AIDS and Behavior

, Volume 17, Issue 1, pp 260–265

No Association Found Between Traditional Healer Use and Delayed Antiretroviral Initiation in Rural Uganda

  • Russell H. Horwitz
  • Alexander C. Tsai
  • Samuel Maling
  • Francis Bajunirwe
  • Jessica E. Haberer
  • Nneka Emenyonu
  • Conrad Muzoora
  • Peter W. Hunt
  • Jeffrey N. Martin
  • David R. Bangsberg
Brief Report


Traditional healer and/or spiritual counselor (TH/SC) use has been associated with delays in HIV testing. We examined HIV-infected individuals in southwestern Uganda to test the hypothesis that TH/SC use was also associated with lower CD4 counts at antiretroviral therapy (ART) initiation. Approximately 450 individuals initiating ART through an HIV/AIDS clinic at the Mbarara University of Science and Technology (MUST) were recruited to participate. Patients were predominantly female, ranged in age from 18 to 75, and had a median CD4 count of 130. TH/SC use was not associated with lower CD4 cell count, but age and quality-of-life physical health summary score were associated with CD4 cell count at initiation while asset index was negatively associated with CD4 count at ART initiation. These findings suggest that TH/SC use does not delay initiation of ART.


HIV/AIDS Traditional healer Spiritual counselor Late presentation Uganda 


La consulta con un curandero tradicional y/o consejero espiritual (TH/SC) ha sido asociada a retrasos para someterse a la prueba de VIH. Evaluamos personas con VIH en el sudoeste de Uganda para poner a prueba la hipótesis de que consultar con un TH/SC también está asociado a un conteo bajo de células CD4 al inicio de una terapia antirretroviral (ART). Se reclutó aproximadamente 450 personas iniciando ART en una clínica de VIH/SIDA en la Universidad de Mbarara de Ciencia y Tecnología (MUST). Los pacientes fueron predominantemente mujeres, entre las edades de 18 y 75, cuyo recuento mediano de CD4 estaba en 130. Se encontró que la consulta con un TH/SC no está asociada a un recuento menor de células CD4. Sin embargo, la edad y la calidad de vida física sí se encontraron asociados al recuento de células CD4 al inicio. En contraste, el índice-de-recurso se encontró asociado negativamente con el recuento de CD4 al inicio del ART. Estos hallazgos sugieren que la consulta con un TH/SC no resulta en un atraso para iniciar la ART.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Russell H. Horwitz
    • 1
    • 2
    • 14
  • Alexander C. Tsai
    • 3
  • Samuel Maling
    • 4
  • Francis Bajunirwe
    • 5
    • 6
  • Jessica E. Haberer
    • 7
    • 8
  • Nneka Emenyonu
    • 9
    • 10
  • Conrad Muzoora
    • 9
  • Peter W. Hunt
    • 10
    • 11
  • Jeffrey N. Martin
    • 12
  • David R. Bangsberg
    • 2
    • 7
    • 8
    • 9
    • 13
  1. 1.Department of PsychiatryMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Robert Wood Johnson Health and Society Scholars ProgramHarvard UniversityCambridgeUSA
  4. 4.Department of PsychiatryMbarara University of Science and TechnologyMbararaUganda
  5. 5.Department of Community HealthMbarara University of Science and TechnologyMbararaUganda
  6. 6.Department of Epidemiology and BiostatisticsCase Western Reserve UniversityClevelandUSA
  7. 7.Harvard Initiative for Global HealthCambridgeUSA
  8. 8.Center for Global HealthMassachusetts General HospitalBostonUSA
  9. 9.Department of MedicineMbarara University of Science and TechnologyMbararaUganda
  10. 10.Department of MedicineUniversity of CaliforniaSan FranciscoUSA
  11. 11.Department of Laboratory MedicineUniversity of CaliforniaSan FranciscoUSA
  12. 12.Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoUSA
  13. 13.Phillip T. and Susan M. Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of TechnologyHarvard UniversityCharlestownUSA
  14. 14.Mental Health DepartmentMGH Revere HealthCare CenterRevereUSA

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