International Journal of Yoga - Philosophy, Psychology and Parapsychology

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Year
: 2019  |  Volume : 7  |  Issue : 1  |  Page : 3--9

Human immunodeficiency virus/acquired immune deficiency syndrome: A relook into the challenge from an integrated, yogic perspective


BP Harichandra, Mavathur N Ramesh, HR Nagendra 
 Department of Life Sciences, S-VYASA, Bengaluru, Karnataka, India

Correspondence Address:
Prof. B P Harichandra
C/O Dr. MN Ramesh, Ekanatha Bhavan, #19, Kempegowdanagara, Bengaluru - 560 019, Karnataka
India

Abstract

HIV/AIDS is said to be one of the deadliest disease of modern times, incurable. The disease, is taking fortune out of the victims physically, mentally, psychologically, socially and economically. Efforts are being made at global level to control the deadly disease. In spite of all the efforts and the money spent, the disease is still a challenging one. UNAIDS has strategized year 2030 to end HIV/AIDS. In this background there is a need to relook the way the challenge of HIV/AIDS is addressed. This paper relooks into the various issues both from preventive and combating perspectives, by providing conceptual notes not well discussed among the scientific community. Taking hints from Ayurvedic texts the paper discusses a multidimensional approach involving food, sexual attitudes, condoms, behavioral, education; all with yogic (yoga based) approach as the base to address the challenge faster and better.



How to cite this article:
Harichandra B P, Ramesh MN, Nagendra H R. Human immunodeficiency virus/acquired immune deficiency syndrome: A relook into the challenge from an integrated, yogic perspective.Int J Yoga - Philosop Psychol Parapsychol 2019;7:3-9


How to cite this URL:
Harichandra B P, Ramesh MN, Nagendra H R. Human immunodeficiency virus/acquired immune deficiency syndrome: A relook into the challenge from an integrated, yogic perspective. Int J Yoga - Philosop Psychol Parapsychol [serial online] 2019 [cited 2019 May 26 ];7:3-9
Available from: http://www.ijoyppp.org/text.asp?2019/7/1/3/255081


Full Text



 Introduction



Human immunodeficiency virus (HIV) that causes acquired immune deficiency syndrome (AIDS), assaults the body's immune system leading, over time, to a situation where the body cannot fight the infections and diseases.[1] HIV/AIDS is one of the biggest public health challenges of the 20th century since its discovery in early 80s.[2] According to the United Nations Programme on HIV/AIDS (UNAIDS) statistics, at the end of 2015, 36.7 million people globally and 2.1 million people in India lived with HIV/AIDS.[1],[3] UNAIDS strategizes making 2030 as the year to end AIDS epidemic,[4] which is about one and a half decades away. Conventional approach to combat HIV includes typically the “A-B-C; Abstinence, Being faithful and use Condoms” strategy to prevent HIV/AIDS and an antiretroviral therapy (ART)-based medication for enhancing the immune system as well as preventing vertical transmission. According to the Montagnier, who shared the Nobel Prize for coinventing the HIV, the virus is just like any other passerby virus, and our body can be exposed to the virus any number of times. If one has a strong immune system, the body can overcome the virus in a matter of weeks.[5] Although Montagnier opines that the immune system can take on the HIV on its own,[6] world over 18.2 million people are on ART as of June 2016, and globally, 35 million people have died of AIDS-related illnesses.[1] Further, it is well known and well accepted that ART has a battery of common and severe side effects. In this background, the current article relooks into the various aspects of HIV/AIDS, and proposes an integrative approach considering yoga as a component, taking hints from Ayurvedic texts to combat the challenge.

To present these, this article explores traditional texts on medical sciences which are largely the Ayurvedic texts, which explain about the immune system referred to as vyādhikshamatva, the factors affecting them and strategies for enhancing them, taking the concept of ojas which is considered to be base of vyādhikshamatva. The article also reviews the modern literature in the area and briefly presents the views of modern Ayurvedic researchers and Vaidyas on the issue. However, in order to address the challenge, the article does not consider the herbal or metal-based Ayurvedic preparations, but explains an integrated yogic perspective based on enhancement of paścakośas, through the practice of yoga as suggested by Maharshi Patanjali and other yogic texts, which also includes lifestyle modification. Further, the article addresses the challenge both in preventive and combating modes.

 Need for Yogic Approach



The basic premise based on which the concept is evolved in this article is that HIV/AIDS primarily is a result of bhogic – the materialistic approach to life. Simple logic implies that the option for tackling it should be the opposite of the bhogic, which is the yogic – the spiritualistic approach to life. Thus far, the problem has largely been addressed from physiological perspective. In addition, an integrative approach accommodating yogic and spiritual perspective could lead to better alleviation. HIV/AIDS is also a significant social issue. Hence, an approach with a lifestyle perspective, promoting responsible social and ethical attitude toward life would also be an advantage. An integrated approach provides all these. An integrated approach considers an yogic approach involving five cardinal principles, namely, (1) physical calming of the body by relaxation (through practice of various āsanās and deep relaxation technique, cyclic meditation, and yoga nidrā), (2) slowing of the breath by taming the breath to help better flow of energies (through practice of different types of pranayāmās and prānic energization technique), (3) mastering of the mind to help calming it and thereby providing conducive environment for channelizing the energy toward combating the disease (through techniques such as silence, observation of breath, the Mind Sound Resonance Techniques), (4) lifestyle changes with a purpose of understanding oneself and true purpose of life (implemented through yogic counseling), and (5) overall energization of oneself by taking precaution against loss of vital energy of the body (through practice of dhyāna). These principles would help both in prevention mode and “supporting the body to improve and combat HIV” mode. Traditional and modern texts provide the practices to enhance each of the paścakośas.[7]

 Human Immunodeficiency Virus/acquired Immune Deficiency Syndrome – the Yogic Dimension



The meaning of the word yoga is “union;” primarily, the union of the body (existence at physical state) and the soul (existence at consciousness state). Primarily, in yoga, we add energy both to physical and conscious levels. In the process of energization of the soul, ojas (dealt with in detail, later in this article) is produced, which is the key to a strong immune system. When the immune system is strong, the body is able to take care of any attempt by disease-causing agents that cause infection. Reports of ability of yoga to increase the CD4+ T-cells in HIV-positive adults[8] also adds credence to examine its efficacy in mitigating AIDS and complications arising out of it.

Mechanism of yoga

Working of yoga can be explained with the help of “the principle of mutual convertibility,” which states that matter and energy are interconvertible. In yoga, the matter of the body is converted into energy of the soul. With persistent practice of higher levels of yoga, matter of the body, represented by the sapta dhātus, is converted into higher state of matter, the ojas. It is worth noting here that, although production of ojas happens naturally during deep sleep when there is a conducive environment in the body, it can be enhanced/assisted through yoga. Fundamentally, the stages in which the production of ojas happens can be explained using description from Ayurvedic texts as follows: Sapta dhātus refer to the seven body tissues, namely, the rasa (basic body fluids), rakta (blood), māmsa (muscles), medas (fats and lipids), asti (bones), majje (bone marrow), and śukra (semen). The sapta dhātus are produced in that order, and each of the sapta dhātu becomes the source for the next dhātu, starting from rasa to end with śukra.[9] The last of the sapta dhātus, the semen is the highest state of matter of all sapta dhātus, that is, a matter with highest quantum of energy which is the key material for production of ojas. Integrated yogic approach enhances the production of ojas. The resulting higher energy state, the ojas thus produced permeates all through the body. Ojas is the energy of life and provides physical, mental, and spiritual vitality. It is considered to be vital in defense mechanism of the body[10] and a biological determinant of bio-strength and immune strength in an individual.[11] The physical, mental, and spiritual strength of an individual totally depends on ojas.[12] Further, ojas is principally responsible for the immunity, referred to as vyādhikshamatva, and its effect is referred to as ojabala or bala. Ojas determines the capacity of an individual to combat diseases, referred to as Vyadhi bala virodhitvam and also resists virulence of a disease referred to as Vyadhi utpadaka pratibandhakatvam.[13] The Ayurvedic texts further explains that if ojas is affected, it leads to a condition called ojas dushti, leading to pathogenesis, which is further divided into three stages, namely, ojas-vistramsa, ojas-vyapat, and ojas-kshaya. Ojas vistramsa results in fatigue and weakness in the body, and results in an environment in the body where disease can easily get lodged in the body. Ojas vyapat results in fluctuation of immunity leading to autoimmune disorders, hypersensitivity, and allergic disorders. The last stage, the ojas-kshaya which refers largely to the loss, absence or deficiency of ojas, causes wasting, decay, degeneration, delirium, apoptosis, and thus destruction of the body.[12],[14],[15],[16] The conditions of the body with ojas-kśaya are similar to that of an HIV positive as explained below.

Similarities in symptoms of Ojas kshaya and human immunodeficiency virus/acquired immune deficiency syndrome

HIV/AIDS does not have unique symptoms but, because of the weakened immune system, the victim will be prone to several opportunistic infections. A similar condition described in the Ayurvedic texts, which is said to be a result of ojas kshaya. There are several references to this in Ayurvedic texts. Typically, a few are mentioned here. Depletion of ojas shows up through symptoms such as fear complex, constant weakness, worry, affliction of sense organs with pain, loss of complexion, cheerlessness, roughness, and emaciation.[17],[18] Further, it is explained that if the ojas is destroyed, the human beings will also perish.[19] Furthermore, according to the Ayurvedic texts, depletion of ojas also leads to diabetes (ojomeha/madhumeha),[20],[21] anemia (pāndu roga),[22],[23],[24],[25] tuberculosis (rajayakshma),[26] loss of immunity,[27] weight loss, and death.[13] Similar conditions are also seen with reference to HIV/AIDS as explained in the modern literature. It is also worth noting that ojas is further subdivided into para ojas and apara ojas. While para is the subtler ojas, apara is the grosser ojas. In general, ojas-kshaya means the deficiency of apara ojas which leads to immune deficiency.[28] Para ojas depletion being a more serious issue could lead to faster death by disorders in cellular apoptosis.[15] Perhaps, this would be a condition that could be called AIDS. The typical symptoms along with references to modern HIV/AIDS and that to ojas kshaya are listed in [Table 1].{Table 1}

Importance of ojas in managing human immunodeficiency virus/acquired immune deficiency syndrome

Both production and preservation of ojas are important in nurturing a person with HIV. There are two routes leading to ojas kshaya (1) deceiving the body of the basic raw material required for the formation of sapta dhātus, which is food; or in other words malnutrition and (2) by rejection of the śukra itself due to indulgence in unregulated, irresponsible sexual practices. Charaka Samhita, a basic text of Ayurveda, also clearly explains this.[18] While Harichandra and Ramesh have dealt with the role of former separately in another study,[39] this article emphasizes on the later as a factor leading to ojas kshaya.

Preservation of śukra requires practice of brahmacharya (Sex sublimation/Celibacy), which forms an integral part of yoga. As such, brahmacharya is a part of the yama, the first stage of yoga explained in the Patanjali Yoga Sutra (PYS) (Sutra 30, Sādhana Pāda) which reads as follows: “ahimsa satya asteya brahmacharya aparigraha yamāha” which means ahimsa- nonviolence, satya-truthfulness, asteya-nonstealing, brahmacharya-celibacy, and aparigraha-non covetousness are the Yamās-the restraints for yoga. Yama being the first stage of yoga, brahmacharya, the part of yama becomes a fundamental part of yoga. PYS 2–38 states “brahmacharya pratiśṭāyam vīrya lābhaha” which means that when brahmacharya is practiced, one acquires abundant vitality and energy, which is required for an HIV victim to combat the virus. Further, uncontrolled release of semen throughout the life does contribute to premature deterioration of vital capacities of brain, overburdens the heart, and depletes the nervous system,[40] thus affecting the overall well-being. Swami Vivekananda in the lessons on Raja yoga states so: “Ojas is most easily made from that force which manifests itself in the sexual powers. If the powers of the sexual centers are not frittered away and their energies not wasted (action is only thought in a grosser state), they can be manufactured into Ojas.”[41] Modern findings also correlate the increased prevalence of hypogonadism in HIV-infected persons.[42],[43] Reduction in the secretion from gonads is what the authors are presenting here as depleted śukra dhātu and thereby the ojas. Further, it is observed that multimorbidities (2+ comorbidities) are high among HIV-infected men with hypogonadism.[44] It is also opined that early recognition of hypogonadism can help improve the quality of life among HIV positives.[42] Thus, it can be safely argued that preventing loss of śukra would also help manage comorbidities among HIV positives; perhaps, more so if śukra were to be converted to ojas; thus preventing the ojas kshaya. Another important thing that is worth noting here is that the effect of ojas, the ojabala, is classified into three categories: sahaja bala (transferred generation to generation), kālaja bala (depending on environment), and yuktikrut bala (induced or gained by nutrition, exercise, and healthy workouts).[12],[45] Of these, sahaja bala which is transferred generation to generation could be safely attributed to be induced or developed in the body well before the formation of zygote through the sperm and ovum, and in the morula stage.[12] Hence, enhanced sahaja bala could also help in preventing mother-to-child transmission of HIV. Incidentally, it is also reported that yoga helps in preventing mother-to-child transmission.[46]

Both modern and traditional literature, based on yoga, also provide clues on beneficial practices of yoga for HIV positives. Some of them are highlighted here. Practice of oli mudras which include vajroli, sahajoli, and amaroli help sublimate sexual energy into ojas.[40],[47] Bhargav et al. provide an integrative approach-based yoga module for HIV positives,[7] which could be promising and worth studying. Further, the factors that are responsible for ojas-kshaya as per classical texts, namely, Abhighata (trauma), kshaya (emaciation), kopa (anger), shoka (depression), dhyana (worrying), Sharma (excessive physical work), akshudha (starvation), ativyayama (excessive exercise), atimadyapana (excessive alcohol intake), and ativyaya (excessive sex)[12],[48] are all addressed in the yogic approach explained in the astānga yoga (eight limbs yoga) explained by Maharshi Patanjali which start right from yama and niyama, which are the aspects requiring lifestyle modification, and are the first two stages of yoga.

The Condoms Formula

Of all the precautionary measures for prevention of HIV/AIDS, the highest importance is given to promotion of condoms; “Use condoms-Prevent AIDS” is the major punch line in all awareness programs. This could be construed as a good strategy for prevention, but misleading for HIV positives. Indulgence in sexual activity results in spending of the energy. Ojas being a product of the semen/sexual energy, its loss bears heavily on the HIV positive individual and repetition of the behavior results in faster progression from HIV positive state to the AIDS state. Thus, while condoms use by HIV positives prevents HIV transfer, it promotes AIDS.

The basic thought of emphasis on condom promotion is based on the premise that its use will prevent HIV from spreading; which addresses only half the problem. Working on ideas to boost the immune system in the infected individual, helping them to fight HIV better would be a more beneficial strategy. To this effect, giving a fillip to ojas is what the authors propose. Needless to say, indulgence in sexual activity results in spending of the energy, leading to ojas kshaya, resulting in faster progression from HIV positive state to the AIDS state. Thus, while condoms use by HIV positives prevent HIV transfer, it promotes AIDS, thus is something like HIV positives digging their own grave. Hence, it should be strongly advised that a HIV positive individual abstain from any kind of sexual activity. Just as some diet would be prescribed for an ill person, who is basically restraining the desires of the tongue; HIV positives should be prescribed to restrain the desires of sex to preserve their vitality. The HIV positives may resume back to responsible sexual activities once the immune system takes over the HIV. For agencies such as World Health Organization, UNAIDS, National AIDS Control Organization, it would be worthwhile to conduct a study, to estimate the correlation between the frequencies of indulgence in sexual activity to the progression of disease. At this juncture, it is worth noting that modifications in behavioral changes with reduction in cases of people having 2+ nonregular sexual partners by 50%, 3+ nonregular sexual partners by over 90%, and premarital sex by around 65% had a major role to play in a successful prevention of HIV cases in Uganda.[49] This establishes that behavioral correction with regard to sex in general will go a long way in combating the HIV epidemic.

Sex education

Educational programs to create awareness about AIDS mainly focus on providing education on “safe sex.” This can address or aggravate the problem depending on the prevalent social ideology. This is required in regions where premarital sex is accepted, but the same can work to adverse effect in regions where premarital sex is a taboo as it would result in curiosity on sex-related matters, possibly leading to irresponsible sexual behavior. A reflection of this can be seen in the teen pregnancy data from the United States (US) which indicates that out of all the babies born in 2014, 89% of babies were to teenage parents (numbering 249,078 in 2014 and 273,105 in 2013).[50] Hence, sex education/condom awareness program plays an important role in such countries where even the school girls becoming pregnant is a major issue. The ideal way of resolving the problem of adolescents involving in free sex would be to offer them an alternative in the way of realizing their true potential and interests by proper introduction and regular practice of yoga and meditation which would also improve their academic performances.

 Additional Concerns



There are several other factors which are required to be addressed for a wholesome approach to manage HIV/AIDS. The following points are worth noting:

Alcohol is known to reduce CD4+ cell count, increase viral load, and result in faster progression of HIV positive to AIDS.[51],[52],[53],[54] As also alcoholism is known to affect ojas to a great extent[55],[56]Use of drugs has played a major role in promoting and spreading of AIDS. Appearance of AIDS in US and Europe in drug users coincided with illicit drug use[57]Researches have given clear indications about the role of drugs (prescribed drugs) in promoting AIDS. The researches go to conclude that drug use is necessary in HIV positive and sufficient in HIV negatives for AIDS diseases.[57] Especially, in this scenario, supplementation with safer complementary and alternative approaches is important which could help taper down drug useMalnutrition is considered to be a marker for poor prognosis among HIV positives.[58] Proper nutrition is a key to maintaining proper immune system and is important for HIV positives.[39] Further, it is the basic source of raw material for production of sapta dhātus should be such that lesser effort is required to be put by the body to assimilate it and it is conducive to produce sapta dhātus. Such foods are traditionally referred to as sātvik foods and help producing ojas.[59] Such nutrition should be an integral part of any HIV care systemYoga is proven to be helpful for HIV positives in reducing psychological distress,[60] reducing anxiety and depression,[61] improving the immune system,[61] improving quality of life,[46] and also in assisting the body to prevent the vertical transmission (mother-to-child transmission) of HIV.[46]

 Conclusions



Considering the discussions made in the article, the following conclusions can be made:

HIV/AIDS has still been a challenge over 30 years. A relook into the way it is fought at is very much essentialOjas, the essence of sapta-dhātus, is a key to health and vitality. Increase of ojas is important to help manage the HIV/AIDSFactors provoking unnatural sexual behavior to be checked to prevent HIV/AIDSCondom promotion is harmful for HIV positives since it promotes AIDS; although not HIVAbstinence from sex is inevitable for HIV positives. This would help both HIV positives and the society. A HIV positive could reserve the energies to fight HIV positives. Society is at advantage since the major route for HIV positive propagation is addressedThe promotion of “condom culture” in the name of AIDS education should be checked. Implied character education should replace sex educationSeveral other factors such as drugs, substance abuse, and alcoholism helps disease progression, which should be checked among HIV positivesSātvik food conducive for production of sapta dhātus should be an inevitable, integral part of HIV managementYoga is an indispensable tool for helping combat HIV/AIDS.

Yoga, in general, promotes health and harmony in the society. Finally, the following message of the śvetāśvatara Upaniśad is worth noting;

na tasya rogo na jarā na vyādhiḥ prāptsya yogāgnimayaś śarīraś;[62]

…which proclaims, “diseases does not touch him, old age does not bother him, death does not approach (has a wishful death) him who has ripened his body, with the fire of Yoga.”

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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