) were inappropriate for testing their system of healing.16
back to top Potential for harm
Some forms of complementary and alternative medicine can cause harmful side effects. Words like “natural” and “traditional” are certainly no guarantee of safety.Herbal or nutritional therapies (notably St John’s Wort) may also interact with other medications, making them less effective or worsening their side effects.
In general, herbal remedies and dietary supplements are not covered by the strict regulations that govern pharmaceutical drugs. Quality is inconsistent even among popular commercial formulations; tests have shown that the concentrations of active ingredients can vary greatly from the amounts listed on the packaging.17
The standard of complementary and alternative practitioners is similarly uneven. Although some countries regulate certain types of practitioners (such as osteopaths in the US and UK), many people practise without any formal qualifications.
Even if a therapy carries little risk of direct physical harm, it may still turn out to be a waste of time and money. Relying on alternative medicine instead of scientifically proven treatment can have very serious consequences. Once HIV has severely weakened the immune system, antiretroviral drugs are less likely to be life-saving.
back to top Advice for those seeking complementary medicine
HIV positive people have a long history of taking control of their own healthcare decision-making. Those interested in complementary medicine can take steps to maximise their chances of success.The Canadian AIDS Treatment Information Exchange (CATIE) suggests ten questions for assessing a new therapy:18
- What am I hoping to get out of this therapy?
- Do other HIV positive people use it?
- Am I able to talk to any of these other people about their experiences?
- Is there any research or additional information about this therapy?
- What are the side effects, if any?
- What sort of commitment do I have to make to use this treatment?
- Where can I get this treatment, and will it be regularly available?
- How much of this treatment is too much and what are the early signs of taking too much?
- Does this treatment interact with anything else I’m taking?
- How much does it cost?
As already discussed, all forms of complementary medicine are unproven according to Western conventional medicine; each individual must make their own assessment of likely risks and benefits based on the available data. The most reliable evidence comes from large human trials – preferably randomised trials in which the treatment is compared to a placebo. Personal testimonies and laboratory findings should be given less weight, especially if they appear only in promotional material. Anyone who makes sensational claims (such as being able to cure many unrelated diseases with a single therapy), or who attacks conventional treatment, is probably best avoided.
If you have done your research and wish to try a complementary therapy, the next step is to talk to your personal doctor or HIV specialist. This is important because there may be a risk of interactions with other medications.
Some medical doctors have received training in complementary medicine. If your doctor lacks such expertise then it may be sensible to also find a complementary practitioner, ideally one with experience in treating people with HIV. Help finding a practitioner may be obtained from your doctor, an AIDS service organisation, or a professional body such as the Institute for Complementary Medicine in the UK, or the American Holistic Medical Association in the US. There are many practitioners available; it is worth taking the time to find one you trust and feel comfortable with. Look for experience, qualifications and references you can verify.
When purchasing a herbal medicine or nutritional supplement, try to choose a reputable seller and manufacturer. Large, long-established companies are generally the most trustworthy because they have more to lose from selling poor quality goods. If possible, look for a company that submits its products for independent quality testing.
Having started a new treatment, it is a good idea to keep a diary of your symptoms. This will help you assess whether the therapy is having the desired outcome, or whether it may be causing unwanted side effects.
back to top List of common complementary and alternative therapies
Complementary and alternative therapies can be divided into five main categories. The list below contains a few of the most popular examples.Whole medical systems
- Naturopathic medicine (mostly practised in the West; includes diet modification, herbal medicine, acupuncture and massage)
- Traditional Chinese medicine (includes herbal medicine, acupuncture and massage)
- Ayurveda (ancient Indian healing system; includes diet modification, herbal medicine, cleansing therapies, massage, meditation and yoga)
- Homeopathy (most commonly prescribes extremely diluted solutions of natural substances)
- Relaxation techniques, meditation and visualization
- Spirituality and prayer
- Yoga (may incorporate spirituality, meditation and body postures)
- Tai Chi (a Chinese martial art incorporating meditation and breathing exercises)
- Qi gong (includes meditation, body postures and breathing exercises)
- Aromatherapy (uses remedies derived from plants that are inhaled, applied to the skin or used internally)
- Vitamins and minerals
- Herbal remedies
- Animal-derived extracts
- Prebiotics and probiotics (aim to encourage the growth of beneficial microbes)
- Massage
- Chiropody (invented in America; manipulates the spine)
- Osteopathy (invented in America; manipulates the spine, joints and muscles; American osteopathic physicians are also trained in conventional medicine)
- Shiatsu (traditional form of Japanese massage therapy)
- Reflexology (invented in America; applies pressure to the feet, hands or ears)
- Rolfing (named after American Ida Pauline Rolf; manipulates soft tissue)
- Acupuncture (involves inserting fine needles into the body)
- Reiki (practitioners claim to channel healing energy through their palms)
- Therapeutic touch and distant healing (practitioners claim to manipulate energy “biofields” with their hands)
- Bioelectromagnetic-based therapies (involve unconventional use of sound, light, magnetism, and other forms of electromagnetic radiation)
back to top African traditional healers and HIV
Sub-Saharan Africa is the region worst affected by AIDS; it is also a region in which most people turn first to traditional healers when they fall ill. There is potential for traditional healers to play an important role in responding to the epidemic.
Although few have been scientifically tested, there can be little doubt that some of the remedies given by traditional healers are effective in treating HIV-related opportunistic infections and drug side effects. However, in common with all forms of medicine, these therapies may also do harm through side effects, drug interactions, or delaying use of conventional treatment. In addition, the reuse of implements for rituals such as scarification, tattooing and circumcision can transmit infections, including HIV. Some African healers blame illness on witchcraft, which can lead to ostracism of those accused.
Collaboration between traditional healers and Western doctors has the potential to improve safety, for example by encouraging better hygiene. Training can also assist traditional healers in identifying illnesses beyond their capacity to treat, hastening referral to a clinic when necessary. In South Africa, The Traditional Health Practitioners Act includes a council to oversee and provide training to traditional health practitioners to protect the interests of the patient. As yet, the Act has not been fully enforced; there have been calls to implement the Act alongside a robust system of scientific testing of 'remedies'.20
Traditional healers are respected within their communities, and know how to convey health information in a culturally appropriate manner.21 They are ideally placed to teach HIV prevention, distribute condoms, conduct counselling, encourage HIV testing, and set up support groups for affected people.
Yet although traditional healers are generally eager to learn from other health workers, experience has shown it is not necessarily easy to establish successful collaboration.22 Traditional theories of disease causation are very different to those of Western science. Traditional healers – suppressed during the colonial era, and often demonised in the media – are understandably suspicious of authority. Many are reluctant to reveal details of their remedies for fear that their ideas will be stolen. Likewise, conventional doctors are inclined to be prejudiced against treatments that lack scientific foundation. These are not the only difficulties:
“How can healers give their clients a diagnosis of AIDS when it means possibly losing their business? How can a traditional healer – the traditional advocate of a clan’s fertility – counsel an HIV-positive woman who wants to have a child? And how can a traditional healer turn away a sick patient who has become dependent on his or her care and support?”23It may take months or even years to establish mutual trust, confidence and respect. Success depends on being sensitive to the local context, and cooperation must be on equal terms, regardless of level of education. Rather than trying to change traditional belief systems, research has shown it is better to stress what is common to both forms of medicine, and to establish a common language.24
The best way to maximise the reach of training is to first identify and train a group of the most influential and respected healers, who can each then train many others. This method, however, requires ongoing support if it is to be sustainable.25
Despite the challenges, a number of organisations – such as THETA in Uganda, TAWG in Tanzania and the Copperbelt Province AIDS Task Force (PATF) in Zambia – have demonstrated the benefits of collaborating with traditional healers in HIV prevention and care.26 27 Much could be gained from replicating these programmes more widely.
http://www.avert.org/alternative-medicine-hiv.htm
HIV part 2...
Finding a doctor is the first and most important step you will take after being diagnosed with HIV. HIV is a complex disease that requires specially trained physicians to deliver the complex care necessary for a healthy life. Complicated drug regimens with a multitude of side effects; the long-term complications of HIV such as lipodystrophy and mitochondrial toxicity (lactic acidosis) makes treating HIV disease a challenge. Because of this, finding a doctor is the first place to start. So how do people living with HIV find a doctor? Here is a brief guide to help you make good decisions. Good decisions by you now will pay off in long-term benefits later.
http://aids.about.com/cs/doctors/a/rightmd.htm
http://www.medicalnewstoday.com/releases/25308.php
http://www.medicalnewstoday.com/articles/234825.php
The types of doctors who specialize in treating HIV and AIDS have a better track record of treating HIV positive patients with the type of drug therapy that these patients need, when compared with the same types of doctors who do not specialize in this area.
To find such a physician, you can ask for a referral from your regular doctor or from a clinic such as Planned Parenthood. Your HMO or insurance provider may also be able to refer you to a specialist.
Once the HIV virus infects the body, the virus cells attach themselves to CD4 lymphocyte helper cells. After they have attached, the viral cells begin to multiply and take over, killing off the helper cells. These helper cells are necessary for the body’s immune system to function normally.
When many of these helper cells are gone, the body struggles to fight off common infections such as pneumonia and even more rarer conditions such as tuberculosis or encephalitis. As HIV progresses in the body and kills off more and more of these helper cells, it develops into full blown AIDS.
Even though there is no specific cure for HIV/AIDS, scientists have discovered a way to treat the HIV virus to slow it down in the body before it becomes full blown AIDS- this is why you need an HIV/AIDS specialty doctor.
Doctors treat patients with HIV/AIDS with antiretroviral drugs between the time when the HIV virus is first discovered and the onset of AIDS. This treatment involves a combination of drugs that combat the viral cells and allow patients to live longer than ever before.
There are actually reported cases of patients that have been diagnosed and treated with antiretroviral drugs who have lived out their entire lives without ever having developed full blown AIDS. The key to being successful with this treatment, however, is finding a doctor with a specialty in HIV AIDS to treat the disease.
http://answers.yourdictionary.com/answers/medical/type-specialty-doctor-treats-hiv-aids.html
http://aids.about.com/cs/doctors/a/rightmd.htm
http://www.medicalnewstoday.com/releases/25308.php
http://www.medicalnewstoday.com/articles/234825.php
What Type of Specialty Doctor Treats HIV AIDS?
What type of specialty doctor treats HIV AIDS? HIV and AIDS are treated by several different types of doctors.
Type of Specialty Doctor Who Treats HIV AIDS
Like any other disease, there are specific doctors that specialize in the treatment of HIV and AIDS. The best types of physicians to treat this disease are infectious disease doctors. You may also be able to find general practitioners that specialize in the treatment of HIV/AIDS treatment.The types of doctors who specialize in treating HIV and AIDS have a better track record of treating HIV positive patients with the type of drug therapy that these patients need, when compared with the same types of doctors who do not specialize in this area.
To find such a physician, you can ask for a referral from your regular doctor or from a clinic such as Planned Parenthood. Your HMO or insurance provider may also be able to refer you to a specialist.
You Need a Specialist to Treat HIV/AIDS
To understand why you need a doctor who specializes in HIV AIDS, it is important to understand the disease. AIDS stands for Acquired Immune Deficiency Syndrome. This disease is caused by the HIV virus. HIV stands for Human Immunodeficiency Virus.Once the HIV virus infects the body, the virus cells attach themselves to CD4 lymphocyte helper cells. After they have attached, the viral cells begin to multiply and take over, killing off the helper cells. These helper cells are necessary for the body’s immune system to function normally.
When many of these helper cells are gone, the body struggles to fight off common infections such as pneumonia and even more rarer conditions such as tuberculosis or encephalitis. As HIV progresses in the body and kills off more and more of these helper cells, it develops into full blown AIDS.
Treatment for HIV/AIDS
The first HIV/AIDS cases identified in the United States were in San Francisco, California and New York, New York more than 20 years ago. Although some people believe there is now a cure for this condition, scientists have yet to find a cure for the HIV/AIDS virus. Since the first discovered case of HIV/AIDS in 1981, more than 25 million infected individuals have died from AIDS and 2 million of them died in 2008 alone.Even though there is no specific cure for HIV/AIDS, scientists have discovered a way to treat the HIV virus to slow it down in the body before it becomes full blown AIDS- this is why you need an HIV/AIDS specialty doctor.
Doctors treat patients with HIV/AIDS with antiretroviral drugs between the time when the HIV virus is first discovered and the onset of AIDS. This treatment involves a combination of drugs that combat the viral cells and allow patients to live longer than ever before.
There are actually reported cases of patients that have been diagnosed and treated with antiretroviral drugs who have lived out their entire lives without ever having developed full blown AIDS. The key to being successful with this treatment, however, is finding a doctor with a specialty in HIV AIDS to treat the disease.
http://answers.yourdictionary.com/answers/medical/type-specialty-doctor-treats-hiv-aids.html
Thursday, October 6, 2011
Tuesday, October 4, 2011
Saturday, October 1, 2011
HIV rising rapidly in Philippines
HIV rising rapidly in Philippines
By ROY C. MABASA and CZARINA NICOLE O. ONG
September 4, 2011, 6:24pm
MANILA, Philippines -- Human immunodeficiency virus (HIV) infections recorded in the Philippines have broken from a 20-year low to a rapidly spreading disease, particularly in Cebu, Davao and Manila, a new report by the Joint United Nations Program on HIV/AIDS (UNAIDS) revealed over the weekend.
The report titled “HIV in Asia and the Pacific: Getting to Zero” cited HIV prevalence among people who inject drugs in the city of Cebu accelerated rapidly from 0.6 percent to 53 percent in just two years, between 2009 and 2011.
In Manila and again Cebu, HIV prevalence among men who have sex with men is now estimated up to 5 percent.
This is in complete contrast to what is happening across Asia and the Pacific.
Although an estimated 4.9 million people were living with HIV in the region in 2009 – a figure that has remained relatively stable since 2005 – a significant 20 percent decline in new infections was seen between 2001 and 2009 from 450,000 to 360,000, the report said.
Cambodia, India, Myanmar and Thailand have reduced their HIV infection rates significantly with intensive, wide-reaching HIV prevention programs for people who buy and sell sex.
The Department of the Interior and Local Government (DILG) has expressed concern over the alarming rise in HIV cases in the country.
by http://www.mb.com.ph/articles/333139/hiv-rising-rapidly-philippines
The report titled “HIV in Asia and the Pacific: Getting to Zero” cited HIV prevalence among people who inject drugs in the city of Cebu accelerated rapidly from 0.6 percent to 53 percent in just two years, between 2009 and 2011.
In Manila and again Cebu, HIV prevalence among men who have sex with men is now estimated up to 5 percent.
This is in complete contrast to what is happening across Asia and the Pacific.
Although an estimated 4.9 million people were living with HIV in the region in 2009 – a figure that has remained relatively stable since 2005 – a significant 20 percent decline in new infections was seen between 2001 and 2009 from 450,000 to 360,000, the report said.
Cambodia, India, Myanmar and Thailand have reduced their HIV infection rates significantly with intensive, wide-reaching HIV prevention programs for people who buy and sell sex.
The Department of the Interior and Local Government (DILG) has expressed concern over the alarming rise in HIV cases in the country.
by http://www.mb.com.ph/articles/333139/hiv-rising-rapidly-philippines
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