WHAT IS HIV?

What is HIV?
HIV stands for Human Immunodeficiency Virus. HIV is the virus that causes AIDS.

While many viruses can be controlled by the immune system, HIV targets and infects the
same immune system cells that are supposed to protect us from illnesses. These are a type
of white blood cell called CD4 cells.

HIV takes over CD4 cells and turns them into virus factories that produce thousands of
viral copies. As the virus grows, it damages or kills CD4 cells, weakening the immune
system.

What is AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is the most advanced
stage of HIV infection.

HIV causes AIDS by attacking the immune system’s soldiers – the CD4 cells. When the
immune system loses too many CD4 cells, you are less able to fight off infection and can
develop serious, often deadly, infections. These are called opportunistic infections (OIs)
because they take advantage of the body's weakened defenses.

When someone dies of AIDS, it is usually opportunistic infections or other long-term

effects of HIV infection that cause death. AIDS refers to the body’s immune-
compromised state that can no longer stop OIs from developing and becoming so deadly.

What is the Difference Between HIV and AIDS?

You don't have AIDS as soon as you are infected with HIV. You can be HIV+ for many
years with no signs of disease, or only mild-to-moderate symptoms. But without
treatment, HIV will eventually wear down the immune system in most people to the point
that they develop more serious OIs.
The Centers for Disease Control and Prevention (CDC) defines someone as having AIDS
if he or she is HIV+ and meets one or both of these conditions:

Has had at least one of 21 AIDS-defining opportunistic infections

Has had a CD4 cell count (T-cell count) of 200 cells or less (a normal CD4 count
varies by laboratory, but usually is in the 600 to 1,500 range)

How Do I Know if I Have HIV?

Most people can not tell that they have been exposed or infected. It can take up to 12
weeks for an HIV test to come back positive. However most people respond much faster.
Within two to four weeks of exposure to HIV, you might have flu-like symptoms such as
fever, swollen glands, muscle aches, or rash.

The only way to know for sure if you are infected is take an HIV test. If you are infected,
your immune system will make antibodies to fight the virus. The HIV test looks for these
antibodies. If you have them in your blood, it means that you have HIV infection.

Do I Need to Get Tested for HIV?

The CDC estimates that more than 25% of HIV+ people are unaware of their HIV status.
Many of these people look and feel healthy and do not think they are at risk. But the truth
is that anyone of any age, gender, race, sexual orientation, or social or economic class can
become infected. It is your actions (or the actions taken against you), that put you at risk.
You should be tested if:

You have had vaginal, anal, or oral sex without a condom

You have shared needles or syringes to inject drugs (including steroids or
hormones)

You are uncertain of your partner’s status or your partner is HIV+

You are pregnant or are considering becoming pregnant

You have ever been diagnosed with a sexually transmitted disease

You have hepatitis C
Why Should I Get Tested?
If you test HIV+ there are effective medications to help you stay well. But you cannot get
the health care and treatment you need if you do not know your HIV status. Being
unaware of your status also makes it more likely to unknowingly pass HIV to others.

If you test HIV- you can take steps to stay that way. You can also spare yourself
unnecessary worrying.

What Tests are Available?

The most common test for HIV is the antibody test (called ELISA). It can be done on
blood, saliva, or urine. According to the CDC, it is more than 99% accurate. Results are
generally available within two weeks. (There is a rapid ELISA test that gives results in
less than half an hour.)

A positive result means your body has developed antibodies for HIV, so you are infected
with the virus. To be completely certain, positive results are confirmed with a more
sensitive test called the Western blot.

A negative result means your body has not developed antibodies and are probably not
infected. To get truly accurate results, it's necessary to wait three to six months after your
last possible exposure to the virus before being tested. That is because the immune
system can take anywhere from three to twelve weeks to make antibodies. In this
"window period," someone may get an unclear result or a false negative.

Where Can I Get Tested?

You can get tested at your doctor’s office, a clinic, the local health department facilities,
or at a hospital. In addition, many states offer anonymous HIV testing. You can also
purchase a kit that allows you to collect your own blood sample, send it to a lab for
testing, and receive the results anonymously. (Only the "Home Access" brand kit is
approved by the Food and Drug Administration.)
AIDS DEFINING CONDITIONS

The Centers for Disease Control and Prevention (CDC) defines an HIV+ person with a
CD4 cell count of 200 or less as having AIDS. The CDC has also developed a list of more
than 20 opportunistic infections (OIs) that are considered AIDS-defining conditions (see
below). If you have HIV and one or more of these OIs, you have a diagnosis of AIDS.

This list comes from a government report and contains medical terms. If you have any
questions, contact a treatment educator at a local AIDS service organization or call an
AIDS information line such as the Project Inform National HIV/AIDS Treatment Hotline
at 800-822-7422.

Candidiasis of bronchi, trachea, or lungs

Candidiasis, esophageal

Cervical cancer, invasive

Coccidioidomycosis, disseminated or extrapulmonary

Cryptococcosis, extrapulmonary

Cryptosporidiosis, chronic intestinal (greater than 1 month's duration)

Cytomegalovirus disease (other than liver, spleen, or nodes)

Cytomegalovirus retinitis (with loss of vision

Encephalopathy, HIV-related

Herpes simplex: chronic ulcer(s) (greater than 1 month's duration); or bronchitis,
pneumonitis, or esophagitis

Histoplasmosis, disseminated or extrapulmonary

Isosporiasis, chronic intestinal (greater than 1 month's duration)

Kaposi's sarcoma

Lymphoma, Burkitt's (or equivalent term)

Lymphoma, immunoblastic (or equivalent term)

Lymphoma, primary, of brain

Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary

Mycobacterium tuberculosis, any site (pulmonary or extrapulmonary)
Mycobacterium, other species or unidentified species, disseminated or
extrapulmonary

Pneumocystis carinii pneumonia

Pneumonia, recurrent

Progressive multifocal leukoencephalopathy

Salmonella septicemia, recurrent

Toxoplasmosis of brain

Wasting syndrome due to HIV
HIV Transmission

How HIV Spreads

There is still misunderstanding about how HIV is transmitted from one person to another.
Knowing the basics helps you avoid getting the virus if you are HIV-, and avoid passing
it on if you are HIV+.

HIV is spread through the following body fluids:

Blood (including menstrual blood)

Semen and other male sexual fluids ("pre-cum")

Vaginal fluids

Breast milk
HIV is not spread through these body fluids:

Sweat

Tears

Saliva (spit)
The spread of HIV can be prevented! There are ways to avoid, or at least, reduce contact
with the bodily fluids that spread HIV (blood, sexual fluids, and breast milk). This info
sheet will explain how.

Methods of Transmission
In the past, HIV was spread in blood products, such as whole blood or the "factor" used
by hemophiliacs. Many people were infected this way. The blood supply is now much
more strictly tested and controlled. The odds of being infected from receiving blood or
factor in the U.S. are extremely low.

You cannot get HIV from donating blood – a new clean needle is used for each donation.

Some people, primarily healthcare workers, are occasionally infected through needle
sticks with infected blood, or through other medical accidents. This is a very tiny
percentage of overall infections.
Today, the most common ways HIV is passed from one person to another are:

Re-using and sharing needles

Unprotected/unsafe sex (no condoms or other barrier devices)

Mother-to-child

Re-using and Sharing Needles

Many HIV infections occur when people share needles to inject heroin,
methamphetamine, or other drugs. This risk can be greatly reduced by cleaning needles
with a bleach solution before re-using them. The risk can be eliminated by using fresh
needles each time. Many cities now offer free needle exchange programs.

When getting a tattoo or body piercing, always go to a licensed professional and make
sure the equipment is autoclaved, not just "sterilized" with alcohol.

Un-protected/unsafe Sex
Every sexual act that involves sexual fluids of some kind has at least some risk. Barriers,
such as condoms (male and female), dental dams, latex gloves, and even plastic food
wrap (such as Saran Wrap), help reduce risk substantially.

Unsafe sex (sex without condoms or barriers) puts you and your partner at risk for HIV or
other sexually transmitted diseases (STDs).

Safer sex (sex using condoms or other barriers correctly and consistently) protects you
and your partner.

Which common sexual activities are most likely to cause HIV transmission when safer
sex isn't used? (Listed from most to least risky.)

Receptive anal sex ("bottoming") remains the most risky activity, due to the
likelihood of direct semen-blood contact. But penetrative anal sex ("topping")
with someone can result in HIV transmission, too.

Vaginal intercourse puts both partners at risk, but HIV is transmitted from men to
women much more easily than from women to men.

Oral sex can be risky for the person performing it, particularly if he or she
swallows semen, vaginal fluids, or menstrual fluids.

Sharing sex toys without sterilizing them can be dangerous.

Rimming (licking the anus) is very unlikely to result in HIV infection.

Mutual masturbation (hand jobs) and fisting (using a hand to penetrate the anus or
vagina) are relatively risk-free, as long as your hand has no open cuts or sores.
Sexual assault can result in infection if the assailant is HIV+. The risk increases when
rape involves anal penetration, force, and/or multiple assailants. Some forced sexual acts
involving wounds can place a victim at very high risk.

In major cities, PEP (post-exposure prophylaxis) is often offered to victims of sexual

assault. This month-long treatment reduces the likelihood of HIV infection substantially.
It is currently only used on a regular basis for victims of sexual assault and for healthcare
workers who have been exposed to HIV on the job. PEP must be started as quickly as
possible, always within 72 hours of the exposure.

Mother-to-Child Transmission
HIV+ mothers can pass the virus to their babies while pregnant, during birth, or by
breastfeeding. New medical techniques have almost eliminated the risk of a baby getting
HIV from its mother when precautions are taken. HIV+ mothers should not breastfeed
their babies.

Freak Transmissions
There are a few isolated cases of people infected from using a razor that had just been
used by an HIV+ man or in other off-beat ways. To be safe, always avoid direct contact
with blood and sexual fluids in any context.
Don't worry too much about freak cases. For instance, there is a documented case of
transmission from deep or "French" kissing – in two people who had terrible dental
problems. The odds of getting HIV from kissing, even when one person is HIV+, are less
than the odds of being struck by lightning.

True versus False Risk of Transmission

HIV cannot be transmitted except when certain bodily fluids are exchanged. You can
greatly reduce the risk of transmission by:

Avoiding contact with sexual fluids by always practicing safer sex

Abstaining from sex unless you and your partner are both HIV- and in a long-
term, monogamous relationship

Not using injection drugs, or if you do, always using new or clean needles

Finding our your HIV status if you are planning to get pregnant and working with
a knowledgeable doctor and obstetrician if you are HIV+
If you protect yourself in these ways, you do not need to be afraid of getting or passing
HIV by casual contact. Remember, HIV is not transmitted by:

Hugs

Dancing

Sharing food or drinks

Using a shower, bath, or bed used by an HIV+ person

Kissing (between people with no significant dental problems)

Sharing exercise equipment
Understanding CD4 and CD8 Cells

The Basics
CD4 and CD8 cells are white blood cells that play important roles in your body’s
immune response. Tests that count your CD4 and CD8 cells provide a picture of your
immune system health. Along with your viral load, your CD4 cell count can help your
doctor tell whether your HIV disease is progressing or not, and how well your HIV drugs
are working.

CD4 cells (sometimes called T-helper cells)
These white blood cells help coordinate the various activities of your immune
system. HIV targets CD4 cells more than any other kind of cell in your body. A
normal CD4 cell count is about 600-1,500 cells. CD4 cell counts are often slightly
higher in HIV+ women compared to HIV+ men (viral load in HIV+ women also
tends to be slightly higher, relative to men, at the same stage of disease). CD4 cell
counts usually fall as HIV disease progresses.

CD8 cells (T-suppressor or killer T cells)
There are two main types of CD8 cells. T-suppressor cells inhibit or suppress
immune responses. Killer T cells attack (“kill”) cancerous cells and cells infected
with viruses. A normal CD8 cell count is about 300–1,000 cells. CD8 cell counts
usually rise over time in HIV+ people, but why and how these increases relate to
the health of your immune system is not well understood.

CD4 Count and HIV

Without HIV medication, the virus infects more and more cells. This causes the CD4
count to decrease, usually by about 30 to 100 cells per year, in most HIV+ people. As the
CD4 count goes down, an HIV+ person becomes more likely to develop opportunistic
infections (OIs) and cancers.

Above 500: People with CD4 counts above 500 cells usually have fairly normal
immune function and are at low risk for OIs

Below 350: Current U.S. government guidelines recommend that you should
consider HIV treatment when your CD4 count falls below 350 cells
Below 200: A person with a CD4 cell count below 200 cells is diagnosed as having
AIDS. The guidelines recommend starting treatment at this point, if you have not already
done so
People with low CD4 counts are prone to developing OIs such as Pneumocystis carinii
pneumonia (PCP), Mycobacterium avium complex (MAC), and cytomegalovirus (CMV).
As CD4 cells drop below 200, your doctor will recommend medications to prevent these
infections.

Many people have dramatic CD4 cell increases when they start effective HIV treatment.
If the drugs succeed in slowing or stopping HIV replication, fewer new CD4 cells will be
infected and the CD4 count can recover—the “proof” of which you see by the increasing
numbers. But the CD4 count can also fall again if you stop taking your drugs correctly, or
if your HIV becomes resistant to the drugs. So, your CD4 count is a very valuable tool
for monitoring your HIV disease progression and how well your HIV medicines are
working.

The U.S. government treatment guidelines now recommend that people consider starting
HIV treatment when their CD4 cell counts fall below 350 cells. The recommended level
for starting treatment used to be 500 cells. This change was made because researchers
found that starting treatment with more than 350 but less than 500 CD4 cells did not add
much benefit.

CD4 and CD8 Cell Tests

CD4 and CD8 cell tests are simple blood tests ordered by your doctor. When you are first
diagnosed as HIV+ or when you first start treatment, you should get “baseline” CD4 and
CD8 cell tests. Baseline tests give a current picture of your immune system, when you
first enter a doctor’s care. Later tests can be compared against these first results to see
how things are changing over time and with treatment.

You should get your CD4 cell count checked about every three to six months--or as often
as your doctor recommends. You may need more frequent CD4 cell tests if your count is
low or falling, or if you are starting or changing treatment.

Many factors can affect your CD4 cell count, including the time of day, stress, your
menstrual cycle, and infections such as the flu. If you get a result or number back that
surprises you or your doctor, your doctor will probably want you to get a second test.
That second test would confirm any unexpected results or prove that those results were
random, sort of a fluke (that is, not significant). Don’t worry too much about a single
abnormal test result; trends over time are usually more important.

In addition to CD4 and CD8 cell counts, your doctor may also want to know your CD4 or
CD8 percentage. Percentages are usually more stable than counts over time. A normal
CD4 cell percentage is about 30-60 percent, and a normal CD8 cell percentage is about
20-50 percent. Sometimes doctors also look at the CD4/CD8 ratio. Healthy HIV- people
usually have at least 1-2 CD4 cells for every CD8 cell. But HIV+ people may have many
more CD8 cells than CD4 cells.

The Bottom Line

Because HIV attacks CD4 cells, CD4 counts usually drop as HIV disease progresses.
Taking effective combinations of HIV drugs may stop CD4 cell count decreases and HIV
disease progression.

Your CD4 cell count is an important indicator of the health of your immune system.
Tracking trends in your CD4 cell count can help you make decisions about starting and
switching treatment. Getting regular CD4 cell tests—along with viral load tests and other
blood tests to monitor treatment side effects—is an important way to take charge of your
health.
Myths and Misperceptions about HIV

Many of the stories and rumors about HIV are exaggerated or just made up. In dealing
with HIV, it's important to know reality from myth. Believing myths can result in fear, in
denial, and even in damage to your health.

Myths About HIV and HIV Treatment

The myth: "HIV doesn't cause AIDS."
The reality: If you don't have HIV, you don't get AIDS. If you have AIDS, you have HIV.
There is 20 years of solid scientific proof on this. AIDS is not caused by party drugs,
AZT, government conspiracies or anything else but a virus.

The myth: "It's not AIDS that kills people, it's the medicines they take!"
The reality: HIV medications, known as antiretrovirals, don't cure HIV, but they can help
keep people healthy for a longer time. People died from AIDS before AZT or any other
drugs came out. In fact, death rates have gone down a great deal in the U.S. since new
HIV medications came out in the mid-nineties. Unfortunately, the drugs do have side
effects and toxicities (for some people) which in very rare cases have resulted in death.

Myths About HIV Tests

The myth: “The 'AIDS test' can't be trusted.”
The reality: The 'AIDS test' measures your body's response to HIV, called antibodies.
The HIV antibody test (called ELISA) is one of the most reliable medical tests.
According to the Centers for Disease Control and Prevention (CDC), it is more than 99%
accurate. In addition, all positive results are confirmed with another test (called the
Western Blot) to insure no mistakes are made.

The myth: “Viral load tests don’t really tell anything about a person's health.”
The reality: Viral load measures the amount of HIV in a person’s blood. Many studies
have shown that people with high viral loads are much more likely to become ill or die
than those with low viral loads.

Myths About HIV Transmission

The myth: "Straight people don't get HIV."
The reality: The majority of HIV+ people worldwide are heterosexual. Men infect
women, and women infect men. Risk is not about labels, it is about behavior. A 'straight'
woman who has unprotected sex with men is at more risk for HIV than a 'gay' man who
always practices safe sex.

The myth: "I'm safe because I'm in a monogamous relationship (or married)."
The reality: Were you tested for HIV before you got into the relationship? Was your
partner? Were both tests negative? And do you spend 24 hours a day together? If you're
faithful, but he or she is not, or he or she was already HIV+ before you met, you can still
get HIV.

The myth: "I'm safe because I'm a virgin."

The reality: Again, virgin is just a label. If you have had no sexual contact at all, you're
fine. If you have had oral or anal sex, but consider yourself a 'virgin' because you haven't
had vaginal sex, you are still at risk.

The myth: "Lesbians don't get HIV."

The reality: Women who only have sex with women are generally at lower risk, because
of the sexual activities they engage in. But they can still get HIV. A recent case was
reported where a lesbian was infected through sharing sex toys with her HIV+ partner.
Also, many women who consider themselves lesbians occasionally have sex with men,
and can get infected that way.

The myth: “HIV can be spread through tears, sweat, mosquitoes, pools or casual contact.”
The reality: HIV can only be transmitted through infected blood, semen, vaginal fluids
and breast milk. The most common ways for HIV to be transmitted are through
unprotected sexual contact and/or sharing needles with an HIV+ person. HIV can also be
passed from mother to baby.

The following “bodily fluids” are NOT infectious:

Tears

Sweat

Saliva

Urine

Feces
Casual contact is not considered risky because it does not include contact with blood or
other infectious body fluids. Examples of casual contact include: social kissing, public
venues (pools, theaters, bathrooms), sharing drinks or eating utensils, etc. Insect bites do
not transmit HIV.

Myths About Clinical Trials

The myth: “Clinical trials are unsafe and I won’t be allowed to leave the study if I don’t
like it.”
The reality: You are always in control. You can quit any study you participate in at any
time for any reason. In some African-American and Latino communities, people know
about the Tuskegee Syphilis Study, which was conducted before the government
established strong ethical guidelines for the conduct of clinical trials. The Federal
Government now has strict rules and regulations that all government and drug company
researchers must follow to protect participants in clinical trials.
Myths about HIV are very dangerous. They can cause you to be afraid of something that
is not dangerous. And they can make you feel like something is not dangerous when it
really is!

So be careful. Sometimes seemingly well-informed or well-meaning people give out

wrong information. If you have a question about HIV, talk to your doctor, your local
AIDS organization, or the CDC National AIDS Hotline at 1-800-342-AIDS.
Complementary Therapies

Decisions about your health care are important--including deciding what types of therapy
to use. Most doctors will agree that using complementary therapies with standard
medicines can help treat HIV and other illnesses. Complementary therapies refer to a
series of health care treatments that are presently not considered to be part of
conventional medicine. These types of treatments can include aromatherapy, massage
therapy, and nutritional supplements.
Where HIV drugs reduce the progression of HIV, complementary therapies strengthen
the immune system.

What are some common complementary therapies?

Herbs and dietary supplements

These therapies may involve the use of herbs such as Echinacea, garlic, goldenseal,
chamomile, and Chinese herbs. Health professionals may also prescribe foods and
vitamins as part of a biological-based therapy. Multivitamins and minerals such as
Vitamin A, C, and E contain antioxidants, which neutralize the effects of dangerous
particles called “free-radicals.” These “free-radical” particles are natural by-products of
the body’s functions, but they cause damage to cells and lead to disease.

And thanks to recent studies, we know additional calcium, soy and soy products,
selenium, and whole-grain products particularly help women living with HIV.

For more details about supplements, please visit our Vitamins and Supplements page.

Essential Oils
Essential oils can fight routine bacterial and viral infections in place of prescription
antibiotics that can weaken the immune system. Essential oils also aid immune cells to
fight viruses and bacteria. Some essential oils such as lavender, bergamot, and eucalyptus
perform both of these functions. Essential oils of rosemary, geranium and black pepper
also support the immune system. Tea Tree oil is an excellent natural antiseptic. Any use
of essential oils should be discussed with your doctor.

Mind-Body Techniques
These activities enhance the mind's ability to affect bodily functions and symptoms.
Mind-body techniques often include patient support groups, meditation, prayer, mental
healing, and therapies that use creative outlets such as art, music, or dance.

Deep Relaxation involves using audiotapes to guide you in accessing deep states of
relaxation. Techniques include meditation, mindfulness, guided visualization, progressive
muscle relaxation, prayer or Chinese exercises such as Chi Gong, and Tai Chi.
Developing a sense of purpose and meaning also enhances immune functions. Research
has found that cancer patients who find purpose in life often experience physical
improvements, and even long-term survival. In a study of people who survived AIDS-
related deaths, survivors had a strong will to live and were engaged in meaningful
activities and relationships. Other studies show that prayer and other spiritual activities
have also been associated with better overall health, healing, and long term survival with
HIV.

How can managing stress improve immune functions?

Mind-body techniques decrease stress, which can physically affect the body. The basic
premise of mind/body medicine is that our thoughts, feelings, and mental states influence
our bodies at the physical level and express themselves in our health.

The brain has often been called the organ of the mind because it connects to the immune
system through nerve fibers that reach into all of the organs and systems. When you
experience stress, the nervous system becomes hyperactive and provokes the effects of
the immune systems over and over again. This causes the body to move into a state
commonly called “fight or flight”. In this state, the immune system becomes weakened
and the adrenal glands become exhausted causing the body to feel weak and lethargic.
You can also experience dizziness, headaches, memory loss, irritability, allergies, cold
and flu symptoms and more serious illnesses.

Studies have shown that people with high levels of social support and intimate
relationships have stronger immune systems and fewer illnesses. Research at Southern
Methodist University in Dallas has shown that confiding thoughts and feelings about
traumas -- if only by writing them down -- improves immune function. Seeking a support
group in your area can reduce stress and benefit overall health.

What kind of complementary treatment may my doctor prescribe?

When prescribing complementary treatment, the doctor makes decisions based on the
patient’s condition and other factors such as the patient’s strengths, lifestyle, medical
history, support systems, and all other factors relating to one’s health and wellness. This
enables the physician to knit together a program tailored for each patient and may involve
the following:

Diet Change: Replacing refined/ enriched carbohydrates with whole grains, fresh
vegetables, and fruits for overall health. Your doctor may also suggest choosing
low-to-moderate fat sources of protein such as turkey, chicken, and fish and
limiting dairy and red meats.

Vitamin and mineral supplements: Your doctor may prescribe
multivitamin/mineral supplements that must include Vitamins A, D, E, K, and C
(these are free- radical fighting anti- oxidants). B-vitamins, calcium, iron, iodine,
magnesium, copper, zinc, manganese, potassium, chromium, and selenium can all
enhance the immune system in proper dosage.

Herbs: A variety of herbs support body functions. These include garlic,
Echinacea, goldenseal, and myrrh. Doctors may prescribe Chinese herbs, such as
Astragulus, Ganoderma, Atractylodes, and Schizandra support immune functions
and contain antiviral, antibacterial and stress reduction properties.

Digestive health treatments: Herbs such as black walnut, berberine, grapefruit
seed extract, and wormwood support digestive functions. Acidophyllus helps
 maintain a healthy digestive system, but should be used with caution. Mainstream
antiparasitic (drugs which kill parasites or “bugs” in the body) drugs also relieve
digestion problems.

Exercise: Each day, one-half hour of enjoyable exercise that causes sweating,
signals the removal of waste from the body (and possibly the reduction of virus
replication). Cardiovascular fitness can strengthen the heart and circulatory
system. This is done by simply increasing one’s heart rate about 20 percent more
than resting heart rate, and keeping it up for at least 20 minutes, at least six times
per week.

Stress reduction: Deep relaxation practice two times per day for 15-20 minutes
can reduce many health risks and maintain one’s focus on practicing good health
and wellness.