Abstract
To determine the extent to which patients' faith in a treatment influences its efficacy, one-hundred and forty men, requesting an alternative therapy for AIDS, consisting of repeated injections of typhoid vaccine, were enrolled in a treatment program by a San Francisco AIDS Clinic and also agreed to participate in this independent study of other factors which might affect treatment efficacy. Patients were interviewed before entry into the protocol and at intervals of every 2 months for 2 years while in the protocol. The patients' "faith in treatment" was assessed at each contact. Clinic physicians made weekly ratings of the patients' sense of subjective improvement. CD4 cell count and white blood cell count were measured regularly. Faith in treatment was associated with treatment efficacy. A fall in "faith in treatment" among those who initially responded very positively to the vaccine preceded by 4-6 months the development of a life-threatening infection and a deterioration in clinical course. The 20 patients who continued to respond to the vaccine at the end of 1 year and 2 years were those who continued to have a high "faith in treatment." Conclusions: An effect of faith in treatment upon the course of AIDS was demonstrated. Faith may be important regardless of the efficacy of a treatment and may be the mediating variable which renders statistically ineffective treatments highly effective for those who believe in them.