Traditional, complementary and alternative medicine use by HIV patients a decade after public sector antiretroviral therapy roll out in South Africa: a cross sectional study

Abstract

BackgroundThe roll out of antiretroviral therapy in the South African public health sector in 2004 was preceded by the politicisation of HIV-infection which was used to promote traditional medicine for the management of HIV/AIDS. One decade has passed since; however, questions remain on the extent of the use of traditional, complementary and alternative medicine (TCAM) by HIV-infected patients. This study therefore aimed at investigating the prevalence of the use of African traditional medicine (ATM), complementary and alternative medicines (CAM) by adult patients in the eThekwini and UThukela Health Districts, South Africa.MethodsA cross- sectional study was carried out at 8 public health sector antiretroviral clinics using interviewer-administered semi-structured questionnaires. These were completed from April to October 2014 by adult patients who had been on antiretroviral therapy (ART) for at least three months. Use of TCAM by patients was analysed by descriptive statistics using frequency and percentages with standard error. Where the associated relative error was equal or greater to 0.50, the percentage was rejected as unstable. A p-value <0.05 was estimated as statistically significant.ResultsThe majority of the 1748 participants were Black Africans (1685/1748, 96.40 %, SE: 0.00045), followed by Coloured (39/1748, 2.23 %, SE: 0.02364), Indian (17/1748, 0.97 %, SE: 0.02377), and Whites (4/1748, 0.23 %, SE: 0.02324), p < 0.05. The prevalence of ATM use varied prior to (382/1748, 21.85 %) and after ART initiation (142/1748, 8.12 %), p <0.05, specifically by Black African females both before (14.41 %) and after uptake (5.49 %), p < 0.05. Overall, 35 Black Africans, one Coloured and one Indian (37/1748, 2.12 %) reported visiting CAM practitioners for their HIV condition and related symptoms post ART.ConclusionDespite a progressive implementation of a successful antiretroviral programme over the first decade of free antiretroviral therapy in the South African public health sector, the use of TCAM is still prevalent amongst a small percentage of HIV infected patients attending public healthcare sector antiretroviral clinics. Further research is needed to explore reasons for use and health benefits or risks experienced by the minority that uses both conventional antiretroviral therapy with TCAM.

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“…Patients with HIV/AIDS who identified as a TCAM user in a number of studies across Sub-Saharan Africa were more likely to be female, 21 168 178–180 not married, 180 181 of low socioeconomic status, 21 180 younger (<39 years), 25 179 180 unemployed, 180 181 educated, 21 25 from a rural area 21 53 and of Christian religious denomination. 180 …”

Prevalence and Characteristics of CAM Use among People Living with HIV and AIDS in Lebanon: Implications for Patient Care

“…From a patient care perspective, this could cause delays in the start of conventional HIV/AIDS treatments, viral rebound, immune decompensation, clinical progression, and decreased survival time [53–55]. Therefore, although the proportion of PLWHA reporting using CAM as an alternative to therapy is relatively low, the repercussions are quite serious with potential negative consequences on patients, their families, and the health system at large (increased cost of treatment).…”

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“…97 TCAM users among patients with HIV/AIDS Patients with HIV/AIDS who identified as a TCAM user in a number of studies across Sub-Saharan Africa were more likely to be female, 21 168 178-180 not married, 180 181 of low socioeconomic status, 21 180 younger (<39 years), 25 179 180 unemployed, 180 181 educated, 21 25 from a rural area 21 53 and of Christian religious denomination. 180 TCAM users among patients with hypertension and diabetes A review of the literature indicates that patients with hypertension who are male, 33 39 46 of low income level, 33 39 less educated, 33 older 106 and reside in rural area 33 are more likely to be TCAM users. A Ugandan study did not BMJ Global Health find any significant association between the sociodemographic profile of patients with hypertension and TCAM use.…”