Health, Hope and HIV
While there is no scientific evidence to back up the inversion theory, the hypothesis is based on improving the efficacy of the thymus, an endocrine system gland that helps regulate immune system necessities like T-cells. PWAs, who often have dangerously low T-cell counts that compromise their immune system, can become vulnerable to opportunistic infections that healthy people can fight. So the logic is that inversions increase circulation to the thymus gland, and backbends open the chest and stimulate thymus activity.
Like Johnson, Shanti Shanti Kaur Khalsa, Ph.D., began working with PWAs early in the epidemic in Los Angeles and has since gone on to become executive director of the Hacienda de Guru Ram Das Center for Medicine and Humanology near Santa Fe. "In the beginning the medical community couldn't help my students, and a lot of the emphasis was on alleviating fear and helplessness," she says. "We used yoga and meditation to help people feel more safe with the unknown because we know fear is the biggest immune suppressor."
Reasons Not to Stress
Kaur Khalsa's intuition was astute. Fear causes stress, and those who study HIV know that the most significant benefit of yoga for PWAs may be stress reduction. A May 1999 study at the University of North Carolina at Chapel Hill found that PWAs with more-than-average amounts of stress got sick two to three times faster. And a study released last summer from the University of Miami, Florida, reported that the stress hormone norepinephrine was significantly lower in PWAs who attended weekly stress-management group sessions. Even better, the study also showed that the same group had higher levels of CD8 cells, which are known to help control the HIV virus.
Even before there was scientific evidence of its benefits, the mind-body program for HIV/AIDS at Beth Israel Deaconess Medical Center at Harvard University had been using yoga for 14 years. Ann Webster, Ph.D., who directs the program, touts yoga as a great way to achieve the "relaxation response," a physiological state defined more than 25 years ago by Harvard Medical School Professor Herbert Benson, M.D.
Stress wreaks havoc on our nervous system and sets off the body's state of emergency, the "fight or flight" response: Blood pressure rises, metabolism speeds up, blood sugar levels spike, and the immune system is not as efficient. But conscious acts of relaxation counteract this state of alarm and allow the body to return to its normal level of functioning. "Relaxation is a state of quiet in the mind and the body," says Webster. "Yoga is a way for people to learn to self-regulate the body. For example, when I put my students in Child's Pose, which is how little babies sleep, it relieves anxiety, and it's almost impossible to worry in that position."
Anxiety, stress, and depression also increase levels of the hormone cortisol. Cheryl Koopman, Ph.D., an associate professor in the Department of Psychiatry and Behavioral Sciences at Stanford University, who specializes in HIV/AIDS, points out that everyone has stress, but PWAs generally have additional factors. "We know too much cortisol is harmful to people with HIV infection," she says, adding that "while everyone has stresses in their lives, people with HIV tend to have additional stress like discrimination, disclosure, racism, homophobia. These kinds of stresses are associated with subgroups that are more likely to have HIV." Koopman also points out that elevated cortisol levels impair the immune system and notes that a 1998 study published in the Journal of the Association of Nurses in AIDS Care indicates that higher levels of cortisol may even increase replication of the HIV virus.