This guide is a brief overview of many complementary therapies used by PHAs. Estimates of the numbers of PHAs using these therapies vary widely according to who is studied, the questions they're asked and how the investigators define complementary therapies. For example, a study of the HIV Ontario Observational Database reported that 89 per cent of PHAs enrolled in its database used complementary therapies. A 1997 study described a random sample of PHAs living in British Columbia and reported that 39 per cent used some form of complementary therapy. Complementary therapy use appears to be increasing in Canada.  At the 1999 Canadian Association for HIV Research conference, B.C. researchers reported that recorded use of complementary therapies among PHAs had effectively doubled in the last four years.

The reasons for complementary therapy use have also changed for PHAs.  Before the introduction of combination drug therapies for the management of HIV infection, complementary therapies were mainly used to prevent opportunistic infections and boost immunity.  With the introduction of highly active antiretroviral therapy (HAART) as an effective way to manage HIV infection, complementary therapies are now being used by PHAs to improve general well-being, reduce symptoms and manage the side effects of HAART.  (The use of a range conventional and complementary therapies in the management of drug side effects is discussed in the CATIE publication, A Practical Guide to HIV Drug Side Effects for People Living with HIV.)

Recent studies indicate that almost all PHAs using complementary therapies do so in conjunction with conventional drug therapies (HAART).  Combining complementary therapies with conventional drugs raises new challenges around the potential for adverse interactions between them. These interactions can lead to increased side effects and/or toxicity. They can also reduce the effectiveness of HAART, possibly leading to drug resistance and treatment failure.  It is therefore important to discuss your use of complementary therapies with your doctor and pharmacist, as well as your use of drug therapies with your complementary therapist.
 
PHAs use a range of different types of complementary therapies. Most studies find that nutritional supplements are very popular, with vitamins, minerals and antioxidants leading when the supplements were specifically identified. (These nutritional therapies, as well as the principles of healthy eating for HIV-positive people, are covered in the CATIE publication, A Practical Guide to Nutrition for People living with HIV, and will not be discussed further in this guide.) In addition to nutritional therapies, PHAs report using various forms of massage and mind-body medicine as well as a range of herbal therapies. We discuss some of these therapies in the following sections. More information about herbal therapies is available in A Practical Guide to Herbal Therapies for People Living With HIV, also published by CATIE.

This Practical Guide is part of a series and is meant to be used in conjunction with the other guides. The other titles are:

• A Practical Guide to HIV Drug Treatment
• A Practical Guide to HIV Drug Side Effects
• A Practical Guide to Nutrition
• A Practical Guide to Herbal Therapies

CATIE’s publications are available free at: http://www.catie.ca or by calling: 1-800-263-1638.