Making the Impossible Possible: Yoga and HIV
By: Karin McKie
The founder of clothing manufacturer Lululemon, Chip Wilson, recently got into hot water when, in response to a recall of his pricey yoga clothespants, he was quoted as saying, "Frankly, some women's bodies just don't actually work," citing "the rubbing through the thighs, how much pressure is there over a period of time, how much they use it."
In actuality, the practice of yoga has become popular because so many people have found in it a helpful and holistic practice for people of all shapes and experiences. That, which most definitely includes those living with HIV.
"The first positive person to whom I taught yoga was myself," Toronto yoga instructor Daniel Uy told EDGE. "Yoga asks us to come to the mat with a curious mind and an open heart."
The integration of body, mind and spirit makes the practice a natural partner to combat HIV by building muscle through movement and stress release via meditation. Yoga can reduce symptoms, increase stamina, deal with the side effects of treatment and meds' side effects (which can be worse than the infection), stabilize and support a compromised immune system, and improve overall health.
"People living with HIV and AIDS need to participate in their own wellness and maintenance," said Chicago writer Michael McColly "Claiming our role in our health is taken for granted, and that's no small thing."
McColly should know. After he was diagnosed with HIV in 1996, he traveled the world collecting stories about the AIDS epidemic for his memoir "The After-Death Room: Journey Into Spiritual Activism." He also began to practice and teach yoga to maintain muscle tone, flexibility and bone strength, improve circulatory health, immune efficiency and body awareness, and to address his general physical and mental well-being.
Like HIV-positive people, yoga comes in many forms, from gentler Yin and restorative asanas (poses) to the more active Ashtanga, Vinyasa, Iyengar and Hatha practices. Uy's first class as a student was a hot Bikram class, which he attended as a way of dealing with the complications from his meds. He liked the feeling of "sweating out the chemicals," but he mostly appreciated the stillness at the end of the session.
Most yoga practices conclude with the shavasana pose, in which practitioners lie on their backs, arms and legs out, like a soft starfish, with closed eyes, and take deep pranayama breaths (in Sanskrit, prana is the life force and ayama is to draw out). "At first, I didn't enjoy lying like a corpse, especially when I had been so close to dying," said Uy. "Yet this calm and restful healing relieved my anxiety and frustrations and gave me peace."
Many teachers consider the "corpse pose" the most important position for a yogi. In addition, lying still while awake offers chemical benefits to people living with HIV. Stress produces the hormone cortisol, which suppresses the immune system.
In addition to everyday 21st century stresses, pozzers have added anxieties, such as homophobic discrimination and disclosure. They might also have related struggles like depression, addiction and sexual abuse.
Meditation addresses the mental and spiritual aspects that accompany the processing of an HIV diagnosis and is integral to yoga’s eight limbs, which include yama (self-restraint and being peaceful toward society), niyama (observing your inner self), dhyana (thinking about a divine aspect), dharana (concentration), and pratyahara (detaching from the world).
McColly met Per Erez through their mutual work in using yoga to help themselves and others with HIV. When he first considered the practice as an alternative therapy, Erez told McColly that "I soaked it up. I needed something like yoga to calm me, to cut away the anxieties about my health."
The Art of Living Foundation offer workshops such as Yoga of the Breath for People Living with HIV to focus specifically on mindful respiration as a way to reduce stress and fatigue, and to address depression, which, the group notes, is twice as common in people living with HIV as it is in the general population. Their Sudarshan Kriya breath technique strengthens the respiratory, cardiovascular and immune systems, and lowers the bad chemical cortisol while increasing prolactin, the well-being hormone.
"I had my blood drawn shortly before the Yoga of the Breath course," a participant in a 2011 San Francisco workshop said. "My T-cells had dropped again, as they had steadily for the past year, even after changing HIV medications. My doctor said if I could not get them over 200, I should go back on a long-term antibiotic to protect against pneumonia. After the seminar, I did the breath work at home, twice daily for 40 days, and my T-cells rose almost 100 points. I don’t have to go back on antibiotics."
Uy focuses on breath in his teaching. "All we truly need is an inhale and an exhale," he said. "Everything else is secondary."
The physical parts of a yoga practice -- asana postures and pranayama breathing -- can ease disease and medication symptoms including digestive and joint problems. A Washington University School of Medicine study posited that yoga could be a safe and effective therapy for HIV-related metabolic syndromes such as high blood pressure, and for health-related risks including stroke, diabetes and heart disease.
Yoga also builds strength through going through the various postures; other poses massage internal systems via backbends and inversions. Some hypothesize that glands like the thymus, an important part of the immune system located behind the sternum, are stimulated by chest-opening, bridge-type poses, and that circulation is opened and increased using head-, shoulder- and hand-stands.
Denver Iyengar instructor Claudia Kuhns has been teaching HIV-positive people yoga since 1989. With the increase of life-prolonging drugs, her classes are now designed to help students keep their internal organs healthy from the side effects of medicine. Meditation is certainly gentler on the body than medication, as well as more available and affordable.
In 2011, the 30th anniversary of Dr. Michael Gottlieb’s first official report of AIDS, New Mexico’s Guru Ram Das Center offered a three-day Kundalini yoga workshop for people living with HIV and Hepatitis-C. Center director and teacher Shanti Shanti Kaur Khalsa, who started teaching positive people in West Hollywood in 1986, brought yogic teachings to modern medicine with this seminar. It was named Immune Fitness to downplay HIV’s stigma, to keep it light and upbeat, and to embrace the Jane Fonda fitness craze at the time it was created.
Over the last three decades, Immune Fitness has educated more than 9,000 people living with HIV and AIDS, along with their families and friends. Many positive people have become long-term non-progressors and survivors. Some students from the ’80s are still alive and thriving. Most have had fewer opportunistic infections, more and more consistent energy, and have been able to address harmful relationships and behaviors.
Even "those who died had less pain and deeper connections to those around them at the time of their passing," said Khalsa, who did her Ph.D. research on the effects of meditation on people with HIV. Immune Fitness continues to blend "the scientific and the subtle, the head and the heart, to link the ancient practice of yoga to modern psychoneuroimmunology and show that movement, breath, mantra and meditation benefit the biological and psychological processes of the human immune system."
The Iyengar Yoga Association of Greater New York teaches weekly classes for people with HIV to encourage them not to isolate themselves. After his diagnosis, "the Chicago yoga community was very helpful and supportive of this new way to see my body, which I needed," McColly noted.
"A room full of people all doing the same thing is a powerful experience," added Uy. Yoga classes are "non-competitive, non-judgmental, safe and sacred spaces," providing a constant and supportive network for the infected community.
When setting up his teaching website, Uy had to decide whether or not to disclose his own HIV status. Naturally, he meditated on it. He ultimately decided to speak out.
After publically posting his own status, he has had numerous conversations with practitioners about their own stories and experiences. "Since allowing myself to become more visible, others have started to seek me out," he said. "To paraphrase ’Field of Dreams,’ ’If you build it, they will come.’"
Kuhns also works with The Yoga Group, which offers free classes to individuals living with life-challenging conditions and lists national HIV yoga classes and other resources on their website. She told EDGE that she considers her job "only to open the door and teach the student how to go inside and explore."
A yoga practice can also provide physical and psychological power in a situation of powerlessness, to move from being a victim to a victor. "Yoga," McColly said, "gave me a sense of agency that was crucial in those months and years when I wasn’t sure of my future."
For his part, McColly worries about the current increases of HIV infections in communities of color and those living in poverty, because these populations, for the most part, don’t have the same access to a yoga studio or classes. Besides, many of them probably wouldn’t feel comfortable "in the mostly Caucasian yoga world of nice studios for 40-something women in Lululemon pants that cost $100," McColly added. "I fear they would be terrified to walk into one of those places."
Even so, Uy remains hopeful that the benefits of yoga can be brought to more and more pozzers in all communities.
Before his own diagnosis, he was a self-described "chubby kid" who became an "awkward, unhealthy guy." He has been teaching for five years, six days a week, in a multitude of styles.
"It did not come easy for me," he said. "The poses and sequences are challenging physically, mentally, emotionally and spiritually. But I believe that anybody, and any body, can benefit from the practice of yoga.
"Making the impossible possible," Uy added, "that is what yoga is about."
This story is part of our special report titled "Keeping Fit with HIV." Want to read more? Here's the full list.