Complementary and Alternative Medicine Use for HIV Management in the State of Florida: Medical Monitoring Project

Abstract

Objective: The aims of this study were to describe complementary and alternative medicine (CAM) use and to assess the relationships between CAM use and antiretroviral therapy (ART) adherence and human immunodeficiency virus (HIV) RNA viral load suppression among a sample of persons living with HIV (PLWH) engaged in care in the state of Florida.Design: The Florida Medical Monitoring Project (n = 803) collected repeated cross-sectional data for surveillance of clinical outcomes among PLWH from 2009 to 2010. Past-year CAM use specifically for the management of HIV was measured via self-report. Logistic regression models were conducted to assess the effect of CAM use on ART adherence and viral load suppression, controlling for demographic and clinical factors using backwards stepwise deletion of factors with a p-value of >0.25.Results: CAM use was reported in 53.3% (n = 428). In bivariate analysis, CAM use was the highest among those 40-49 years of age (61%; p < 0.05), males (56%; p < 0.01), whites (61%; p = 0.001), and those educated beyond high school (59%; p < 0.05). Among those using CAM, 63% and 37% reported one and two or more CAM modalities, respectively. CAM modalities included biologically based therapies (89%), mind-body medicine/manipulative body-based therapies (30%), spiritual healing (23%), energy therapies (6%), and whole medical systems (6%). In multivariable analyses, any CAM use and number of CAM methods used were not associated with ART adherence. Any CAM use was not associated with detectable viral load (adjusted odds ratio [aOR] 0.81; 95% confidence interval [CI] 0.58-1.12; p = 0.20). Those using two or more methods had significantly decreased risk for detectable viral load (aOR 0.60; 95% CI 0.39-0.92; p < 0.02).Conclusions: CAM use was not associated with negative effects on ART adherence. CAM users were less likely to have detectable viral load compared with non-users. Future research should focus on CAM use among PLWH not engaged in HIV care and the longitudinal patterns of CAM use and possible effects of long-term health outcomes.

HIV care provider perceptions and approaches to managing unhealthy alcohol use in primary HIV care settings: a qualitative study

“…Among persons living with HIV (PLWH), unhealthy alcohol use, ranging from at-risk use [> 14 (7) drinks per week for men (women)], binge drinking [> 4 (3) standard drinks on one occasion in men (women)] to alcohol use disorder (AUD) [1], is associated with lower adherence to antiretroviral therapy (ART), compared to abstinence [2]. Approximately 10–30% of PLWH receiving services at HIV primary care clinics report unhealthy alcohol use [3, 4] and up to 19% meet criteria for AUD [5]. Any alcohol consumption is inversely associated with engagement in HIV-related care at each step of the HIV care continuum [6, 7].…”

Yes to Recreational Drugs and Complementary Medicines But No to Life-Saving Medications: Beliefs Underpinning Treatment Decisions Among PLHIV

“…CM are also known as 'traditional' or 'alternative' medicines and include substances such as vitamins, minerals, herbal remedies, aromatic oils and homeopathic products [49]. The use of CM among PLHIV is common [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. In a recent survey of Australians living with HIV (n=1211), 53% of respondents reported they had used one or more CM in the 12 months prior to the study, 50% in the previous week [52].…”

“…However, this study did not specifically seek views of HIV positive individuals. Studies that have explored CM use among PLHIV have mainly focused on providing prevalence data [51][52][53][54][55][56][57]61,65], while those that have sought to understand the beliefs underpinning use have been conducted overseas in countries that may differ from Australia in areas such as access and cultural norms [62,65]. Of the limited number of studies that sought to understand motivation for CM use among PLHIV in Australia, the majority involved small participant numbers [53,58,64].…”

The association of therapeutic versus recreational marijuana use and antiretroviral adherence among adults living with HIV in Florida

“…Many consider medical marijuana to represent that which is prescribed or recommended by a physician, but PLWH often report using it to self-manage medical conditions, as it is one of the most common types of complementary and alternative medicine used by PLWH in Florida. 30 We therefore sought to compare ART adherence among PLWH who used marijuana to self-manage specific symptoms or health conditions (therapeutic use), compared to those who used it recreationally.…”