Complementary and alternative medicine use among African-Americans with AIDS.

摘要

The use of complementary and alternative medicine (CAM), a group of health care practices and products that are not considered part of conventional medicine, has increased in recent years, particularly among individuals with Human Immune Deficiency Virus (HIV). Assessing the prevalence and predictors of CAM use among HIV+ populations is important as some CAM therapies may adversely affect the efficacy of conventional HIV medications. Unfortunately, CAM use is not comprehensively or systematically assessed among HIV+ populations. Therefore, the aims of the present study were: (1) evaluate the quality of the current instruments employed in studies assessing CAM use among HIV+ populations, (2) develop and evaluate a new measure of CAM use, and (3) use this refined measure to investigate the prevalence and predictors of CAM use. First, a systematic review was conducted to evaluate the quality of studies that used CAM instruments among HIV+ study populations. Results indicate that approximately 20% of studies assessed the reliability and 3% assessed the validity of the CAM instrument employed. This information was the impetus for the next two data collection phases with a HIV+ study population. In Phase 1, focus group data were used to refine an already-existing CAM measure. In Phase 2, this refined instrument was implemented with a larger sample. The resulting data were then analyzed to evaluate the psychometric properties of the instrument and to investigate the patterns and predictors of CAM use. Results indicate that the revised CAM instrument had adequate internal consistency (alpha=0.67) and test-retest reliability (r=0.79, p<0.01). The majority of participants (94%) reported using at least 1 type of CAM therapy in the past 12 months. In regression models, being female, having a higher income, higher health literacy and higher HIV viral load were associated with a greater frequency of CAM use while stronger emotional well-being was associated with a lower frequency of CAM use, even after controlling for other variables in the model. Findings underscore the need for more precise assessment of CAM use among HIV+ populations and dissemination of these research findings to HIV healthcare providers to facilitate more effective doctor-patient dialogue about CAM use.