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Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Research article

Use of traditional complementary and alternative medicine for HIV patients in KwaZulu-Natal, South Africa

Authors: Karl Peltzer, Natalie Friend-du Preez, Shandir Ramlagan, Henry Fomundam

Published in: BMC Public Health | Issue 1/2008

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Abstract

Background

Traditional medicine use has been reported is common among individuals with moderate and advanced HIV disease. The aim of this cross-sectional study was to assess the use of Traditional Complementary and Alternative Medicine (TCAM) for HIV patients prior to initiating antiretroviral therapy in three public hospitals in KwaZulu-Natal, South Africa.

Methods

Using systematic sampling, 618 HIV-positive patients were selected from outpatient departments from three hospitals and interviewed with a questionnaire.

Results

TCAM was commonly used for HIV in the past six months by study participants (317, 51.3%) and herbal therapies alone (183, 29.6%). The use of micronutrients (42.9%) was excluded from TCAM since mostly vitamins were provided by the health facility. Herbal therapies were the most expensive, costing on average 128 Rand (US$16) per patient per month. Most participants (90%) indicated that their health care provider was not aware that they were taking herbal therapies for HIV (90%). Herbal therapies were mainly used for pain relief (87.1%) and spiritual practices or prayer for stress relief (77.6%). Multivariate logistic regression with use of herbs for HIV as the dependent variable identified being on a disability grant and fewer clinic visits to be associated with use of herbs, and TCAM use for HIV identified being on a disability grant, number of HIV symptoms and family members not contributing to main source of household income to be associated with TCAM use.

Conclusion

Traditional herbal therapies and TCAM are commonly used by HIV treatment naïve outpatients of public health facilities in South Africa. Health care providers should routinely screen patients on TCAM use when initiating ART and also during follow-up and monitoring keeping in mind that these patients may not fully disclose other therapies.
Literature
2.
go back to reference Bodecker G: Planning for cost-effective traditional health services. WHO. Traditional medicine, better science, policy and services for health development. 2000, Awaji Island, Japan: Hyogo Prefecture, 31-70. Bodecker G: Planning for cost-effective traditional health services. WHO. Traditional medicine, better science, policy and services for health development. 2000, Awaji Island, Japan: Hyogo Prefecture, 31-70.
4.
go back to reference Kasilo O: Traditional African medicine. WHO, Traditional medicine, better science, policy and services for health development. 2000, Awaji Island, Japan: Hyogo Prefecture, 86-94. Kasilo O: Traditional African medicine. WHO, Traditional medicine, better science, policy and services for health development. 2000, Awaji Island, Japan: Hyogo Prefecture, 86-94.
5.
go back to reference Dhalla S, Chan KJ, Montaner JS, Hogg RS: Complementary and alternative medicine use in British Columbia – a survey of HIV positive people on antiretroviral therapy. Complement Ther Clin Pract. 2006, 12 (4): 242-248. 10.1016/j.ctcp.2006.05.002.CrossRefPubMed Dhalla S, Chan KJ, Montaner JS, Hogg RS: Complementary and alternative medicine use in British Columbia – a survey of HIV positive people on antiretroviral therapy. Complement Ther Clin Pract. 2006, 12 (4): 242-248. 10.1016/j.ctcp.2006.05.002.CrossRefPubMed
6.
go back to reference London AS, Foote-Ardah CE, Fleishman JA, Shapiro MF: Use of alternative therapists among people in care for HIV in the United States. Am J Public Health. 2003, 93 (6): 980-987.CrossRefPubMedPubMedCentral London AS, Foote-Ardah CE, Fleishman JA, Shapiro MF: Use of alternative therapists among people in care for HIV in the United States. Am J Public Health. 2003, 93 (6): 980-987.CrossRefPubMedPubMedCentral
7.
go back to reference Wiwanitkit V: The use of CAM by HIV-positive patients in Thailand. Complement Ther Med. 2003, 11: 39-41. 10.1016/S0965-2299(02)00108-5.CrossRefPubMed Wiwanitkit V: The use of CAM by HIV-positive patients in Thailand. Complement Ther Med. 2003, 11: 39-41. 10.1016/S0965-2299(02)00108-5.CrossRefPubMed
8.
go back to reference Department of Health: The national ARV treatment guidelines. 2004, Pretoria: Department of Health Department of Health: The national ARV treatment guidelines. 2004, Pretoria: Department of Health
9.
go back to reference Dwyer JT, Salvato-Schille AM, Coulston A, Casey VA, Cooper WC, Selles WD: The use of unconventional remedies among HIV-positive men living in California. J Assoc Nurses AIDS Care. 1995, 6: 17-28. 10.1016/S1055-3290(05)80026-3.CrossRefPubMed Dwyer JT, Salvato-Schille AM, Coulston A, Casey VA, Cooper WC, Selles WD: The use of unconventional remedies among HIV-positive men living in California. J Assoc Nurses AIDS Care. 1995, 6: 17-28. 10.1016/S1055-3290(05)80026-3.CrossRefPubMed
10.
go back to reference Nyika A: Ethical and regulatory issues surrounding African traditional medicine in the context of HIV/AIDS. Dev World Bioeth. 2007, 7 (1): 25-34. 10.1111/j.1471-8847.2006.00157.x.CrossRefPubMed Nyika A: Ethical and regulatory issues surrounding African traditional medicine in the context of HIV/AIDS. Dev World Bioeth. 2007, 7 (1): 25-34. 10.1111/j.1471-8847.2006.00157.x.CrossRefPubMed
11.
go back to reference Mills E, Cooper C, Kanfer I: Traditional African medicine in the treatment of HIV. Lancet Infect Dis. 2005, 5 (8): 465-467. 10.1016/S1473-3099(05)70172-9.CrossRefPubMed Mills E, Cooper C, Kanfer I: Traditional African medicine in the treatment of HIV. Lancet Infect Dis. 2005, 5 (8): 465-467. 10.1016/S1473-3099(05)70172-9.CrossRefPubMed
12.
go back to reference Langlois-Klassen D, Kipp W, Jhangri GS, Rubaale T: Use of traditional herbal medicine by AIDS patients in Kabarole District, western Uganda. Am J Trop Med Hyg. 2007, 77 (4): 757-63.PubMed Langlois-Klassen D, Kipp W, Jhangri GS, Rubaale T: Use of traditional herbal medicine by AIDS patients in Kabarole District, western Uganda. Am J Trop Med Hyg. 2007, 77 (4): 757-63.PubMed
13.
go back to reference Babb DA, Pemba L, Seatlanyane P, Charalambous S, Churchyard GJ, Grant AD: Use of traditional medicine by HIV-infected individuals in South Africa in the era of antiretroviral therapy. Psychol Health Med. 2007, 12 (3): 314-20. 10.1080/13548500600621511.CrossRefPubMed Babb DA, Pemba L, Seatlanyane P, Charalambous S, Churchyard GJ, Grant AD: Use of traditional medicine by HIV-infected individuals in South Africa in the era of antiretroviral therapy. Psychol Health Med. 2007, 12 (3): 314-20. 10.1080/13548500600621511.CrossRefPubMed
14.
go back to reference Malangu N: Self-reported use of traditional, complementary and over-the-counter medicines by HIV-infected patients on antiretroviral therapy in Pretoria, South Africa. Afr J Trad CAM. 2007, 4 (3): 273-278.CrossRef Malangu N: Self-reported use of traditional, complementary and over-the-counter medicines by HIV-infected patients on antiretroviral therapy in Pretoria, South Africa. Afr J Trad CAM. 2007, 4 (3): 273-278.CrossRef
15.
go back to reference Chopra M, Kendall C, Hill Z, Schaay N, Nkonki LL, Doherty TM: "Nothing new": responses to the introduction of antiretroviral drugs in South Africa. AIDS. 2006, 20 (15): 1975-7. 10.1097/01.aids.0000247120.12327.6b.CrossRefPubMed Chopra M, Kendall C, Hill Z, Schaay N, Nkonki LL, Doherty TM: "Nothing new": responses to the introduction of antiretroviral drugs in South Africa. AIDS. 2006, 20 (15): 1975-7. 10.1097/01.aids.0000247120.12327.6b.CrossRefPubMed
16.
go back to reference Liu J: The use of herbal medicines in early drug development for the treatment of HIV infections and AIDS. Expert Opin Investig Drugs. 2007, 16 (9): 1355-64. 10.1517/13543784.16.9.1355.CrossRefPubMed Liu J: The use of herbal medicines in early drug development for the treatment of HIV infections and AIDS. Expert Opin Investig Drugs. 2007, 16 (9): 1355-64. 10.1517/13543784.16.9.1355.CrossRefPubMed
17.
go back to reference Williams A, Friedland G: Adherence, compliance, and HAART. AIDS Clin Care. 1997, 9 (7): 51-53.PubMed Williams A, Friedland G: Adherence, compliance, and HAART. AIDS Clin Care. 1997, 9 (7): 51-53.PubMed
18.
go back to reference Mehta S, Moore RD, Graham NM: Potential factors affecting adherence with HIV therapy. AIDS. 1997, 11 (14): 1665-70. 10.1097/00002030-199714000-00002.CrossRefPubMed Mehta S, Moore RD, Graham NM: Potential factors affecting adherence with HIV therapy. AIDS. 1997, 11 (14): 1665-70. 10.1097/00002030-199714000-00002.CrossRefPubMed
20.
go back to reference Mor V, Laliberte L, Morris JN, Wiemann M: The Karnofsky performance status scale. An examination of its reliability and validity in a research setting. Cancer. 1984, 53 (9): 2002-2007. 10.1002/1097-0142(19840501)53:9<2002::AID-CNCR2820530933>3.0.CO;2-W.CrossRefPubMed Mor V, Laliberte L, Morris JN, Wiemann M: The Karnofsky performance status scale. An examination of its reliability and validity in a research setting. Cancer. 1984, 53 (9): 2002-2007. 10.1002/1097-0142(19840501)53:9<2002::AID-CNCR2820530933>3.0.CO;2-W.CrossRefPubMed
21.
go back to reference Holzemer WL, Hudson A, Kirksey KM, Hamilton MJ, Bakken S: The revised Sign and Symptom Check-list for HIV (SSC-HIVrev). J Assoc Nurses AIDS Care. 2001, 12 (5): 60-70. 10.1016/S1055-3290(06)60263-X.CrossRefPubMed Holzemer WL, Hudson A, Kirksey KM, Hamilton MJ, Bakken S: The revised Sign and Symptom Check-list for HIV (SSC-HIVrev). J Assoc Nurses AIDS Care. 2001, 12 (5): 60-70. 10.1016/S1055-3290(06)60263-X.CrossRefPubMed
22.
go back to reference Makoae LN, Seboni NM, Molosiwa K, Moleko M, Human S, Sukati NA, Holzemer W: The symptom experience of people living with HIV/AIDS in Southern Africa. J Assoc Nurses AIDS Care. 2005, 16 (3): 22-32. 10.1016/j.jana.2005.03.005.CrossRefPubMed Makoae LN, Seboni NM, Molosiwa K, Moleko M, Human S, Sukati NA, Holzemer W: The symptom experience of people living with HIV/AIDS in Southern Africa. J Assoc Nurses AIDS Care. 2005, 16 (3): 22-32. 10.1016/j.jana.2005.03.005.CrossRefPubMed
23.
go back to reference Furler MD, Einarson TR, Walmsley S, Millson M, Bendayan R: Use of complementary and alternative medicine by HIV-infected outpatients in Ontario, Canada. AIDS Patient Care STDs. 2003, 17 (4): 155-168. 10.1089/108729103321619764.CrossRefPubMed Furler MD, Einarson TR, Walmsley S, Millson M, Bendayan R: Use of complementary and alternative medicine by HIV-infected outpatients in Ontario, Canada. AIDS Patient Care STDs. 2003, 17 (4): 155-168. 10.1089/108729103321619764.CrossRefPubMed
24.
go back to reference Kirksey KM, Goodroad BK, Kemppainen JK, Holzemer WL, Bunch EH, Corless IB, Eller LS, Nicholas PH, Nokes K, Bain C: Complementary therapy use in persons with HIV/AIDS. J Holist Nurs. 2002, 20 (3): 264-278. 10.1177/089801010202000306.CrossRefPubMed Kirksey KM, Goodroad BK, Kemppainen JK, Holzemer WL, Bunch EH, Corless IB, Eller LS, Nicholas PH, Nokes K, Bain C: Complementary therapy use in persons with HIV/AIDS. J Holist Nurs. 2002, 20 (3): 264-278. 10.1177/089801010202000306.CrossRefPubMed
25.
go back to reference Tsao JC, Dobalian A, Myers CD, Zeltzer LK: Pain and use of complementary and alternative medicine in a national sample of persons living with HIV. J Pain Symptom Manage. 2005, 30 (5): 418-432. 10.1016/j.jpainsymman.2005.05.012.CrossRefPubMedPubMedCentral Tsao JC, Dobalian A, Myers CD, Zeltzer LK: Pain and use of complementary and alternative medicine in a national sample of persons living with HIV. J Pain Symptom Manage. 2005, 30 (5): 418-432. 10.1016/j.jpainsymman.2005.05.012.CrossRefPubMedPubMedCentral
26.
go back to reference Pawluch D, Cain R, Gillett J: Lay knowledge of HIV/AIDS and complementary therapy use. Soc Sci Med. 2000, 51 (1): 251-264. 10.1016/S0277-9536(99)00450-5.CrossRefPubMed Pawluch D, Cain R, Gillett J: Lay knowledge of HIV/AIDS and complementary therapy use. Soc Sci Med. 2000, 51 (1): 251-264. 10.1016/S0277-9536(99)00450-5.CrossRefPubMed
27.
go back to reference Kalichman SC, Simbayi LC, Jooste S, Toefy Y, Cain D, Cherry C, Kagee A: AIDS & Beh. 2005, 9 (2): 135-143. 10.1007/s10461-005-3895-x.CrossRef Kalichman SC, Simbayi LC, Jooste S, Toefy Y, Cain D, Cherry C, Kagee A: AIDS & Beh. 2005, 9 (2): 135-143. 10.1007/s10461-005-3895-x.CrossRef
28.
go back to reference Becker MH: The Health Belief Model and Personal Health Behavior. Health Educ Monographs. 1974, 2: (entire issue) Becker MH: The Health Belief Model and Personal Health Behavior. Health Educ Monographs. 1974, 2: (entire issue)
29.
30.
go back to reference Ronis DL: Conditional health threats: Health beliefs, decisions, and behaviors among adults. Health Psychol. 1992, 11: 127-134. 10.1037/0278-6133.11.2.127.CrossRefPubMed Ronis DL: Conditional health threats: Health beliefs, decisions, and behaviors among adults. Health Psychol. 1992, 11: 127-134. 10.1037/0278-6133.11.2.127.CrossRefPubMed
31.
go back to reference Gao X, Nau DP, Rosenbluth SA, Scott V, Woodward C: The relationship of disease severity, health beliefs and medication adherence among HIV patients. AIDS Care. 2000, 12 (4): 387-398. 10.1080/09540120050123783.CrossRefPubMed Gao X, Nau DP, Rosenbluth SA, Scott V, Woodward C: The relationship of disease severity, health beliefs and medication adherence among HIV patients. AIDS Care. 2000, 12 (4): 387-398. 10.1080/09540120050123783.CrossRefPubMed
32.
go back to reference Thomas SL, Lam K, Piterman L, Mijch A, Komesaroff PA: Complementary medicine use among people living with HIV/AIDS in Victoria, Australia: practices, attitudes and perceptions. Int J STD AIDS. 2007, 18 (7): 453-7. 10.1258/095646207781147292.CrossRefPubMed Thomas SL, Lam K, Piterman L, Mijch A, Komesaroff PA: Complementary medicine use among people living with HIV/AIDS in Victoria, Australia: practices, attitudes and perceptions. Int J STD AIDS. 2007, 18 (7): 453-7. 10.1258/095646207781147292.CrossRefPubMed
33.
go back to reference Sutherland LR, Verhoef MJ: Alternative medicine consultations by patients attending a multidisciplinary HIV clinic. AIDS Patient Care STDs. 1995, 9: 106-110.CrossRef Sutherland LR, Verhoef MJ: Alternative medicine consultations by patients attending a multidisciplinary HIV clinic. AIDS Patient Care STDs. 1995, 9: 106-110.CrossRef
34.
go back to reference Coleman CL, Eller LS, Nokes KM, Bunch E, Reynolds NR, Corless IB, Dole P, Kemppainen JK, Kirksey K, Seficik L, Nicholas PK, Hamilton MJ, Tsai YF, Holzemer WL: Prayer as a complementary health strategy for managing HIV-related symptoms among ethnically diverse patients. Holist Nurs Pract. 2006, 20 (2): 65-72.CrossRefPubMed Coleman CL, Eller LS, Nokes KM, Bunch E, Reynolds NR, Corless IB, Dole P, Kemppainen JK, Kirksey K, Seficik L, Nicholas PK, Hamilton MJ, Tsai YF, Holzemer WL: Prayer as a complementary health strategy for managing HIV-related symptoms among ethnically diverse patients. Holist Nurs Pract. 2006, 20 (2): 65-72.CrossRefPubMed
35.
go back to reference Peltzer K, Ramlagan S: Cannabis use trends in South Africa. SAJP. 2007, 13 (4): 126-131. Peltzer K, Ramlagan S: Cannabis use trends in South Africa. SAJP. 2007, 13 (4): 126-131.
36.
go back to reference Fogarty A, Rawstorne P, Prestage G, Crawford J, Grierson J, Kippax S: Marijuana as therapy for people living with HIV/AIDS: social and health aspects. AIDS Care. 2007, 19 (2): 295-301. 10.1080/09540120600841930.CrossRefPubMed Fogarty A, Rawstorne P, Prestage G, Crawford J, Grierson J, Kippax S: Marijuana as therapy for people living with HIV/AIDS: social and health aspects. AIDS Care. 2007, 19 (2): 295-301. 10.1080/09540120600841930.CrossRefPubMed
37.
go back to reference Ostrow MJ, Cornelisse PG, Heath KV, Craib KJ, Schechter MT, O'Shaughnessy M, Montaner JS, Hogg RS: Determinants of complementary therapy use in HIV-infected individuals receiving antiretroviral or anti-opportunistic agents. J Acquir Immune Defic Syndr Hum Retrovirol. 1997, 15 (2): 115-20.CrossRefPubMed Ostrow MJ, Cornelisse PG, Heath KV, Craib KJ, Schechter MT, O'Shaughnessy M, Montaner JS, Hogg RS: Determinants of complementary therapy use in HIV-infected individuals receiving antiretroviral or anti-opportunistic agents. J Acquir Immune Defic Syndr Hum Retrovirol. 1997, 15 (2): 115-20.CrossRefPubMed
38.
go back to reference Pfeiffer J: African Independent Churches in Mozambique: healing the afflictions of Iiequality. Med Anthropol Q. 2002, 16 (2): 176-199. 10.1525/maq.2002.16.2.176.CrossRefPubMed Pfeiffer J: African Independent Churches in Mozambique: healing the afflictions of Iiequality. Med Anthropol Q. 2002, 16 (2): 176-199. 10.1525/maq.2002.16.2.176.CrossRefPubMed
39.
go back to reference Agnoletto V, Chiaffarino F, Nasta P, Rossi R, Parazzini F: Use of complementary and alternative medicine in HIV-infected subjects. Complementary therapies in medicine. 2006, 14 (3): 193-199. 10.1016/j.ctim.2006.01.008.CrossRefPubMed Agnoletto V, Chiaffarino F, Nasta P, Rossi R, Parazzini F: Use of complementary and alternative medicine in HIV-infected subjects. Complementary therapies in medicine. 2006, 14 (3): 193-199. 10.1016/j.ctim.2006.01.008.CrossRefPubMed
40.
go back to reference Ridge D, Williams I, Anderson J, Elford J: Like a prayer: the role of spirituality and religion for people living with HIV in the UK. Sociol Health Illn. 2007 Ridge D, Williams I, Anderson J, Elford J: Like a prayer: the role of spirituality and religion for people living with HIV in the UK. Sociol Health Illn. 2007
41.
go back to reference Chinouya M, O'Keefe E: 'God will look after us': Africans, HIV and religion in Milton Keynes. Diversity Health Soc Care. 2005, 2: 177-86. Chinouya M, O'Keefe E: 'God will look after us': Africans, HIV and religion in Milton Keynes. Diversity Health Soc Care. 2005, 2: 177-86.
42.
go back to reference Doyal L, Anderson J: 'My fear is to fall in love gain ...': how HIV-positive African women survive in London. Soc Sci Med. 2005, 60: 1729-38. 10.1016/j.socscimed.2004.08.041.CrossRefPubMed Doyal L, Anderson J: 'My fear is to fall in love gain ...': how HIV-positive African women survive in London. Soc Sci Med. 2005, 60: 1729-38. 10.1016/j.socscimed.2004.08.041.CrossRefPubMed
43.
go back to reference Chinouya M, Davidson O: The Padare Project: assessing health-related knowledge, attitudes and behaviours of HIV-positive Africans accessing services in North Central London. 2003, London: African HIV Policy Network Chinouya M, Davidson O: The Padare Project: assessing health-related knowledge, attitudes and behaviours of HIV-positive Africans accessing services in North Central London. 2003, London: African HIV Policy Network
44.
go back to reference Rosen S, Ketlhapile M, Sanne I, DeSilva MB: Cost to patients of obtaining treatment for HIV/AIDS in South Africa. S Afr Med J. 2007, 97: 524-529.PubMed Rosen S, Ketlhapile M, Sanne I, DeSilva MB: Cost to patients of obtaining treatment for HIV/AIDS in South Africa. S Afr Med J. 2007, 97: 524-529.PubMed
45.
go back to reference Manfredi R, Chiodo F: Non-conventional treatments and HIV disease: determining factors and consequences. Med Maladies Infect. 1999, 29: 125-129. 10.1016/S0399-077X(99)80022-5.CrossRef Manfredi R, Chiodo F: Non-conventional treatments and HIV disease: determining factors and consequences. Med Maladies Infect. 1999, 29: 125-129. 10.1016/S0399-077X(99)80022-5.CrossRef
46.
go back to reference Anderson W, O'Connor BB, MacGregor RR, Schwartz JS: Patient use and assessment of conventional and alternative therapies for HIV infection and AIDS. AIDS. 1993, 7 (4): 561-5. 10.1097/00002030-199304000-00016.CrossRefPubMed Anderson W, O'Connor BB, MacGregor RR, Schwartz JS: Patient use and assessment of conventional and alternative therapies for HIV infection and AIDS. AIDS. 1993, 7 (4): 561-5. 10.1097/00002030-199304000-00016.CrossRefPubMed
47.
go back to reference Muula AS, Ngulube TJ, Siziya S, Makupe CM, Umar E, Prozesky HW, Wiysonge CS, Mataya RH: Gender distribution of adult patients on highly active antiretroviral therapy (HAART) in Southern Africa: a systematic review. BMC Public Health. 2007, 7 (147): 63-10.1186/1471-2458-7-63.CrossRefPubMedPubMedCentral Muula AS, Ngulube TJ, Siziya S, Makupe CM, Umar E, Prozesky HW, Wiysonge CS, Mataya RH: Gender distribution of adult patients on highly active antiretroviral therapy (HAART) in Southern Africa: a systematic review. BMC Public Health. 2007, 7 (147): 63-10.1186/1471-2458-7-63.CrossRefPubMedPubMedCentral
48.
go back to reference African Religious Health Assets Programme [ARHAP]: Appreciating assets: the contribution of religion to universal access in Africa. 2006, Cape Town: ARHAP African Religious Health Assets Programme [ARHAP]: Appreciating assets: the contribution of religion to universal access in Africa. 2006, Cape Town: ARHAP
Metadata
Title
Use of traditional complementary and alternative medicine for HIV patients in KwaZulu-Natal, South Africa
Authors
Karl Peltzer
Natalie Friend-du Preez
Shandir Ramlagan
Henry Fomundam
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-255

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