Map downloaded from CIA World Factbook website

The Mae On Project is a pilot project using acupuncture for symptom relief and improved quality of life in people living with HIV/AIDS (PLHIV) in northern Thailand.  The first case of AIDS in Thailand was recorded in 1984 (1). Widespread transmission of the virus is believed to have hit epidemic proportions in the late 1980s, especially among injection drug users (IDU) and sex workers.  The disease soon proliferated amongst other populations causing increasing concern for healthcare workers and government officials who initiated successful educational and treatment programs in the early 1990’s.  At the end of 2005, the population of Thailand was around 65 million with approximately 560,000 adults and 16,000 children estimated to be living with HIV.  Twenty-one thousand individuals were estimated to have died of AIDS related disease in this year alone.  The northern region was found to have the highest prevalence of HIV in the country.  At the end of June 2005, the number of people undergoing antiretroviral (ARV) therapy was estimated to be between 67,000 and 82,000 (2).

Mae On Hospital, Thailand

The idea for the project was conceived in 2002 by Dr. Laura Louie, a Canadian naturopathic physician and acupuncturist, while visiting Mae On Hospital, a rural community hospital, located about 35 km east of Chiang Mai. 

She volunteered her services and provided free acupuncture treatments to HIV/AIDS patients at the hospital.  Within 2 to 4 sessions, her Thai patients experienced a considerable decrease in symptoms, which led to a significant improvement in their quality of life.  Based on this dramatic result, Dr. Louie collaborated with Mae On Hospital to develop a clinical program to train nurses to administer acupuncture treatments for HIV/AIDS patients in this rural region.

The Mae On Project was officially launched in April 2004 with 3 main objectives:

1. To develop a pilot program to train medical staff in acupuncture as adjunctive treatment for HIV/AIDS patients at Mae On Hospital in northern Thailand. 
2. To create a free clinic at Mae On Hospital to provide acupuncture for people living with HIV/AIDS. 
3. To undertake an evaluative pilot study using quantitative and qualitative data to assess the efficacy of acupuncture on quality of life, the symptoms of chronic HIV infection and the side effects of anti-retroviral therapies. 

Dr. Laura Louie, ND, with Thai Nurses, Ms. Duangdean Ruensa and Ms. Unchalee Pultajuk

Initially two Thai nurses volunteered for training in basic acupuncture.  Teaching was conducted by 3 traditional Chinese medicine (TCM) practitioners – Dr. Laura Louie, Dr. Rungrat Pawaradhisan and Dr. Sudhisak Pawaradhisan.  The nurses received 110 hours of didactic training in acupuncture over a 4.5 month period.  The training was conducted in two phases.  The first phase focused on fundamentals of TCM, acupuncture points and meridians, and diagnosis using TCM criteria.  The second phase emphasized acupuncture therapeutics and clinical skills. Clinical training consisted of supervised weekly acupuncture for HIV patients over six months.

Once the clinic opened in August 2004, 32 PLHIV in various stages of HIV-infection regularly attended weekly acupuncture treatments in a group out-patient setting.  Both nurses were able to perform acupuncture on the opening day of the clinic.

Acupuncture Model Outlining Acupuncture Points and Meridians

To assess the efficacy of the acupuncture treatment, a non-randomised, single-arm study was carried out over a 6-month period, for which 27 HIV-positive participants with stable medication use and no significant morbidities were enrolled.  The study began in August 2004. 

Overall, the findings of the study suggested that acupuncture may be beneficial to people living with HIV/AIDS in this rural region, improving physical symptoms and quality of life.  The project demonstrated the feasibility of establishing and maintaining a hospital-based acupuncture clinic for people living with HIV/AIDS in a rural area.  This low-cost intervention program was established in less than 12 months and drew on local nursing expertise.  The project confirmed that acupuncture was acceptable to this population, with many participants requesting that similar clinics be started in other districts to accommodate those HIV patients who were unable to travel to the Mae On Hospital.  The director of Mae On Hospital and the head nurse of the HIV/AIDS program expressed great satisfaction with the acupuncture program, requesting training for more nurses.  Thus far, 5 nurses have received basic training in the foundations of traditional Chinese medicine and acupuncture.  Training is on-going.  The acupuncture clinic continues to run on a weekly basis at the Mae On Hospital and has a waiting list for new patients.  The results of the first phase of the Mae On Project have been published in the Autumn 2006 issue of HIV Nursing.

Here is what some of the participants said about the project:

“Since acupuncture, I don’t think about getting sick any more, because I feel ‘normal’. But if I get sick, I feel confident that acupuncture can help.”

“Since doing acupuncture I really firmly believe my life has improved.  My physical symptoms are all gone…..  [I have] more concentration……  I feel that my health is better than those who don’t have HIV.  I feel it’s a combination of antiretrovirals and acupuncture.”

The nurses who trained in acupuncture also had strongly positive comments about the project.  One of them commented:

“I feel honoured to have been able to participate in the (acupuncture) program.  It’s provided an opportunity for me to help many people.  A program like this can’t be found anywhere else in Thailand.”

Dr. Rungrat Pawaradhisan Teaching Clinical Acupuncture Skills to Thai Nurses at Mungkala Clinic in Thailand

The Foundation is setting up a follow-up research study to elicit more sophisticated data regarding the effectiveness of acupuncture as an intervention for symptom relief and improved quality of living with PLHIV.  The study will take place at Mae On Hospital and will begin in November 2006. The treatment will consist of a 3–month course of individualized acupuncture. The main investigators will be Laura Louie, ND and Ian Hodgson, PhD.

Currently, the Mae On Project is primarily a grassroots effort that now functions in the hands of the medical staff at Mae On Hospital.  The Foundation continues to provide acupuncture supplies, financial assistance, education in advanced acupuncture therapeutics and abundant encouragement.  At this time, the Mae On Project is the only acupuncture clinic in a community hospital in Thailand that is dedicated specifically to treating people living with HIV/AIDS.  It continues to provide acupuncture treatments free of charge to HIV patients.

Footnotes

1. In this paragraph , all the statistics with the exception of the numbers noted in the last sentence were taken from www.avert.org/aidsthai.htm. This website was accessed on September 5, 2006.

2. The statistics for this sentence on ARV therapies was taken from a document prepared by UNAIDS and The World Health Organization in June 2005 titled Progress on Global Access to HIV Antiretroviral Therapy: An Update on “3 by 5”.