2013 – Working with HIV/AIDS: A personal journey

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By Julia Griss It was a late Friday afternoon, when I stood buzzing a doorbell to one of the apartment blocks in Sea Point. A voice answered, sounding American. “Hi Juliaaah, come up.” I am almost certain that you have had a massage intervention with a client  who has deeply touched and moved you. In some way you have learnt something about yourself and your practice as a therapist. My client, Damian (fictitious name), was such a person. That first treatment in the confines of his apartment brought me face-to-face with HIV/AIDS and the impact regular massage can have on a person living with the disease. At our first session I took a detailed account of his medical history. He claimed to have ‘cancer’, yet I suspected that he was HIV positive. Interestingly he truly believed the cancer theory until he died. According to him HIV/AIDS was a conspiracy by drug companies. Had he admitted the possibility that he had HIV, he might still be living today. But I digress. My experience with Damian supported what research has pointed out, that with massage his serotonin levels increased and he was able to manage the pain. I would spend at least 15 minutes before each session talking to him and allowing him to talk about his ‘cancer.’ This seemed to calm him. During the massage he relaxed completely and allowed me to use deep pressure strokes. Over a period of eight months I saw his muscles begin to waste. He got thinner and thinner, yet I continued to massage him on a weekly basis. SOMATIC APPROACH I used a somatic approach to my massage treatments. Let me explain. Somatics involves awareness of the whole self – body, mind, spirit and emotions. During our sessions we spoke about his body and what it represented in his life. Through describing some of his symptoms, I was able to find effective ways of working with his chronic pain. He would candidly express his feelings to me. The level of trust between us was profound. He had a mountain of information on a wide variety of organic foods and supplements. He religiously followed a strict vegan diet. Yet Damian refused conventional medical treatment. In our time together I was aware of my presence in hearing him and listening to his accounts of his illness. I was present, yet able to maintain a professional boundary. In many ways I was ‘there’ for him- able to offer support without being an intrusion. STIGMA Damian had isolated himself from society and had virtually become a recluse when I first started seeing him. However, as our weekly sessions progressed, he seemed to come out of his shell and...

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2013 – HIV/AIDS RESEARCH ROUND-UP: SA physio’s review massage research for people with HIV/AIDS

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What do we know about the effects of massage for people with HIV/AIDS? A group of physiotherapists from the University of Stellenbosch and the University of Southern Australia have undertaken a systematic review with the Cochrane HIV/Aids and South African Cochrane Centre to find out. Authors Susan L Hillier, Quinette Louw, Linzette Morris, Jeanine Uwimana and Sue Statham are currently about halfway through the review. According to Dr Susan Hellier of the Centre for Allied Health Evidence, School of Health Sciences , University of South Australia in Adelaide who is working in Cape Town for six months, the group is reviewing trials already done, rather than doing their own. “We have found four quality studies that have studied this question for adults and children,” she says. The idea for the topic came from one of the team members who is from and has extensive experience working with people with HIV/AIDS. “It was felt that the literature would benefit from more understanding about things that can improve quality of (patient’s) life etc. as a balance to the spotlight always being on medication and cure (which are obviously vital),” Dr Hellier explains. The team has promised to let InTouch have a copy of the final results once it is published. Below follows an extract from the review protocol kindly provided by Dr. Hellier. Massage therapy for people with HIV/AIDS: Protocol information Authors  Susan L Hillier, Quinette Louw, Linzette Morris, Jeanine Uwimana, Sue Statham Background  The Human Immunodeficency Virus (HIV) and Acquired Immunodeficency Syndrome (AIDS) is a threatening pandemic that has eroded many lives and affected millions of people globally. The 2007 AIDS epidemic update report from WHO/UNAIDS highlights that an estimated 33.2 million [30.636.1 million] people are living with HIV/AIDS (PWHA) worldwide, of which about 95% are living in the developing world (Stjernswärd 2002). More than two out of three (68%) adults and nearly 90% of children infected with HIV live in sub-Saharan Africa (SSA) and more than three in four (76%) result in AIDS deaths (UNAIDS/WHO 2007).  There has been some decline in HIV infection and deaths in SSA in the past two years partly due to effective prevention interventions and availability of antiretroviral treatment services (ART). However, AIDS remains a leading cause of mortality worldwide (UNAIDS/WHO 2007). Moreover, the increasing HIV infection rate and lack of good treatment options in some areas has been negatively affecting the quality of life (QoL) of PWHA. Description of the condition  The main symptoms reported by PWHA include opportunistic infections (OIs), night sweats, fatigue, weight loss, Pneumocystis carini pneumonia, Kaposi’s sarcoma, cytomegalo-virus lymphadenitis, depression, anxiety, poor sleep quality and pain. Peripheral neuropathic or nociceptive pain is a unique form of chronic pain that...

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2005 – HIV/AIDS & MASSAGE: The effects of therapeutic massage on HIV and AIDS patients

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By Jacob Gnanakkan. This article first appeared in Massage Today, September, 2005, Vol. 05, Issue 09 The author Jacob Gnanakkan is a licensed massage therapist, information technology specialist, health & safety instructor, and piano instructor in the United Sates of . He is the founder of Hunger Strike! Inc. (in the ) and Genesis Health Foundation (in and ), both of which serve the needy. Jacob conducts seminars worldwide on health, nutrition and natural remedies. He has an educational background in religious philosophies, medicine, medical science, health science and sports medicine, and currently is working on his doctorate in health sciences. With the wide prevalence of individuals living with the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), it is essential for massage therapists to understand the etiology, pathogenesis and treatment trends of the disease. It is likely that a person living with HIV/AIDS is, or at some point will be, under a massage therapist’s care. The importance of understanding HIV/AIDS in massage therapy practice is reiterated by its inclusion in the curriculum for continuing education and maintenance of a license. Epidemiology The first AIDS case was reported in the 24 years ago. Since then, the Centers for Disease Control (CDC) reports HIV infection leading to AIDS is the fifth leading cause of death in people between the ages of 35-44, and AIDS is the leading cause of death among African-Americans ages 35-44.1 Moreover, data recently presented at the 2005 National HIV Prevention Conference in Atlanta, Ga., reports that more than 1 million Americans currently are infected with HIV.2 Each year, 40,000 new cases are diagnosed in the U.S. alone.3 A person infected with HIV does not always transition to the AIDS phase. Pathogenesis The aetiological agent of acquired immunodeficiency virus (AIDS) is the human immunodeficiency retrovirus (HIV). The virus primarily targets the CD4+ T-lymphocyte, because of the affinity of the virus to the CD4+ T CELL surface marker. The clinical categories of HIV infection are: Category A, which includes asymptomatic or acute HIV infection; Category B, symptomatic conditions not included in Category C; and Category C, clinical conditions associated with AIDS.4 (For more information on clinical categories, visit www.cdc.gov.) Current treatments Since there is no cure for HIV, the current medical treatment is to inhibit replication of the virus and thus prevent it from causing AIDS. The virus is transmitted through direct blood contact with an infected person; the most common method of transmission is through sexual contact. Other modes of transmission include needle sharing, blood transfusions and the birth of a child to an infected mother. Antiretroviral medications (ART) are used to inhibit the spread of HIV at various sites of activity. The ART medications are used alone or in a combination known...

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