Published in the Bulletin of Experimental Treatments for AIDS April 1998 issue, by the San Francisco AIDS Foundation.

April 1998 Table of Contents

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Herbs for HIV

Leslie Hanna

In the U.S. today, the mention of herbal medicine is likely to conjure images of Chinese herbalist shops, Mexican tiendas naturalistas or hippie alternative natural food stores. Yet more and more North Americans report use of herbs to treat some form of illness or interest in learning more about herbal medicine. In fact, herbal medicine has been practiced responsibly for thousands of years in different cultures around the world. People with HIV living in the U.S. today may seek qualified health care from legitimate herbalists ranging from the naturopathic to the Chinese medicine disciplines. In addition, the number of medical doctors who also have received some training in holistic medicine -- and thus may be well informed about herbal medicine -- is increasing.

This article was largely based on an interview with Carlo Calabrese, ND (Doctor of Naturopathy), MPH, co-director of the AIDS Research Center at Bastyr University in Bothell, WA, who, along with a team of dedicated researchers, is conducting groundbreaking research into alternative medicine and HIV disease. Here, the basics of herbal medicine in the context of HIV disease will be outlined. For an article that discusses complementary and alternative medicine (CAM) in general, see the January 1998 issue of BETA.

What is Herbal Medicine?

No widely accepted or standardized definition of herbal medicine has yet been established. Simply put, herbal medicine uses herbs as the active agent to treat disease. It is one type of CAM that may be used beneficially by HIV positive people, but that also may involve risks. Botanical medicine is an alternative term for herbal medicine. Various conventional medicines in widespread use in the West today derive from plants. For example, digitalis is extracted from foxglove, and aspirin is derived from the willow tree. The prescription of specific herbal treatments is an individualized process, since herbalism takes into account not only a person's illness or condition, but also lifestyle factors such as diet and exercise.

Botanical or herbal medicine refers to a spectrum of healing philosophies and treatments. Often, the choice of word reflects the type of practice. At one end of the spectrum is herbalism, which refers to what some consider the hippie tradition of herbal use -- an ad hoc, do-it-yourself approach. On the other, more scientific, end is phytopharmaceuticals ("phyto" means plant), which approaches plants as drugs, with specific biologic action(s), that are given in standardized, established doses in order to achieve an intended effect. With plants, as with synthetic drugs, people have individual variable responses and sensitivities.

What passes for herbal medicine in daily life is usually less scientific. The following is an example of what may be classified by the non-practitioner as "herbal medicine." A man with HIV brews a bitter melon tea using a teabag that has been sitting on a shelf in his kitchen for 2 years. Before the man purchased the tea, the teabag was stored at a supplier's warehouse for a year and a half; the supplier in turn purchased the tea from a collector in southeast Asia, where the tea was acquired. Whether or not there is any activity left in the dried formula when the tea is brewed is far from clear, which is one reason consumers are advised to purchase products that include expiration or "best used by" dates on their labels.

One beneficial consequence of this sort of use may be the placebo effect, an important medical term and concept. The placebo effect refers to benefits that a person experiences while taking some treatment, such as a reduction in symptoms, that are attributable to the treatment process, rather than to the therapeutic value of the agent or therapies used. The placebo effect is not specific to herbs, but may occur with any type of therapy, whether orthodox Western treatment (drugs, procedures) or complementary and alternative therapy (herbs, yoga, acupuncture, etc.) Most likely, the placebo effect is directly related to the expectations of the patient. The simple act on the part of the patient of seeking medical assistance and making decisions about how to better one's health may have extremely powerful health benefits. Although the benefits thus may be seen as psychologically based, they are nonetheless real. "Personally, I feel that this sort of use still may be beneficial, as long as there is no harm. Often when people use something because they believe that it may help them, then it will, via the placebo effect," says Calabrese.

Calabrese cites another, related consequence of herbal use of the type just described. "In real life, people tend to use several approaches simultaneously. In this way, they may hit on something good for them." Yet the obvious risk inherent in the sort of scenario described above is that an individual may also "hit on" something that is not good for them. For example, kombucha "mushroom" tea was all the alternative rage for a short time in the mid 1990s, particularly on the West Coast, until reports began to surface from within the HIV positive community of adverse reactions, at which point enthusiasm declined sharply. (Kombucha is actually a gelatinous, globular fungus, not a true mushroom.) Several persons in Los Angeles reported nausea, vomiting and severe yeast infection. Aspergillus, the fungus that causes the life-threatening infection aspergillosis in people with AIDS, was identified in some Kombucha "mushrooms."

Although some herbal studies have been conducted, few have been rigorous clinical trials. Fewer still have been conducted in the context of HIV/AIDS. As with many forms of CAM, there are few data available from strictly conducted, Western-style scientific studies. Still, documented medicinal use of plants and herbs to treat illness or to promote health dates back at least to the time of the ancient Egyptians. Documentation dated around 1500 BC describes 700 plant-derived medicines. Other documentation exists from Greece and from Western Europe, from 400 BC through the Medieval period and into the present. The history of herbalism in Europe and China is similarly lengthy and continuous. The historic use of herbs has led many contemporary proponents of herbal medicine to opine that herbs have, in effect, been evaluated extensively.

However, since safety data in humans may not exist, it is important for anyone considering herbal medicine to consult as many sources and to collect as much information as possible before trying an herbal treatment.

Some Herbal Medicine Applications are Better than Others

Most authorities on the medicinal use of herbs, like Calabrese, consider botanical medicine to be most appropriate for treating chronic, incurable diseases including HIV, hypertension and cardiovascular disease (including heart failure) and arthritis.

Calabrese offered arthritis as an example. "First-line conventional treatment is nonsteroidal anti-inflammatory drugs [NSAID]. If relief is not achieved with the first dose level of an NSAID, then the next step typically is to take more of the NSAID. If that does not work, some patients have been instructed to take still more; some people have reported the side effect of the sensation of ringing in the ears. At this point the patient may be given steroids, and then possibly methotrexate, which can have significant adverse effects."

"On the other hand," Calabrese says, "up to 60% of people with arthritis who have tried glucosamine sulfate, a nutritional supplement derived from plants and available in many health food stores, report symptomatic relief without side effects." Yet conventional doctors do not typically recommend the substance.

In the context of HIV disease, there are better and worse applications for herbal medicine. In general, herbal medicine is better used for chronic, non-urgent HIV-related complaints. For instance, herbs might be used to boost the immune system, but probably would not be used to treat cryptococcal meningitis. The goal of herbal medicine in the context of HIV disease is to restore overall immune balance, strength and health, rather than to isolate and cure symptomatic illnesses.

Depending on the individual's health status, herbal treatment may emphasize elimination and detoxification, nourishment or health maintenance. Herbs that have been used in HIV disease management include tea tree oil (for fungal infections), garlic (an extract called allicin for cryptosporidiosis), sage (for night sweats), slippery elm (for diarrhea) and echinacea (for HIV infection). Incidentally, echinacea is an immune stimulant that is used cautiously by herbalists, who consider it possibly too strong for people with fewer than 200 CD4 cells/mm3. Certain plant polysaccharides (sugar chains) are being evaluated for immune stimulation in the U.S., Switzerland and Japan.

Herbs for HIV

In the context of HIV infection, there are 4 aspects to or purposes for using herbal medicine:

1. to attack the virus (the anti-HIV ability of plants)
2. to support the immune system and/or to correct HIV-related immune deficits
3. to treat or prevent specific opportunistic infections or neoplasms
4. to relieve side effects from conventional antiviral medications.

The Examination in the Western Herbal Tradition

Other articles have discussed the traditional Chinese medicine approach to diagnosis. This section describes evaluation in the Western tradition of herbal or botanical medicine, which in the U.S. goes by the term naturopathy.

Persons trained in naturopathy receive the ND degree, which stands for Doctor of Naturopathy. The degree is awarded after 4 years of postgraduate work and clinical training that resembles medical school. The first 2 years consist primarily of coursework in the basic sciences, and the last 2 years focus on treatment. There are 5 modalities that NDs work with: physical medicine, nutrition, botanical or herbal medicine, homeopathy, and counseling or psychotherapy. In North America there currently are 5 accredited schools of naturopathy. NDs are licensed to practice in about 12 states. Prospective patients should always inquire about an ND's training and licensure, especially in states where NDs are not officially licensed and where fraud may be easier to perpetrate. The American Association of Naturopathic Physicians may provide some information about members, as well as about the field.

The practice of herbal medicine does have parallels to other forms of alternative medicine, all of which are in at least partial contrast to conventional or orthodox Western medicine. Practitioners report that the heavy emphasis on individualization that is part of the process, from evaluation to diagnosis to treatment and follow-up, is an attraction and possibly a benefit in and of itself. In herbal medicine as in, for example, Chinese medicine, the typical amount of time the practitioner spends with the patient is much greater than the typical amount of time the Western style physician spends with the patient. Practitioners do not attempt to prescribe any treatment without first trying to synthesize a great deal of information gathered about the individual patient as a "whole person," a term often used to describe the approach taken by alternative medicine practitioners. The type of information gathered about the individual often differs with an alternative practitioner, compared to a Western doctor; for example, the herbalist may ask more about diet or emotions. When a patient meets with an ND, the ND takes an extensive history, does a physical exam and comes up with an evaluation, which is more or less the same thing as a diagnosis. Treatments can vary widely from individual to individual, which is why the word "evaluation" is more appropriate than "diagnosis."

How Can Herbs Be Used to Treat Disease?

In botanical medicine, plant extracts are used for treatments the way synthetic drugs or pharmaceuticals are used in orthodox Western medicine. An advantage of plants over drugs is that plants often have several helpful ingredients. Today, the science of creating plant extracts is becoming more precise. While assuring the amount of active ingredient in an herbal medicine through precise manufacturing and quality control is a desirable goal, a less fortunate consequence is the loss of efficacy. Some compounds in development became increasingly less effective as they were purified. In other words, other active agents were removed during purification. So, although the recent tendency has been to purify extracts until they have become a single identifiable chemical molecule (often with the intention of then synthesizing the molecule in order to create an industrial material for mass manufacturing), drawbacks have become apparent.

Another drawback to the purification of plant extracts is that, in effect, the traditional use of the herb becomes less and less clinically relevant. Although Western scientific data are lacking for many plants, there is, in some cases, a tradition of use for many plants dating back thousands of years. In this traditional manner of use, multiple chemicals in a plant may work together to produce the desired effect; a single, isolated chemical may be less effective. Oral and sometimes written records have been dated far back in the Chinese and Ayurvedic traditions. Naturopaths, who practice the traditional European use of plants, still consider one of the most influential and important sources to be the Culpepper records, created in 1650. Thus, while indications for the use of specific plants may have changed through the generations, their original use dates back to Avocenia and Galen from the late Roman times. (Today, some pharmaceutical companies in Europe have a Galenical department, named after Galen.)

The centuries-old traditional use primarily relied upon crude extracts or whole plants. Even though crude extracts or whole plants involve possible toxicities -- like drugs, plants can have deleterious effects -- they are probably generally safer than synthetic compounds for human use. One reason for this is that humans have coevolved with plants; human livers are more accustomed to dealing with plants and adverse reactions to them than with synthetic chemicals that did not exist until fairly recently. Since plants generally have multiple ingredients, usually the first adverse reaction to occur is nausea and vomiting, an effective way of purging the problematic substance. With drugs, on the other hand, people may develop neurologic or kidney-related reactions before the body recognizes a problem and purges itself. For example, too much Tylenol may cause liver damage, along with vomiting. A study by the New York Academy of Sciences found that 9% of hospital admissions were related to adverse effects of conventional medicine. Another study found that 16,000 deaths during a 1-year period in New York state were attributable to iatrogenic causes -- not necessarily the individually prescribed treatment or drug, but indirectly through the receipt or delivery of treatment or health care. In other words, conventional medical treatments are not free of the possibility of harm to the patient.

The best way to address these concerns may be to establish a healthcare system that takes advantage of the strengths of both orthodox and alternative medical approaches.

Some Words of Caution

Herbs should be regarded as drugs. Although herbal treatments often may work well as a complement to standard Western medical treatment, herbs may be very potent and toxic. They also may interact with standard medicines. The Chinese herb ma huang (Ephedra sinica), sometimes used in tea marketed as a dieting aid, has caused serious health problems; the U.S. Centers for Disease Control and Prevention (CDC) has reported deaths associated with ma huang in herbal teas or other formulations. At the July 1996 XI International Conference on AIDS, Sherwood Gorbach, MD, reported near-fatal reactions in people with HIV that were linked to the following herbs: chaparral, germander, comfrey, mistletoe, skullcap, margosa oil, Gordolobo yerba tea, Kombucha tea, pennyroyal (squawmint oil) and some types of Mate teas. Because of the potency and potential toxicity associated with some herbs, pregnant women should be especially cautious about their use. Certain herbs, like certain medicines, have been linked to birth defects. Some herbs are contraindicated with homeopathy as well as with certain Chinese medical treatments.

Since herbal books are widely available in bookstores and natural food stores, herbalism lends itself to self-treatment. The "materia medica" is the list of herbal remedies and dosages found in herbal books. However, people with HIV are advised to seek the assistance of professional healthcare providers before beginning any herbal (or other CAM) regimen. But beware -- people presenting or advertising themselves simply as "herbalists" are not required to have specific training. On the other hand, certified practitioners of traditional Chinese medicine who often prescribe herbal remedies have undergone extensive training. Likewise, medical doctors who are also trained in holistic medicine or those who have received an ND degree have undergone training that has specific standards and licensing requirements.

Other caveats remain. Herbal products available in stores contain variable amounts of the herb in question, which, when self-medicating, can lead to adverse reactions including undesirable interactions with other medications. They may also contain compounds other than the pharmacologically active ingredient that may be toxic. In herbal formulas, "other" compounds include coumarins, which cause the blood to thin, and allergens, which may provoke severe reactions in people who are allergic to ragweed (e.g., chamomile and yarrow formulas). Finally, not all herbal products are labeled with expiration dates; look for those that bear both the plant's Latin name and the product's expiration date.

Patients should discuss both symptoms and CAM therapies with their primary care provider. Sometimes harm results inadvertently from people using herbal medicine or some other form of CAM; people sometimes delay seeking professional care, due to an attempt to self-diagnose and self-treat. On the other hand, people have been harmed in the course of dutifully employing conventional treatments as well. Open and regular communication between patients and providers is essential.

Why People with HIV are Interested in Herbalism

Use of herbal and other alternative forms of medicine by people with HIV is widespread. Data gathered in a comprehensive survey of 1,689 people with HIV/AIDS conducted by Bastyr University researchers is currently being analyzed. Among the first 500 people surveyed, there were reports of 500 different treatments, including substances (echineacea, SPV 30), modalities (bitter melon enemas, the orgone box) or practices (yoga, aerobic exercise), that survey respondents used and considered alternative medicine. In a parallel study with Johns Hopkins University and the Multicenter AIDS Cohort Study (MACS), participants at 2 of the regular 6-month evaluations received questionnaires asking about alternative medicine. Of the MACS participants, 86% considered themselves to be using some form of alternative medicine.

Although there are few data, there are different levels of evidence for the effects of herbal medicine in treating HIV. None of the evidence is definitive. "There is no such thing as proof, only evidence," says Calabrese. "Given that we do not have a cure for HIV/AIDS, even if some herbal treatments confer benefits through a placebo effect alone, these are worthwhile." Persons with HIV who are interested in herbal medicine can consult buyers' clubs, which often have much information.

Plans are underway at Bastyr University to screen combination herbal agents for antiviral use. Part of the rationale is that both HIV research and clinical practice clearly suggest the preferability of a multipronged antiviral attack. Traditional herbalism uses herbs in combination, since each person seeking treatment presents with a unique combination of symptoms.

First, researchers will scan the literature and look for botanicals and nutrients that have been clearly shown in laboratory studies to attack HIV. Next, they will evaluate the traditional use of the herbs to see if it lends itself to possible use in HIV disease. Another goal is to determine whether or not the traditional dose would reach therapeutic levels in vivo (in the body) as well as in the in vitro (laboratory) studies.

Key questions to be addressed by this screening study of combination botanicals include: Is there any in vitro evidence of action against HIV? Is there a history of safe use? Is there any clinical evidence of benefit? Can a sufficient concentration be achieved in vivo that would correspond to in vitro levels without causing toxicity? Combinations that appear promising would be tested to evaluate their in vivo longevity and to determine the half-life of the herb in the bloodstream. Possible formulations would then be considered. Is the herb palatable? Can it be eaten? Is it available, i.e., can it be grown in many locales? Is it affordable? People who cannot tolerate or who do not benefit from conventional antiviral cocktails, as well as people who cannot afford them, might benefit from herbal cocktails.

Although there is little clinical evidence of anti-HIV efficacy, herbs that have already aroused interest in researchers for that potential application include curcumin, glycerrhizin (licorice), hyssop (Hyssopus officinalis, being developed in Japan) and lentinan (shitake mushroom). Other, less familiar herbs are also of interest, including Prunella vulgaris, commonly known as "heal all" and long used by herbalists in both the Eastern and Western traditions. Another interesting example involves rosemary compounds, or Rosemary officinalis, which appear in vitro to have anti-HIV potency. Studies conducted in France indicated that rosemary compounds suppressed HIV replication without damaging cells studied in the laboratory.

Does this mean that people with HIV who like to cook with Provencal herbs might be receiving some additional, antiviral benefit? Obviously, it is impossible to answer this question definitively, at least for the time being. However, Calabrese points out that garlic, which may be useful for treating oral candidiasis, may be consumed raw, boiled or baked, and that some beneficial properties remain after being heated.

A key question with regard to using herbal medicine to support the immune system is what are the targets and desired effects. As with any treatment that stimulates the immune system, herbs that stimulate the cells and cellular machinery to fight HIV may also stimulate the virus.

Published HIV-Related Herbal Medicine Research

A literature search revealed 10-15 articles that have been published in peer-reviewed journals that report HIV-related herbal studies. Several were from Asian publications not widely available in the U.S. Others were surveys that gauge the opinions and preferences of people with HIV, serving as a first step in beginning to design relevant clinical research.

Over the years, community-based publications have reported on various plant-based therapies, ranging from the now debunked Kombucha "mushroom" to SPV-30, which has active proponents today, to curcumin (studied at New England CRIA), to garlic (allicin, studied at Search Alliance in Los Angeles). While some small community-based efforts produced data, none progressed to a larger clinical trial.

Summaries of published studies

• Canadian researchers studied CAM use by people with HIV, and evaluated the associations between CAM use and personal (sociodemographic, clinical) characteristics. A survey, completed between September 1995 and June 1996, questioned people's reasons for use. CAM was defined to include alternative medicinal, dietary, tactile (e.g., massage) and relaxation (e.g., meditation) therapies. Of 657 participants, 39% reported ever using some sort of CAM. Of these 256 people, 141 (22%) used herbal or other medicinal therapies, 195 (30%) used dietary supplements, 145 (22%) used tactile therapies and 128 (20%) used some sort of relaxation technique. CAM use was associated with being young, having an annual income greater than $7,300, being college educated and experiencing greater physical pain. Thus researchers concluded that use of herbal medicine or other CAM was associated with being young, highly educated and experiencing symptoms associated with HIV disease.
  
  
• Researchers from the University of Alabama at Birmingham surveyed 20 area health food stores, asking employees what they might recommend for people with AIDS. Store employees recommended many herbal products to customers with HIV/AIDS. The authors concluded that physicians with HIV/AIDS patients should be aware of this alternative herbal use among their patients and of the possible side effects of such use.
  
  
• On behalf of the Australian Federation of AIDS Organisations in Sydney, Australia, I. McKnight and M. Scott described the frequent use of CAM by people with HIV and their lack of disclosure of such use to their primary care physicians. They suggested that doctors learn more about what sorts of CAM are being used by people with HIV and be willing to discuss CAM use.
  
  
• An agent called Sho-saiko-to (SST), used in the Japanese Kampo tradition, was studied at Kagoshima University and found, in vitro, to enhance the anti-HIV efficacy of 3TC (Epivir). SST has been studied elsewhere, and is known to have anti-HIV potential. The conclusion of the study was that combination SST/3TC might be a powerful antiviral regimen for use by people with HIV.
  
  
• From Aichi Medical University in Japan, researchers report the in vitro anti-HIV activity of rooibos tea (Aspalathus linearis). Active substances were derived from the leaves of rooibos tea leaves, Du Zhong and Japanese tea leaves, and were studied in the laboratory. In short, researchers found that alkaline extracts of the rooibos and Du Zhong tea leaves were safe and able to suppress the ability of HIV to kill human cells in vitro.
  
  
• A review article published in the Journal of Traditional Chinese Medicine looked at studies of single herbs and herbal combinations used, both in China and elsewhere, in the Chinese medicine tradition to treat HIV, apparently with some promise.
  
  
• A couple of African studies have examined how traditional use of herbs may contribute to increased risk of HIV transmission. In one behavioral study, 75 HIV positive and 76 HIV negative women were interviewed in-depth. A majority reported using an average of 4 different types of herbs intravaginally over the 5 previous years to enhance sexual pleasure, yet a significant number of women experienced post-coital adverse symptoms including vaginal and abdominal pain, vaginal lacerations and increased secretions. Twice as many HIV positive as HIV negative women reported using intravaginal substances. In another, similar study in Zimbabwe, researchers concluded that this "dry sex" custom may adversely impact HIV prevention strategies primarily because of the way it affects condom use or effectiveness. Basically, some women reported not using condoms when they used drying herbs because they felt condoms would prevent the intended magical effects; others reported that they used both condoms and drying herbs, but that condoms frequently broke when used with herbs. This custom has clear implications for locally implemented AIDS prevention practices and technologies.
  
  
• M.J. Balick from the Institute of Economic Botany in New York described the increasing number of ethnobotanical studies that are trying to identify new products. Recently there have been initiatives on the part of government and the private sector to sponsor interdisciplinary efforts that involve experts in the areas of anthropology, botany, medicine, pharmacology and chemistry. In particular, the Belize Ethnobotany Project has brought in scientists on behalf of pharmaceutical companies to become acquainted with traditional medical systems. (Terra Nova Rainforest Reserve is an ethno-biomedical reserve in Belize that received legal status in June 1993.)
  
  
• In another study, a flavonoid compound called baicalin that was purified from Chinese herbal medications was tested for its anti-HIV potency. The compound was purified from the plant Scutellaria baicalensis georgi, which has been used as a traditional Chinese herbal medicine, and studied in vitro. It appeared to inhibit HIV-1 replication.
  
  
• A study from Japan looked at the effect of a Chinese herbal medicine, called BG-104, in 2 HIV positive hemophiliacs. Both persons, who had been losing CD4 cells, took BG-104 daily and were able to maintain stable CD4 cell counts for 3 years. Disease progression halted as well.
  
  
• A study conducted in Hong Kong devised a way to screen multiple compounds used in Chinese medicine as antivirals to evaluate their anti-HIV potential. The 19 agents were evaluated in a laboratory. Six of the herbal extracts were found to inhibit the interaction between HIV-1 and CD4 cell receptors, 2 extracts appeared to be potent reverse transcriptase inhibitors and 14 inhibited another enzyme involved in cell infection (glycohydrolase).
  
  
• Another study evaluated anti-HIV drug leads garnered from Kallawaya herbalists in Bolivia. Studying extracts of over 60 species of herbs used in the Kallawaya medical tradition, and using a "therapeutic index," researchers found that aqueous formulations appeared more promising than alcoholic extracts, and that plants traditionally used to treat lung and liver disease had the most anti-HIV activity.
  
  
• A report from Brigham Young University evaluated the ethnopharmacological tradition in Samoa. Tests of plants used in traditional Samoan medicine indicated pharmacological activity in over 86%. Some appeared very promising as anti-inflammatory agents. However, both the practice of traditional Samoan medicine and the sites where the plants are grown -- the rain forest -- are threatened. Currently people are trying to set up rainforest reserves.

Conclusion

According to Calabrese, more than 75% of higher plants would likely possess anti-HIV potential, were they to be tested. The primary problem is that many plants and their extracts are toxic to humans. The bottom line today is that there are no large, controlled Western-style studies that can be consulted for insight into the various herbal remedies in use. However, many promising herbal approaches are available for evaluation. Persons with HIV -- the consumers -- are advised to carefully consider any potential treatment and to follow the guidelines for making decisions about any type of CAM. Close and open communication with primary healthcare providers is essential.

For herbal medicine, as for most forms of CAM, studies and data are lacking at this time. There is widespread agreement that more research is needed, to understand what agents work, and how. Today's lack of understanding of how herbal medicine works, from a conventional scientific perspective, clearly does not mean that it does not work. That is, absence of evidence that herbal medicine works is not the same as evidence that herbal medicine does not work. Public awareness and educational programs must expand as well. In any case, both conventional and CAM practitioners need to be aware of whatever a patient is using, for optimal safety and health. This is especially true for persons with chronic conditions, including people with HIV.

Leslie Hanna is Associate Editor of BETA.

National HIV/AIDS and Alternative Medicine Information Resources

Organizations

• AIDS Clinical Trials Information: Phone 800-874-2572
• AIDS, Medicine and Miracles: P.O. Box 20650, Boulder, CO 80308-3650
  Phone 303-447-8777, 800-875-8770; email: amm@inspirational.org
• AIDS Project Los Angeles -- Greenburg Alternative Treatment Library
  1313 North Vine St. Los Angeles, CA 90028; Phone 213-993-1529
• American Association of Naturopathic Physicians (AANP)
  601 Valley Street, Suite 105 Seattle, WA 98109; Phone 206-298-0125
• Center for Natural and Traditional Medicines
  PO Box 21735 Washington, DC 20009; Phone 202-234-9632
• DAAIR (Direct AIDS Alternative Information Resources)
  31 East 30th St., Suite #2A New York, NY 10016
  Phone 212-725-6994 or 1-888-951-LIFE
• Healing Alternatives Foundation
  1748 Market St., Suite 204 San Francisco, CA 94102; Phone 415-626-4053
• Health Education AIDS Liaison (HEAL)
  937 Fulton St. Brooklyn, NY 11238; Phone 718-398-9478
• International Foundation for Alternative Research in AIDS: Phone 954-630-8002
• National Commission for the Certification of Acupuncturists: Phone 202-232-1404
• Positive Images and Wellness Inc.
  13100 New Hampshire Ave. Silver Springs, MD 20904; Phone 301-236-4614
• Project Inform
  205 13th St. #2001 San Francisco, CA 94103; Phone 800-822-7422

Internet Resources

• AIDS Treatment Data Network: www.aidsnyc.org/network
• AIDS Treatment News Directory: www.aidsnews.org
• Bastyr University Home Page: www.bastyr.edu/index.html
• CDC National AIDS Clearinghouse: www.cdcnac.org
  Provides access to HIV-related news and resources through the AIDS Daily Summary, communication through electronic mail, access to AIDS-related articles in the Morbidity and Mortality Weekly Report, and databases of AIDS organizations and resources.
• Critical Path AIDS Project: www.critpath.org/critpath.htm
• Project Inform: www.projinf.org
• The Body: www.thebody.com
  A world wide web site dedicated entirely to AIDS. Patients and others can obtain information, talk with others, and organize politically.
• Quackwatch, Inc.: www.quackwatch.com
  A nonprofit corporation whose stated purpose is to combat health-related frauds, myths, fads and fallacies.

References

Runganga AO and Kasule J. The vaginal use of herbs/substances: an HIV transmission facilitatory factor? AIDS Care 7(5):639-645. 1995.

Bastyr University AIDS Research Center Bibliography of Selected Works

Books

Newest Disease. Long Beach, CA: Oriental Healing Arts Institute, 1990.

Journal Articles

Page last updated 5 May 1998