Perception of health, HIV clinical disease status, and the use of complementary and alternative medicines among a cohort of HIV-positive women

The objectives of this study are two-fold: (a) to assess the association between use of CAM and HIV clinical disease indicators; and (b) to assess the association between patient's self-perceived health status (POH) and clinical disease indicators. Clinical disease indicators were measured per CD4+ T-cell count, viral load, number of infections, CDC stage, and Karnofsky Performance Scores (KPS).;This was a cross-sectional study including 391 HIV-positive women ages 18--50 years, living in Alabama and Georgia. Participants included 84% African Americans (n = 327), 15% Caucasians (n = 58), and 1% other races (n = 6). A written survey examining POH, use of CAM, and other sociodemographic variables were used and trained interviewers collected data via face-to-face interview. Clinical disease indicators were abstracted from clinic medical records.;About 60% of study participants reported using at least one CAM. About 16% reported using herbs, 22% used dietary supplements, 27% practiced religious healing, 10% used bodywork (e.g. message and yoga), and 1% practiced some type of psychic healing. Vitamin supplements were the most commonly used CAM, where 36% of women in our study reported using vitamins.;Women reporting CAM use tended to be older (≥35 years, p = 0.059), were more educated (>high school, p = 0.002), had no health insurance coverage (p = 0.04), and had longer disease duration (≥4 years, p = 0.002) compared to those who did not report CAM use. When examining the association between CAM use and clinical disease indicators, higher number of infections (≥3), were found to be associated with CAM use (p = 0.028). No significant association was found with other clinical indicators such as CD4+ T-cells, viral load, CDC score, and KPS.;Vitamin supplements were identified as the most commonly used CAM among this population (∼36%). Similar to CAM users, vitamin users had significantly higher education levels (p = 0.012), higher income ( p = 0.002), and longer disease duration (p = 0.044). A trend towards more vitamin use was noted among Caucasian compared to African American women (p = 0.09). When examining the association between vitamin use and clinical disease indicators, women who used vitamins had lower viral load levels (p = 0.011) and higher number of infections (p = 0.003).;Multivariate logistic regression analysis was conducted to eliminate any potential confounders. None of the significant associations with CAM users were eliminated during the regression analysis. CAM users were more educated (>high school, OR = 2.34) and had longer disease duration (≥4 years, OR = 2.21) than women who did not use CAM. CAM users were about twice as unlikely to have health insurance coverage as non-CAM users (OR = 0.49). Regarding clinical disease indicators, women who used CAM were approximately twice as likely to have a higher number of infections as non-CAM users (OR = 0.58).;Vitamin users had a higher education level (>high school, OR = 2.34), were more Caucasian than African American women (OR = 0.41), and had longer disease duration (≥4 years, OR = 1.87) than non-vitamin users. Income and clinical indicators (viral load and number of infections) were eliminated during the regression analysis.;We concluded that CAM use was prevalent among women living with HIV/AIDS. Longitudinal studies and clinical trials are needed to investigate the effectiveness of CAM use, potential drug interactions and side effects of CAM. (Abstract shortened by UMI.).