Mind-body practices for people living with HIV: a systematic scoping review

Maria Pilar Ramirez-Garcia,Myriam Dupont,Sébastien Colson,Jorge Flores-Aranda,Marie-Pier Gagnon,José Côté

doi:10.1186/s12906-019-2502-z

Abstract

BackgroundMind-body practices are frequently used by people living with HIV to reduce symptoms and improve wellbeing. These include Tai Chi, Qigong, yoga, meditation, and all types of relaxation. Although there is substantial research on the efficacy of mind-body practices in people living with HIV, there is no summary of the available evidence on these practices. The aim of this scoping review is to map available evidence of mind-body practices in people living with HIV.MethodsThe Arksey and O’Malley (Int J Soc Res Methodol 8:19-32, 2005) methodological framework was used. A search of 16 peer-review and grey literature databases, websites, and relevant journals (1983–2015) was conducted. To identify relevant studies, two reviewers independently applied the inclusion criteria to all abstracts or full articles. Inclusion criteria were: participants were people living with HIV; the intervention was any mind-body practice; and the study design was any research study evaluating one or several of these practices. Data extraction and risk of bias assessment were performed by one reviewer and checked by a second, as needed, using the criteria that Cochrane Collaboration recommends for systematic reviews of interventions (Higgins and Green, Cochrane handbook for systematic reviews of intervention. 2011). A tabular and narrative synthesis was carried out for each mind-body practice.ResultsOne hundred thirty-six documents drawing on 84 studies met the inclusion criteria. The most widely studied mind-body practice was a combination of least three relaxation techniques (n = 20), followed in declining order by meditation (n = 17), progressive muscle relaxation (n = 10), yoga (n = 9) and hypnosis (n = 8). Slightly over half (47/84) of studies used a RCT design. The interventions were mainly (46/84) conducted in groups and most (51/84) included daily individual home practice. All but two studies were unblinded to participants.ConclusionThe amount of available research on mind-body practices varies by practice. Almost half of the studies in this review were at high risk of bias. However, mindfulness, a combination of least three relaxation techniques and cognitive behavioral strategies, and yoga show encouraging results in decreasing physical and psychological symptoms and improving quality of life and health in people living with HIV. More rigorous studies are necessary to confirm the results of Tai Chi, Qigong, and some relaxation techniques.

Highlights

Mind-body practices are frequently used by people living with Human immunodeficiency virus (HIV) to reduce symptoms and improve wellbeing
Two Randomized controlled trials (RCT) combining progressive muscle relaxation with cognitive behavioral strategies [64, 65] showed the beneficial effects of these interventions on symptoms of depression in people living with HIV
Autogenic training, breathing, and neurofeedback We found four documents reporting on three studies that assessed autogenic relaxation technique [82], neurofeedback [84], and breathing exercises [83] in people living with HIV

Summary

Introduction

Mind-body practices are frequently used by people living with HIV to reduce symptoms and improve wellbeing. These include Tai Chi, Qigong, yoga, meditation, and all types of relaxation. To reduce symptoms and treatment side effects and to improve general wellbeing, 55–60% of people living with HIV used complementary health approaches (CHA) [7,8,9,10]. They reported using CHA to round out conventional HIV care and antiretroviral treatment [7, 10, 11]. Some other CHA are traditional healers, Ayurvedic medicine, and traditional Chinese medicine [12]

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