Some people express anger directly and openly, usually in private, though Dean has cried in church. “Tremendous anger wells up in me,” Dean says. “I cry during hymns, reading those words. At home alone, I lose my temper, bang doors, throw things, yell. It’s important to me to release my anger, but I try to be careful not to hurt anything.” Steven uses almost identical words: “I feel anger building up on a weekly basis. I want to run up and down the road and cry. When I’m really angry, I beat on the bed with a piece of hose, which is noisy and very satisfying.       Or I go in the bedroom and jump up and down and yell.”     Other people express anger more obliquely. “I’d cry every morning and night in the car on the way to and from work,” said Helen. “Sometimes I’d have to pull over to the side. And I went through a period where I snapped at my customers in the post office. When they asked why, I’d say, ‘Oh, the stupid Xerox machine won’t work.’ ” In fact, people generally express anger not at the true causes, at unfairness or at loss of control. Instead, like Helen and the Xerox machine, they get angriest at little things: “My husband expressed a lot of anger about things so small, they were all out of proportion to what he was angry about,” said Lisa. “I’d fix him oatmeal, and it was not what he’d wanted, or it wasn’t hot enough.”     People also get angry at whatever is nearest. Sometimes, like Lisa’s husband, they get angry at their caregivers. Some people turn their anger toward the medical system. They say that government medical assistance requires that you first become impoverished before you can get help, and that you fill out an amount of paperwork equaled only by the IRS. They say that hospital clinics make you wait for hours, that the clinic doctor you felt you had rapport with last time has been replaced by someone else, and that the clinic clerks are rude. The drugs have unpleasant side effects, tests are painful and invasive, and so are the procedures. Hospitals do not allow a sense of control and privacy. Doctors seem impersonal and inattentive, nurses too slow. The rooms are too hot or too cold. And, Steven said to his doctor angrily, “Why are they taking so long to find a cure?”     Some people, like Alan Madison, say they are not particularly angry. They are uncomfortable with expressing an emotion which is, after all, overwhelming. They worry that giving in to anger means losing face or losing self-control. Their anger at unfairness and loss of control, however, often has not disappeared. Instead of getting angry at co-workers or the medical system, these people turn their anger on themselves. They feel depressed or guilty or they dislike themselves: Alan felt hopeless and stopped seeing his friends. Some eat too much: Lisa gained twenty pounds after her husband’s diagnosis. Others rely too heavily on alcohol or drugs. Some continue the behavior that put them at risk for the infection in the first place: for a while, though she denied doing it, Helen went back to injecting drugs intravenously. In general, when people are depressed, they quit taking care of themselves.
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In India, majority of the people with HIV infection cannot afford or have access to the allopathic medicines recommended for treatment of HIV infection. A large number of people therefore seek treatment from practitioners of Indian systems of medicine or traditional healers. There have been several reports of successful treatment of HIV infection by a few practitioners of the Indian systems of medicine such as Ayurveda and Siddha.
Although most of these claims have not yet been proven, the Government of India has been supporting studies to test some 114 of these medicines. There have been some initial success with some Ayurvedic and Siddha medicines (for example Immu-21) but further research is needed for definite indication on their effectiveness.
It is important that people with HIV infection do not seek treatment from unverified sources or traditional practitioners who promise them a definite cure. If specific treatment from Indian systems of medicine is preferred, it should be taken from a major government hospital where they are being studied scientifically. Also, seeking treatment from a major hospital will help detect opportunistic infections at the earliest and start appropriate treatment.
The key to effective treatment for HIV infection is early detection and intervention. This is because early treatment helps strengthen the immune system, reduces stress and allows lifestyle changes such as eating a well-balanced nutritious diet.
Complimentary systems such as Ayurveda, Homoeopathy, Unani, Nature Cure and Yoga can help reduce stress and maintain health. Several medicines recommended in these systems are believed to strengthen the immune system. Thus, even if the HIV infection cannot be cured, it can be controlled by making the immune system stronger and preventing opportunistic infections.
Before treatment is started from a practitioner of Indian systems of medicine, it is desirable that objective information about the therapy is obtained.
In addition to talking to the medical practitioner promoting the treatment, it is important to talk to people who have been treated by the same practitioner in the past, especially a few months or years before. Information on the advantages, disadvantages, side-effects and associated risks should be collected from all the available sources.
Extracts of some herbs used in Ayurveda and Nature Cure that are known to strengthen the body’s natural defence mechanism are available as capsules or tablets. These include among others, aloe vera, liquorice, ginseng, St. Johnswort, etc. While the effectiveness of these herbs on the HIV infection is not yet known, they can help improve general health.
Severe stress is common among people with HIV infection. They are often isolated from the family and community and are not given the necessary care. Regular exercises in  consultation  with  the   medical practitioner, yoga, meditation, etc. can reduce stress levels and improve the quality of life. The exercise routine needs to be started in consultation with a medical practitioner.
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The human immunodeficiency virus (HIV) epidemic in the United States has entered its third decade, and with the passage of time, new challenges have arisen for the medical community. Whereas the first decade of the epidemic was marked by careful study of viral biology and the opportunistic infections that complicate advanced HIV infection, the second decade offered an explosion of antiretroviral treatment options and new hope for long-term control of the virus. But this new optimism is tempered by the ongoing recognition that many HIV-infected patients still present late in the illness, often with serious opportunistic infections or late complications of disease that are only partially reversible (e.g., peripheral neuropathy, nephropathy). Therefore, the third decade of the American HIV epidemic opens with an important challenge that will largely fall to primary care physicians: the identification of all patients infected with HIV. The Centers for Disease Control and Prevention (CDC) estimate that up to 280,000 HIV-infected people in the United States are unaware of their diagnosis. Unless they are identified, these patients – and some portion of the 40,000 patients newly infected each year – will continue to suffer the consequences of advanced HIV infection while simultaneously (and unknowingly) propagating the spread of the virus and the continuation of the deadliest epidemic in more than 80 years.
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