greater attention to alternative or traditional treatments, in addition to mainstream pharmaceutical industry drugs. Many physicians and researchers believe that as time passes and the limitations of Western medicine become more defined, it is increasingly important for there to be cooperation among different medical traditions.
In 1993, partly as a response to the growing popularity of alternative medicine in the United States, President Clinton signed into law on June 14, 1993, the National Institutes of Health Revital-ization Act, now known as Public Law 103-43. In the law, Congress permanently established the Office of Alternative Medicine (OAM) within the Office of the Director of National Institutes of Health. The purpose of the OAM is "to facilitate the evaluation of alternative medical modalities, including acupuncture and Oriental medicine, homeopathic medicine and physical manipulation therapies."
Some members of the AIDS community dismiss all alternative treatments, regardless of evidence demonstrating efficacy, and others defend all alternative treatments, regardless of evidence demonstrating lack of efficacy or toxicity. The reality seems to be that some alternative treatments may be effective, some are clearly ineffective, and most are in some degree toxic. The chief difficulty with using alternative treatments is a lack of empirical data. In the absence of the usual university, government, or corporate sponsorship of scientific research into them, there is no infrastructure that systematically addresses the potential benefits and risks of alternative treatments.
Since toxicity studies on most alternative treatments have not been conducted, it must be assumed that they may be toxic. There is no legal or regulatory mandate to disclose negative side effects. It must be kept in mind that profit is as big a motive for the marketers of "alternative" medicines as it is for the conventional pharmaceutical industry.
Access is also an issue with regard to alternative approaches to AIDS treatment. Alternative medicine, with its roots in traditional ethnomedicine, has the reputation of being a "new age" phenomenon, of interest mainly to the affluent middle class. This is due to its fringe status, which means that insurance and entitlement programs do not cover it, rather than to any lack of interest on the part of lower-income people. Increasing the availability of potentially useful treatments is directly related to their gaining wider acceptance among the medical and insurance industries.
Among the most common alternative agents are plants and plant extracts, derived from natural products or medicinal herbs. These are used for their possible antiviral properties and antibacterial and antifungal activity in the treatment of opportunistic infections. They include acemannan, astragalus, bitter melon, blue-green algae, burdock, garlic extract, glycyrrhizin, hypericin, iscador, maitake mushroom, mulberry roots and seeds, pine cone extracts, red marine algae, shiitake mushrooms, Siberian ginseng, traditional medicinal herbs, trichosanthin, and woundwaret.
Nutritional supplements are used in an attempt to restore natural levels of nutrients, to enhance resistance to opportunistic infections, and, when taken in high doses, to treat various HIV/AIDS-related conditions. Vitamins, minerals, and other substances in this category include beta-carotene, calcium, folic acid, iron, vitamins B6 and B12, vitamin c, vitamin E, acidophilus, colostrum, coenzyme qio, L-lysine, n-acetylcysteine, and selenium.
Dietary management is used to maintain or improve general health. Special regimes, such as those eliminating refined sugar or yeast to prevent or treat fungal infections, can be used as prophylaxis or treatment.
Physical techniques are used to treat certain conditions, relieve physical symptoms, and improve comfort and the quality of life. They can be combined with other therapies without fear of interactions with medication. Treatments include acupuncture, chiropractic manipulation, hydrother-apy, and massage.
Spiritual and psychological approaches seek to provide a holistic balance to complement other treatment strategies for HIV/AIDS. Although benefits are highly individual and subjective, they can contribute to an overall state of health. Treatments include hypnotherapy, meditation, psychotherapy, spiritual healing, stress reduction, and visualization.
Other treatments include aspirin, colonics, dehydro-epiandrosterone (dhea) DNCB (dini-trichlorobenzene), ozone therapy (super oxygenation), passive immunotherapy, shark cartilage
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