The aims of the study are to investigate individual, combined and added effects of
acupuncture and the relaxation response in reducing gastrointestinal symptoms, improving
medication adherence and quality of life among people living with HIV/AIDS. The study will
also explore the mechanism of these therapeutic effects of acupuncture and the relaxation
1. Confirmed HIV-positive status or AIDS diagnosis
2. Self report of having at least one of the 6 GI symptoms: diarrhea, loose stools,
gas/flatulence or bloating, abdominal pain, nausea, or vomiting that have persisted
for at least 8 weeks.
3. Being on a stable antiretroviral regimen containing Nucleoside/nucleotide reverse
transcriptase inhibitors and/or protease inhibitors- for at least 8 weeks.
1. Incident diagnosis of any of the following conditions within the past month or during
study period: Pneumocystis carinii pneumonia, Kaposi's sarcoma, Mycobacterium avian
complex, Cytomegalovirus, Non-Hodgkins lymphoma, Lymphoma or other cancer, Pelvic
inflammatory disease, AIDS-related dementia, Bacterial or other infection, Diabetes,
Acute moderate or severe neutropenia, Cryptococcus, Progressive multifocal
leukoencephalopathy, Idiopathic thrombocytopenic purpura. All of these conditions are
major opportunistic infections or medical complications that may require
hospitalization and additional pharmaceutical intervention.
2. GI diagnoses of irritable bowel syndrome, Crohn's Disease, parasites, any type of
gastric ulcer or ulcerative colitis or cancer in any part of the gastrointestinal
system. These are conditions not related to HIV diagnosis and could result in
digestive problems similar to those we are investigating.
3. Onset of acute opportunistic infection.
4. Hemophilia or other bleeding disorder since that will make acupuncture treatment
5. Pregnant women will be excluded since, although none of the acupuncture points or
combinations are contraindicated in pregnancy, the presence of morning sickness could
serve as a potential confounding factor.
6. Current users of acupuncture for treating GI symptoms.
7. Current practice of relaxation response.
8. Current enrollment in another clinical intervention study.
9. Cognitive impairment as measured by Mini Mental Status Examination (MMSE), a reliable
and valid screening instrument for the detection of cognitive impairment, using a
commonly used cut-off point of 24.
10. If use of Chinese herbs has been recently discontinued, a potential participant must
have at least 2 weeks without herb use to be eligible for the study. Because use of
herbs is occasionally accompanied by digestive disorders,a period of stabilizing is
required before acupuncture treatment can be initiated. This washout period has been
conservatively estimated by ACP staff herbalists to constitute a sufficient time for
effects of herbs to cease.