A Review of the Use of Complementary and Alternative Medicine and HIV: Issues for Patient Care

Abstract

HIV/AIDS is a chronic illness, with a range of physical symptoms and psychosocial issues. The complex health and social issues associated with living with HIV mean that people living with HIV/AIDS (PLWHA) have historically often turned to complementary and alternative medicine (CAM). This article provides an overview of the literature on HIV and CAM. Databases were searched using keywords for CAM and HIV from inception to December 2012. Articles in English and in Western countries were included; letters, commentaries, news articles, articles on specific therapies and basic science studies were excluded. Of the 282 articles identified, 94 were included. Over half reported prevalence and determinants of CAM use. Lifetime use of CAM by PLWHA ranged from 30% to 90%, with national studies suggesting CAM is used by around 55% of PLWHA, practitionerbased CAM by 15%. Vitamins, herbs, and supplements were most common, followed by prayer, meditation, and spiritual approaches. CAM use was predicted by length of time since HIV diagnosis, and a greater number of medications/symptoms, with CAM often used to address limitations or problems with antiretroviral therapy. CAM users rarely rejected conventional medicine, but a number of CAM can have potentially serious side effects or interactions with ART. CAM was used as a self-management approach, providing PLWHA with an active role in their healthcare and sense of control. Clinicians, particularly nurses, should consider discussing CAM with patients as part of patient-centered care, to encourage valuable self-management and ensure patient safety.

Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration

“…[11] Therefore an important lesson to be learnt is the fact that healthcare providers should actively discuss CAM with their patients as it may encourage valuable self-management and ensure patient safety. [11,12] This may also highlights towards the importance of the current knowledge on CAM among healthcare providers. [12] Although a variety of CAM modalities are being practiced among PLWHA, certain similarities can be found when evaluating the reasons for such practices.…”

“…[11,12] This may also highlights towards the importance of the current knowledge on CAM among healthcare providers. [12] Although a variety of CAM modalities are being practiced among PLWHA, certain similarities can be found when evaluating the reasons for such practices. The findings helped in learning the common motives associated with CAM use, where participants generally reported alleviation of symptoms, counteracting ARTs side effects as well as boosting immunity to complement ARTs as the most common reasons.…”

“…[39,40] Since a variety of traditional medications, approaches and processes are regarded as CAM, there is no explicit list of such modalities [26]; moreover CAM practices greatly depends upon peoples' beliefs, cultures and other psychosocial factors. [23] Even though the recent data on CAM use among PLWHA is promising [12], there are still issues where oral CAM can cause potential safety issues through interactions with conventional ARTs. [11] Therefore an important lesson to be learnt is the fact that healthcare providers should actively discuss CAM with their patients as it may encourage valuable self-management and ensure patient safety.…”

“…Some of these modalities are not substantiated by scientific evidence [40,42], while many have proven beneficial in dealing particular aspects of the disease. [12,43] In addition, a high number of HIV individuals using various forms of CAM remained unreported to the healthcare providers and physician in particular. [19] This puts greater emphasis on healthcare providers to engage HIV patients in their discussion on treatment from various aspects including CAM use.…”

“…On the contrary, in developed countries such practices are not as common, because ARTs are readily accessible. [10] Beside these realities, beliefs and positive attitudes towards the effectiveness of CAM [12] along with poor/negative understanding of ARTs [13,14] could also be the strong contributing factors toward widespread use of CAM modalities among PLWHA.…”