Mindful Medicine: Yoga and HIV

By Maureen Bogues

"It's a way of looking at the world. Not just bending and stretching."

The hope of maintaining a quiet, focused mind and a flexible, toned body might be a good reason for anyone to enter yoga class, but it is especially vital for people living with HIV or AIDS.

"They are the most dedicated students," Denise Johnson, president of the Littleton, Colo. Nonprofit, The Yoga Group. "I've never seen this sort of dedication before. They're an inspiration to all of us."

Since 1988, The Yoga Group has offered free yoga classes to people with HIV or AIDS in the Denver area, and has spun off similar programs in other U.S. cities including San Francisco, Atlanta, New York, Chicago and Milwaukee. All told, the group has programs in about 15 cities worldwide.

Though it may seem an unusual treatment for serious illnesses like HIV/AIDS, yoga practitioners believe in the power of the pose. Just ask Mac Phillips, a 36-year-old San Francisco resident who is HIV-positive.

"It's a way of looking at the world," Phillips said. "Not just bending and stretching."

Phillips points to the Learning Immune Function Enhancement (LIFE) program for people with HIV that lists 19 psychological traits of long-term survivors; yoga incorporates two of them, a spiritual discipline and exercise.

An age-old Indian form of exercise and philosophy, yoga offers solace, community and inspiration to those who seek it out. By meshing a series of postures — asanas — and breathing exercises — pranayamas, yoga creates a state of what is sometimes called "moving meditation."

For people living with HIV, yoga gives them a chance to quiet the mind and minimize stress, which is especially important for those with compromised immune systems. People with HIV face complex psychological as well as troubling physical side effects from the disease or the medications. All these factors can build up or add to the stress.

'Yoga is good for the immune system," Johnson said. "It's a stress reducer and stress causes the body to break down."

A regular yoga routine — especially with some of the inverted poses like shoulder stands or headstands — can help boost the immune system, according to L. Barton Goldman, M.D., a yoga practitioner and medical director for HealthONE Occupational Health and Outpatient Rehabilitation in Denver. Though the evidence is anecdotal, Barton said, it is "begging for the implementation of scientific study."

"I have noted over the years that individuals who perform yoga on a regular basis, particularly those that include headstands and shoulder stands in their daily practice, tend to rarely get sick and, when they do become ill, tend to heal much more rapidly than expected."

Inverting feet above the head helps more blood circulate through the thymus, which can increase white blood-cell production, and it decreases blood flow to the adrenal glands, possibly reducing the adrenaline production associated with stress. These particular poses, as well as many of the easier ones, can be modified to limit strain or effort.

Yoga, after all, is not about competition or over-exertion, but about being gentle with the body and working only within its limits. Inversions, which are advanced, should only be performed, at first, under supervision of a yoga teacher. Beginners are advised to start with easier poses.

"It almost makes me grateful to have HIV because it pushed me back to yoga," said Phillips, who had practiced yoga intermittently since 1993, but became more serious about it after he became HIV-positive last year. In late June, he received his yoga teaching certification from San Francisco's Integral Yoga Institute.

"It's very stressful living with HIV," he said. "You live from one blood test to the next, and then there are side effects from the medication. There are a lot of toxic things in the body."

Protease inhibitors, for example, can cause lipodystrophy, or fat redistribution, so HIV-positive people are encouraged to exercise. Because many of the male patients are also on testosterone therapy, they tend to bulk up.

"Yoga offers another way for them to improve their health and it doesn't have the same effect of making the body big and stiff," said David Nelson, co-owner of Castro Yoga.

Some other drugs can be mood- or mind-altering and cause side effects ranging from fatigue to hallucinations. Phillips said that the mental focus of meditation and yoga help to stem the "mind wandering" that some drugs induce. He said that he has also benefited from other aspects of the yogic lifestyle, including dietary changes (whole foods, vegetarian cuisine), meditation and breathing exercises.

Jivana Heyman, a yoga instructor also from the Integral Yoga Institute, teaches sliding-scale or free classes for HIV-positive people twice a week at California Pacific Medical Center near the city's Castro District. Anywhere from eight to 12 people attend classes regularly.

Heyman's decision to focus on HIV illness was born of personal experience. "I had so many friends who got sick and then died that I had always considered it," he said. In the March 2000 issue of Yoga International magazine, Heyman wrote about losing a friend named Kurt, who studied the spiritual tradition before his death five years ago.

"As I went on to teach, I found that many people facing illness were ripe for self-exploration and were willing to see their illness as an opportunity for growth, as Kurt had," Heyman wrote.

The meshing of physical, mental and spiritual harmony is important, but so is the sangha, or community, especially among a group of people with chronic illness. Heyman's classes with HIV-positive students also feature a time for open discussion.

"Even though the physical part feels nice, the other part — community and spiritual connection — is equally important," Heyman said.

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