HIV This Week

Peltzer K, Preez NF, Ramlagan S, Fomundam H. Use of traditional complementary and alternative medicine for HIV patients in KwaZulu-Natal, South Africa. BMC Public Health. 2008;8:255.

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 for HIV patients prior to initiating antiretroviral therapy in three public hospitals in KwaZulu-Natal, South Africa. Using systematic sampling, 618 HIV-positive patients were selected from outpatient departments from three hospitals and interviewed with a questionnaire. Traditional complementary and alternative medicine 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 traditional complementary and alternative medicine 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 traditional complementary and alternative medicine 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 traditional complementary and alternative medicine use. Traditional herbal therapies and traditional complementary and alternative medicine are commonly used by HIV treatment naïve outpatients of public health facilities in South Africa. Health care providers should routinely screen patients on traditional complementary and alternative medicine use when initiating ART and also during follow-up and monitoring keeping in mind that these patients may not fully disclose other therapies.

Editors’ note: This study revealed that treatment naive HIV patients in South Africa use a variety of traditional herbal therapies and other complementary/alternative medicines that they may be reticent to discuss fully with their care providers and that may negatively affect household income. Creating trust and involving patients more in treatment decision-making processes may help determine which aspects of their alternative treatment can be safely incorporated into their medical regimen.