Mental Health Physical Health Vaccines/Antiretroviral drugs treatment Complementary Therapies
Mental Health
Is it necessary?
Nobody invites HIV into his/her body. But once it enters in our body we need great patience and a positive approach towards our own life. Being HIV positive is not the end of life. We cannot change the mistakes we made in the past, but we can plan our remaining life more positively.

There are many HIV positive persons in India who openly admit that they are HIV+ve. On behalf of all Indians, I appreciate their courage, daring, and a clear vision. The remaining HIV-positive persons hide about their illness. They really need to take care of their mental health. As based on the principle," as mind as body", our body and immune system remains stronger only if our mind is strong. Please do not give up. There are many medicines which can keep your body and the immune system in a healthy condition for many long years. The researchers all over the world are behind the virus, and definitely will find some medicine in the coming years. Please keep your mind and body alive and healthy till that day.

All about feelings
It is normal to have strong reactions when you find out you are HIV positive, including feelings such as fear, anger, and a sense of being overwhelmed. Often people feel helpless, sad, and anxious about the illness.

Some things to keep in mind about your feelings:
  • No matter what you are feeling, you have a right to feel that way
  • There are no "wrong" or "right" feelings; feelings just are.
  • Feelings come and go .Nothing is permanent in this world
  • You have choices about how you respond to your feelings.
It is important that you talk out your feelings with your doctor or someone you trust. It is important to do this so that you can begin to receive the care and support you need.

Here are some common feelings and the way we should dealt with them.

Denial
People who find out that they are HIV positive often deal with the news by denying that it is true. You may believe that the HIV test came out wrong or that there was a mix-up of test results. This is a natural and normal first reaction.

( talk out your feelings with your doctor or someone you trust. )

Anger
Many people are upset about how they got the virus or angry that they didn't know they had the virus.
( Ways to handle anger )
  1. Try to get some exercise–like gardening, walking, or dancing--to relieve some of the tension and angry feelings you may be experiencing.
  2. Avoid situations–involving certain people, places, and events--that cause you to feel angry or stressed out.)
Sadness or depression
It is also normal to feel sad when you learn you have HIV. If, over time, you find that the sadness doesn't go away or is getting worse, talk with your doctor or someone else you trust. You may be depressed.

Symptoms of depression can include the following, especially if they last for more than 2 weeks:
  • Feeling sad, anxious, irritable, or hopeless
  • Gaining or losing weight
  • Sleeping more or less than usual
  • Moving slower than usual or finding it hard to sit still
  • Losing interest in the things you usually enjoy
  • Feeling tired all the time
  • Feeling worthless or guilty
  • Having a hard time concentrating
  • Thinking about death or giving up
To deal with these symptoms
  1. Talk with your doctor about treatments for depression, such as therapy or medicines........
  2. Get involved with a support group......
  3. Spend time with supportive people, such as family members and friends.
Fear and anxiety
The origin of the feeling of fear and anxiety is the uncertainty of future, not knowing how others will treat you after they find out you have HIV. You also may be afraid of telling people-friends, family members, and others-that you are HIV positive.
  • Fear can make your heart beat faster or make it hard for you to sleep.
  • Anxiety also can make you feel nervous or agitated.
  • Fear and anxiety might make you sweat, feel dizzy, or feel short of breath.
Ways to control your feelings of fear and anxiety ,
  1. Learn as much as you can about HIV . .....
  2. Talk with your friends, family members, and health care providers. ....
  3. Help others who are in the same situation, such as by volunteering at an HIV service organization. This may empower you and lessen your feelings of fear. ....
  4. Talk to your doctor about medicines for anxiety if the feelings don't lessen with time or if they get worse.
Stress
If you are HIV positive, you and your loved ones constantly have to deal with stress. Stress is unique and personal to each of us. When stress does occur, it is important to recognize and deal with it. As you gain more understanding about how stress affects you, you will come up with your own ideas for coping with stress.

ways to handle stress:
  • Try exercise or some other kind of physical activity. Walking, yoga, and gardening are just some of the activities you might try to release your tension.
  • Get enough rest and eat well.
  • Talk to someone about your concerns and worries. You can talk to a friend, family member, counselor, or health care provider.
  • A good cry can bring relief to your anxiety, and it might even prevent a headache or other physical problem. Taking some deep breaths also releases tension.
AIDS dementia
HIV/AIDS and some medications for treating HIV may affect your brain. When HIV itself infects the brain, it can cause a condition known as AIDS Dementia Complex (ADC) . Symptoms can include the following:
  • Forgetfulness
  • Confusion
  • Difficulty paying attention
  • Slurred speech
  • Sudden shifts in mood or behavior
  • Muscle weakness
  • Clumsiness
If you think you may have ADC:
  • Don't be afraid to tell your doctor that you think something is wrong.
  • Keep a notepad with you and write down your symptoms whenever they occur. This information can help your doctor to help you.
  • Build as much support as possible, including friends, family, and health care providers. Although it's possible to treat ADC successfully, it may take a while for some symptoms to go away.
Remember
You should always talk with your doctor about your options. There are many ways to care for your emotional health, but treatments must be carefully chosen by your physician based on your specific circumstances and needs.

The most important thing to remember is that you are not alone; there are support systems in place to help you, including doctors, psychiatrists, family members, friends, support groups, and other services.
Physical Health
Regular exercise is part of a healthy lifestyle. Many long-term HIV positive survivors have stronger immune systems. Newly infected persons have hope for a normal lifespan, if they take care of their bodies. And that includes getting regular exercise.
The physical exercises can be divided in three major types. Aerobic exercise.
Aerobic exercise strengthens your lungs and heart. Walking, jogging, running, swimming, hiking, and cycling are forms of this exercise.

This movement increases the rate and depth of your breathing, which in turn increases how much blood and oxygen your heart pumps to your muscles. To achieve the maximum benefit of this kind of exercise, your heart rate should reach the target rate for at least 20 minutes. It may take you weeks to reach this level if you haven't been exercising much.

Target heart rate
Your target heart rate is the rate (the number of times your heart beats per minute) at which you receive the maximum benefit from exercise. At your target heart rate, you're working hard but not too hard. To find your target heart rate, you have to measure your pulse at different times while you exercise. The table below gives target heart rates for different ages. If you're just starting out, aim for the lower end of your range. To measure your heart rate while you're exercising, find your pulse (usually easiest to find at your wrist near the base of your thumb, or on the side of your neck), and count how many times you feel your pulse beat in a minute. You can also count how many times you feel your pulse beat in 10 seconds, and then multiply this number by 6.

Age Target Heart Rate Zone 50-75%
20 years 100-150 beats per minute
25 years 98-146 beats per minute
30 years 95-142 beats per minute
35 years 93-138 beats per minute
40 years 90-135 beats per minute
45 years 88-131 beats per minute
50 years 85-127 beats per minute
55 years 83-123 beats per minute
60 years 80-120 beats per minute
65 years 78-116 beats per minute
70 years 75-113 beats per minute


If you don't want to take your pulse while you are exercising, here's some other ways to tell if your workout is too hard or too easy:
  • If you can talk while you exercise, you are not working too hard.
  • If you can sing while you exercise, you are not working hard enough.
  • If you get out of breath quickly, you are working too hard.
Resistance training
Resistance or strength training is important for people with HIV because it can help offset the loss of muscle sometimes caused by the disease. This form of exercise involves exertion of force by moving (pushing or pulling) objects of weight. They can be barbells, dumbbells, or machines in gyms. You can also use safe, common household objects such as plastic milk containers filled with water or sand, or you can use your own body weight in exercises such as push-ups or pull-ups. The purpose of resistance training is to build muscle mass.

Use the correct amount of weight for the exercise you are performing. You should not feel pain during the exercise. When starting a resistance training program, you should feel a little sore for a day or two, but not enough to limit your regular activities. If you do feel very sore, you have used too much weight or have done too many repetitions. Rest an extra day and start again using less weight.

The Great Indian Yoga. (topic under construction.)
Note (^.^) :::: no book, video, or other written instruction can take the place of personal instruction from a qualified Yoga instructor who can teach you the poses, make adjustments to the poses for any physical limitations you may have, and make corrections as you perform the poses!

Yoga is believed to calm the nervous system and balance the body, mind, and spirit. It is thought by its practitioners to prevent specific diseases and maladies by keeping the energy meridians open and life energy ( qi ) flowing. Yoga is usually performed in classes, sessions are conducted at least once a week and for approximately 45 minutes. Yoga has been used to lower blood pressure, reduce stress, and improve coordination, flexibility, concentration, sleep, and digestion. It has also been used as supplementary therapy for such diverse conditions as cancer , diabetes, asthma, and AIDS.

Primary Sequence of Poses for HIV/AIDS
  1. Handstand (Adho Mukha Vrksasana).
  2. Peacock pose (Pinca Mayurasana)(optional pose, to be done only if student is strong enough and can perform other poses).
  3. Supported downwards dog (Adho Mukha Svanasana) (with head supported by a block).
  4. Headstand (Sirsasana) (students with neck problems or weakness may try "chair headstand."
  5. Inverted staff pose (Viparita Dandasana) (supported with chair).
  6. Supported bridge pose (Setu Bandha Sarvangasana) (supported by setu bandha bench or blocks).
  7. Simple cross leg pose (Sukhasana) (leaning forward, head supported by chair).
  8. Supported shoulderstand (Salamba Sarvangasana) (use chair under buttocks for support).
  9. Supported plow pose (Ardha Halasana) (use chair or halasana bench for support).
  10. Legs up the wall (Viparita Karani)(with buttocks supported by blankets or bolsters).
  11. Supine bound angle pose (Supta Baddha Konasana)(with back and head supported by blankets or bolsters).
  12. Supported relaxation pose (Savasana)(with back and head supported by blankets or bolsters).
Alternate Sequence of Poses for HIV/AIDS
This sequence is for students who should not perform the full inversions, but it can be done by others as well (see cautions above).
  1. Supported downwards dog (Adho Mukha Svanasana) (with head supported by a block).
  2. Supported head/knee forward bend (Janu Sirsasana)(support head with blankets or bolsters).
  3. Three part forward bend (Triang Mukhaikapada Pascimottanasana) (support head with blankets or bolsters).
  4. Supported half bound lotus forward bend (Ardha Baddha Padma Pascimottanasana)(support head with blankets or bolsters).
  5. Seated forward bend, or West stretch (Pascimottanasana)(support head with blankets or bolsters).
  6. Supported plow pose (Ardha Halasana) (use chair or halasana bench for support).
  7. Supported shoulderstand (Salamba Sarvangasana) (use chair for support).
  8. Supported bridge pose (Setu Bandha Sarvangasana) (supported by setu bandha bench or blocks).
  9. Legs up the wall (Viparita Karani) (with buttocks supported by blankets or bolsters).
  10. Supine bound angle pose (Supta Baddha Konasana)(with back and head supported by blankets or bolsters).
  11. Supported relaxation pose (Savasana)(with back and head supported by blankets or bolsters).
...............(topic under construction.)
Vaccines/ Antiretroviral drugs treatment
“A future vaccine will not be a ‘magic bullet'. But future vaccination against HIV, applied alongside prevention measures based on safer behavior and STI control, holds out realistic hope for ending the AIDS epidemic.” -UNAIDS.

kindly have a look over this facts
  • $682 million (US dollars) is spent on AIDS vaccine research annually.
  • 14,000 new infections occur each day.
  • A few people have some kind of natural resistance to HIV infection, meaning they never become infected despite repeated exposure to the virus.
  • After becoming infected with HIV, some persons have survived as long as 20 years without developing AIDS.
  • People can recover from AIDS and live with HIV for a very long time with proper medication.
  • Over 60% of AIDS patients contract and ultimately die of TB.
  • In India only 7% HIV infected persons are receiving the Antiretroviral drugs
Vaccine
A vaccine is something that teaches the body to recognize and defend itself against viruses or bacteria that cause disease. Vaccines are designed to help people who are not yet infected, either by preventing infection or by slowing disease progression following future infection. A vaccine is not the same thing as a cure.

Effective vaccines have already been developed for some diseases, such as smallpox, polio and tetanus, and these have saved millions of lives. But there is still no vaccine against HIV, the virus that causes AIDS.

An AIDS vaccine could be effective in either of two ways.
  • A “preventive” vaccine would stop HIV infection occurring altogether, whereas
  • A “therapeutic” vaccine would not stop infection, but would prevent HIV causing disease, and might also help prevent onward transmission.
Although a preventive vaccine would be ideal, a therapeutic vaccine would also have great value.

How do HIV vaccines work?
The basic idea behind all AIDS vaccines is to encourage the human immune system to fight HIV. The immune system works using a combination of cells and chemicals called antibodies. Early vaccine research focused on teaching the immune system to produce antibodies that would block HIV entering human cells. However, products designed to work this way failed in clinical trials, because the antibodies produced worked only against lab-cultured HIV, and not against the wild strains of virus. Today most research focuses on encouraging the immune system to produce cells to fight HIV. Nevertheless, many scientists believe such “cell-mediated” approaches will not be very effective on their own, even as therapeutic vaccines. It seems likely that a really effective vaccine will have to take a two-pronged approach involving both cells and antibodies.

Difficulties in developing HIV vaccines.

Developing a vaccine against HIV is a very difficult challenge for scientists. There are many reasons for this, including:
  • Nobody has ever recovered from HIV infection, so there is no natural mechanism to imitate.
  • HIV destroys the immune system cells that are meant to fight against it.
  • Soon after infection, HIV inserts its genetic material into human cells, where it remains hidden from the immune system.
  • HIV occurs in several subtypes , each of which is very different from the others
  • Even within each subtype, HIV is highly variable and constantly changing.
  • There are no good animal models with which to experiment.
Antiretroviral Drugs Treatment.
This is the main type of treatment for HIV or AIDS. It is not a cure, but it can stop people from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of someone's life.

The antiretroviral HIV drugs that are currently available can improve the quality of life of someone infected with HIV, helping them to stay well much longer than they otherwise would. The drugs slow down the replication of HIV within the body, but it must be remembered that they are a treatment and not a cure.

The Treatment and combination therapy.

Antiretroviral treatment for HIV infection consists of drugs which work against HIV infection itself by slowing down the replication of HIV in the body. The drugs are often referred to as:
  • Antiretrovirals
  • Anti-HIV drugs
  • HIV antiviral drugs
For antiretroviral treatment to be effective for a long time, it has been found that you need to take more than one antiretroviral drug at a time. This is what is known as Combination Therapy. The term Highly Active Antiretroviral Therapy (HAART) is used to describe a combination of three or more anti-HIV drugs.

For most people, there are a number of drug combinations available to choose from. There are more than 20 approved drugs belonging to four different groups. It is not always easy to tell which will be the best option, since a combination that suits one person might not suit another.

When HIV replicates (makes new copies of itself) it often makes mistakes. This means that within any infected person there are many different strains of virus. Occasionally, a new strain is produced that happens to be resistant to the effects of an antiretroviral drug. If the person is not taking any other type of drug then the resistant strain is able to replicate quickly and the benefits of treatment are lost.

Taking two or more antiretrovirals at the same time vastly reduces the rate at which resistance develops.

The groups of antiretroviral drugs.

There are four groups of anti-HIV drugs. Each of these groups attacks HIV in a different way.
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors
The first group of antiretroviral drugs are the Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTI's). These were the first type of drug available to treat HIV infection in 1987. NRTI's (also known as nucleoside analogues or nukes) interfere with the action of an HIV protein called reverse transcriptase, which the virus needs to make new copies of itself. NRTI's are sometimes called the "backbone" of combination therapy because most regimens contain at least two of these drugs.

Non-Nucleoside Reverse Transcriptase Inhibitors
The second group of antiretroviral drugs are the Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI's), which started to be approved in 1997. Like the nukes, NNRTI's (also known as non-nucleosides or non-nukes) stop HIV from replicating within cells by inhibiting the reverse transcripase protein.

Protease Inhibitors
The third type of antiretrovirals is the protease inhibitor (PI) group. The first protease inhibitor was approved in 1995. Protease inhibitors, as the name says, inhibit protease, which is another protein involved in the HIV replication process.

Fusion or Entry Inhibitors
The fourth group of antiretrovirals is comprised of entry inhibitors, including fusion inhibitors. One of these drugs - commonly called T-20 - has been licensed both in the US and in Europe since 2003, but only for use by people who have already tried other treatments. The T-20 fusion inhibitor differs from the other antiretrovirals in that it needs to be injected (otherwise it would be digested in the stomach). Entry inhibitors prevent HIV from entering human cells.

The right time to start the treatment
Deciding when to start treatment can be difficult as there is no proven ‘right' time. Still most guidelines recommend not starting treatment until the advanced stages of HIV infection. (stage-3 and stage-4)

Based on some factors the treatment should be started
  • When the CD4 test shows between 200 to 350 T-helper cells per cubic millimeter of blood ( Advice varies slightly between countries.)
  • Your viral load is medium or high.
  • If one of the opportunistic infections/ illnesses has become a serious problem.
The anti-HIV drugs should reduce viral load to below the level of detection of the current tests, and the drugs should also boost CD4 levels.

Treatment coverage around the world
As of June 2006, UNAIDS and the World Health Organization (WHO) estimate that 6,800,000 people in low- and middle-income countries were in need of antiretroviral (ARV) treatment for AIDS. Of these, only 24% were receiving it.

Region People receiving treatment in June 2006 People needing treatment in 2005 Treatment coverage in June 2006
Sub-Saharan Africa 1,040,000 4,600,000 23%
Latin America and the Caribbean 345,000 460,000 75%
East, South and South-East Asia 235,000 1,440,000 16%
Europe and Central Asia 24,000 190,000 13%
North Africa and the Middle East 4,000 75,000 5%
All developing and transitional countries 1,650,000 6,800,000 24%


In India only 7 % HIV infected persons are receiving the Antiretroviral drugs treatment.
Complementary Therapies
Note :- Complementary therapies are not substitutes for the treatment and drugs you receive from your doctor. Never stop taking your anti-HIV drugs just because you've started another therapy.

It is also important to remember that not all complementary therapies are safe for you. In fact, some therapies (including certain herbs) can be very dangerous because they can interact with your HIV drugs or cause severe side effects.

What are complementary and alternative therapies ?
Many people use complementary (sometimes known as alternative) health treatments to go along with the medical care they get from their doctor. CAM (complementary and alternative medicines) includes all types of healing practices that range from cultural tradition medical systems and practices to products that are not presently considered to be part of conventional medicine

These therapies are called "complementary" therapies because usually they are used alongside the more standard medical care you receive (such as your doctor visits and the anti-HIV drugs you might be taking).

They are sometimes called "alternative" because they don't fit into the mainstream, Western ways of looking at medicine and health care. These therapies may not fit in with what you usually think of as "health care."

Are complementary therapies useful?
Definitely. The Healthy people use these kinds of therapies to try to make their immune systems stronger and to make themselves feel better in general.

People who have diseases or illnesses, such as HIV, use these therapies for the same reasons. They also can use these therapies to help deal with symptoms of the disease or side effects from the medicines that treat the disease.

Major types of complementary therapies
The complementary therapies can be classified in three major groups.
  • Physical (body) therapies, such as yoga, massage, and acupuncture.
  • Relaxation techniques, such as meditation and visualization.
  • Herbal medicine (from plants)
Let's see in detail the various types of therapies.
1. Yoga.
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Yoga is believed to calm the nervous system and balance the body, mind, and spirit. It is thought by its practitioners to prevent specific diseases and maladies by keeping the energy meridians (see acupuncture ) open and life energy ( qi ) flowing. Yoga is usually performed in classes, sessions are conducted at least once a week and for approximately 45 minutes. Yoga has been used to lower blood pressure, reduce stress, and improve coordination, flexibility, concentration, sleep, and digestion. It has also been used as supplementary therapy for such diverse conditions as cancer , diabetes, asthma , and AIDS.

2. Massage.
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Advantages of massage
  • Enhance immune function
  • Reduce chronic pain
  • Relieve chronic muscle tension
  • Increase lymph flow
  • Ease the mental and emotional stress that accompany the illness
  • Decrease anxiety, increase self-esteem and positive body image.
  • Provide human touch
  • Risks: – Few risks with licensed and trained practitioners – An inexperienced or poorly trained practitioner may cause bruising or pain by the use of rough techniques
Body manipulation/massage techniques that are being used to treat HIV/AIDS include acupressure, the Alexander technique, deep muscle therapy, polarity therapy, Reiki, Rolfing, Shiatsu, Rubenfeld Synergy, Swedish massage, and therapeutic massage.

3. Acupuncture.
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4. Meditation.
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"Meditation" as a form of alternative medicine brings about mental calmness and physical relaxation by suspending the stream of thoughts that normally occupy the mind. Generally performed once or twice a day for approximately 20 minutes at a time, Meditation is used to reduce stress, alter hormone levels, and elevate one's mood.

Health applications of meditation.
Meditation has entered the mainstream of health care as a method of stress and pain reduction. For example, in an early study in 1972 transcendental meditation was shown to effect the human metabolism by lowering the biochemical byproducts of stress, such as lactate ( lactic acid ), and by decreasing heart rate and blood pressure and inducing favorable brain waves. (Scientific American 226: 84-90 (1972))

5. Herbal medicine.
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The top ten CAM therapies in United States.
  • The 10 most commonly used CAM therapies in the United States during 2002 when use of prayer is excluded.
  • Herbalism (18.9%)
  • Breathing Meditation (11.6%)
  • Meditation (7.6%)
  • Chiropractic medicine (7.5%)
  • Yoga (5.1%)
  • Body work (5.0%)
  • Diet-based therapy (3.5%)
  • Progressive relaxation (3.0%)
  • Mega-vitamin therapy (2.8%)
  • Visualization (2.1%)
  • NCCAM classification of CAM categories, grouped by popularity when the use of prayer is excluded.
  • Biologically Based Therapy (20.6%)
  • Mind-Body Interventions (16.9%)
  • Herbal therapy (18.9%)
  • Diet-based therapy (3.5%)
  • Exercise-based therapy (not rated)
  • Manipulative therapy (10.9%)
  • Alternative Medical Systems (2.7%)
  • Energy Therapy (0.5%)

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