Current HIV/AIDS Reports

, 8:257 | Cite as

A Global Perspective on Complementary and Alternative Medicine Use Among People Living with HIV/AIDS in the Era of Antiretroviral Treatment

  • Rae A. Littlewood
  • Peter A. Vanable
Behavioral Aspects of HIV Management (Ralph J. DiClemente and Jennifer Brown, Section Editors)


Complementary and alternative medicine (CAM) is a popular adjunct to conventional medicine across medical populations, and is particularly relevant in the global HIV epidemic. Use of antiretroviral therapy (ART) to treat HIV is ubiquitous in high-resource areas and efforts to increase coverage in low-resource areas are underway. To better understand the role of CAM in HIV treatment and the implications of CAM use for ART uptake and adherence, we review international research published between 2007 and 2011. Findings confirm that CAM is commonly used as an adjunct to ART; however, in countries where ART is less accessible, many HIV-positive individuals take a pluralistic approach to health care, incorporating both traditional and, when available, conventional medicine. The reviewed studies provide no consensus on whether the use of CAM interferes with ART uptake or adherence; instead, research suggests that illness-related behaviors are driven by multiple factors and determined, at least in part, by the availability and accessibility of ART.


HIV AIDS CAM Complementary medicine Traditional medicine HIV treatment 



No potential conflicts of interest relevant to this article were reported.


Papers of particular interest, published recently, have been highlighted as: •Of importance

  1. 1.
    Eisenberg DM, Kessler RC, Foster C, et al. Unconventional medicine in the United States: prevalence, costs, and patterns of use. NEJM. 1993;328(4):246–52.PubMedCrossRefGoogle Scholar
  2. 2.
    NCCAM. What is Complementary and Alternative Medicine? Available at [Accessed May 11, 2011].
  3. 3.
    Littlewood RA, Vanable PA. Complementary and alternative medicine use among HIV-positive people: research synthesis and implications for HIV care. AIDS Care. 2008;20(8):1002–18.PubMedCrossRefGoogle Scholar
  4. 4.
    Wootton JC, Sparber A. Surveys of complementary and alternative medicine: Part III. Use of alternative and complementary therapies for HIV/AIDS. J Altern Complement Med. 2001;7(4):371–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Thorpe RD. 'Doing' chronic illness? Complementary medicine use among people living with HIV/AIDS in Australia. Sociol Health Illn. 2009;31(3):375–89.PubMedCrossRefGoogle Scholar
  6. 6.
    Thomas SL, Lam K, Piterman L, et al. 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.PubMedCrossRefGoogle Scholar
  7. 7.
    Furler MD, Einarson TR, Walmsley S, et al. Use of complementary and alternative medicine by HIV-infected outpatients in Ontario, Canada. AIDS Patient Care STDS. 2003;17(4):155–68.PubMedCrossRefGoogle Scholar
  8. 8.
    Colebunders R, Dreezen C, Florence E, et al. The use of complementary and alternative medicine by persons with HIV infection in Europe. Int J STD AIDS. 2003;14(10):672–4.PubMedCrossRefGoogle Scholar
  9. 9.
    Ladenheim D, Horn O, Werneke U, et al. Potential health risks of complementary alternative medicines in HIV patients. HIV Med. 2008;9(8):653–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Vazquez Hernandez M, Hurtado Gomez MF, Blanco JR. The influence of alternative medicine in highly active antiretroviral treatment. Farm Hosp. 2009;33(1):31–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Ernst E. The dark side of complementary and alternative medicine. Int J STD AIDS. 2002;13(12):797–800.PubMedCrossRefGoogle Scholar
  12. 12.
    Ernst E. Herbal medicines—they are popular, but are they also safe? Eur J Clin Pharmacol. 2006;62(1):1–2.PubMedCrossRefGoogle Scholar
  13. 13.
    Hoogbruin A. Complementary and alternative therapy (CAT) use and highly active antiretroviral therapy (HAART): current evidence in the literature, 2000–2009. J Clin Nurs. 2011;20(7–8):925–39.PubMedCrossRefGoogle Scholar
  14. 14.
    Cohen MH. Legal and ethical issues in complementary medicine: a United States perspective. Medical Journal of Australia. 2004;181(3):168–9.PubMedGoogle Scholar
  15. 15.
    Nasi M, Pinti M, Troiano L, and Cossarizza A, Complementary and alternative medicine during HIV infection. In Complementary and Alternative Approaches to Biomedicine. Edited by E.L. Cooper and N. Yamaguchi. Kluwer Academic/Plenum Publishers; 2004 105–110.Google Scholar
  16. 16.
    Merenstein D, Yang Y, Schneider MF, et al. Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation. Altern Ther Health Med. 2008;14(5):18–22.PubMedGoogle Scholar
  17. 17.
    Josephs JS, Fleishman JA, Gaist P, Gebo KA. Use of complementary and alternative medicines among a multistate, multisite cohort of people living with HIV/AIDS. HIV Med. 2007;8(5):300–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Bormann JE, Uphold CR, Maynard C. Predictors of complementary/alternative medicine use and intensity of use among men with HIV infection from two geographic areas in the United States. J Assoc Nurses AIDS Care. 2009;20(6):468–80.PubMedCrossRefGoogle Scholar
  19. 19.
    Milan FB, Arnsten JH, Klein RS, et al. Use of complementary and alternative medicine in inner-city persons with or at risk for HIV infection. AIDS Patient Care STDS. 2008;22(10):811–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Merenstein DJ, Hu H, Robison E, et al. Relationship between complementary/alternative treatment use and illicit drug use among a cohort of women with, or at risk for, HIV infection. J Altern Complement Med. 2010;16(9):989–93.PubMedCrossRefGoogle Scholar
  21. 21.
    McDonald K, Slavin S. My body, my life, my choice: practices and meanings of complementary and alternative medicine among a sample of Australian people living with HIV/AIDS and their practitioners. AIDS Care. 2010;22(10):1229–35.PubMedCrossRefGoogle Scholar
  22. 22.
    Kaufman K, Gregory WL. Discriminators of complementary and alternative medicine provider use among men with HIV/AIDS. Am J Health Behav. 2007;31(6):591–601.PubMedGoogle Scholar
  23. 23.
    Bishop FL, Yardley L, Lewith GT. A systematic review of beliefs involved in the use of complementary and alternative medicine. J Health Psychol. 2007;12(6):851–67.PubMedCrossRefGoogle Scholar
  24. 24.
    Liu C, Yang Y, Gange SJ, et al. Disclosure of complementary and alternative medicine use to health care providers among HIV-infected women. AIDS Patient Care STDS. 2009;23(11):965–71.PubMedCrossRefGoogle Scholar
  25. 25.
    WHO and UNAIDS. Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report 2010. Geneva: World Health Organization; 2010.Google Scholar
  26. 26.
    Mills E, Singh S, Wilson K, et al. The challenges of involving traditional healers in HIV/AIDS care. Int J STD AIDS. 2006;17(6):360–3.PubMedCrossRefGoogle Scholar
  27. 27.
    Fritts M, Crawford CC, Quibell D, et al. Traditional Indian medicine and homeopathy for HIV/AIDS: a review of the literature. AIDS Res Ther. 2008;5:25.PubMedCrossRefGoogle Scholar
  28. 28.
    Lamorde M, Tabuti JR, Obua C, et al. Medicinal plants used by traditional medicine practitioners for the treatment of HIV/AIDS and related conditions in Uganda. J Ethnopharmacol. 2010;130(1):43–53.PubMedCrossRefGoogle Scholar
  29. 29.
    Mills E, Foster BC, van Heeswijk R, et al. Impact of African herbal medicines on antiretroviral metabolism. AIDS. 2005;19(1):95–7.PubMedCrossRefGoogle Scholar
  30. 30.
    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.PubMedCrossRefGoogle Scholar
  31. 31.
    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.PubMedGoogle Scholar
  32. 32.
    Bepe N, Madanhi N, Mudzviti T, et al. The impact of herbal remedies on adverse effects and quality of life in HIV-infected individuals on antiretroviral therapy. J Infect Dev Ctries. 2011;5(1):48–53.PubMedGoogle Scholar
  33. 33.
    Taylor TN, Dolezal C, Tross S, Holmes WC. Comparison of HIV/AIDS-specific quality of life change in Zimbabwean patients at western medicine versus traditional African medicine care sites. J Acquir Immune Defic Syndr. 2008;49(5):552–6.PubMedCrossRefGoogle Scholar
  34. 34.
    • Taylor TN: “Because I was in pain, I just wanted to be treated”: competing therapeutic goals in the performance of healing HIV/AIDS in rural Zimbabwe. J Am Folk 2010, 123(489): 304–28. For readers who are unfamiliar with the beliefs and practices involved in traditional African medicine, this paper provides an interesting account that covers both the perspective of the healer and the HIV-positive client. This paper also highlights the role of HIV stigma and social status in HIV-infected individuals’ decisions to get treatment and the type of treatment they choose. Google Scholar
  35. 35.
    • Langlois-Klassen D, Kipp W, and Rubaale T: Who’s talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda. Soc Sci Med 2008, 67(1): 165–76. This research highlights the importance of patient–provider communication as a realistic method for reducing the risks associated with traditional medicine use by HIV-positive individuals in Africa. Google Scholar
  36. 36.
    • Peltzer K, Friend-du Preez N, Ramlagan S, et al.: Traditional complementary and alternative medicine and antiretroviral treatment adherence among HIV patients in Kwazulu-Natal, South Africa. Afr J Tradit Complement Altern Med 2009, 7(2): 125–37. This is the only study to directly examine the relationship between CAM use and ART adherence in a low-resource setting. The results suggest that the benefits of ART may eclipse the need for traditional medicine to treat HIV through a process of education and routine care. Google Scholar
  37. 37.
    Dalal K, Dawad S. Non-utilization of public health care facilities: examining the reasons through a national study of women in India. Rural Remote Health. 2009;9(3):1178.PubMedGoogle Scholar
  38. 38.
    Balarajan Y, Selvaraj S, Subramanian SV. Health care and equity in India. Lancet. 2011;377(9764):505–15.PubMedCrossRefGoogle Scholar
  39. 39.
    • Chomat AM, Wilson IB, Wanke CA, et al.: Knowledge, beliefs, and health care practices relating to treatment of HIV in Vellore, India. AIDS Patient Care STDS 2009, 23(6): 477–84. One of the first and only studies to contextualize HIV treatment in Indian culture. The authors examine the intersection between Indian traditional medicine and conventional HIV care and explore how the competing goals of traditional versus conventional medicine influence the landscape of HIV treatment. Google Scholar
  40. 40.
    Kurien M, Thomas K, Ahuja RC, et al. Screening for HIV infection by health professionals in India. Natl Med J India. 2007;20(2):59–66.PubMedGoogle Scholar
  41. 41.
    Nyamathi A, Singh VP, Lowe A, et al. Knowledge and attitudes about HIV/AIDS among homoeopathic practitioners and educators in India. Evid Based Complement Alternat Med. 2008;5(2):221–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Han M, Chen Q, Hao Y, et al. Design and implementation of a China comprehensive AIDS response programme (China CARES), 2003–08. Int J Epidemiol. 2010;39 Suppl 2:ii47–55.PubMedCrossRefGoogle Scholar
  43. 43.
    Ma K, Lee SS, Chu EK, et al. Popular use of traditional Chinese medicine in HIV patients in the HAART era. AIDS Behav. 2008;12(4):637–42.PubMedCrossRefGoogle Scholar
  44. 44.
    Chen WT, Shiu CS, Simoni J, et al. Attitudes toward antiretroviral therapy and complementary and alternative medicine in Chinese patients infected with HIV. J Assoc Nurses AIDS Care. 2009;20(3):203–17.PubMedCrossRefGoogle Scholar
  45. 45.
    Peltzer K. Traditional health practitioners in South Africa. Lancet. 2009;374(9694):956–7.PubMedCrossRefGoogle Scholar
  46. 46.
    Peltzer K, Mngqundaniso N, Petros G. HIV/AIDS/STI/TB knowledge, beliefs and practices of traditional healers in KwaZulu-Natal, South Africa. AIDS Care. 2006;18(6):608–13.PubMedCrossRefGoogle Scholar
  47. 47.
    Kaboru BB, Falkenberg T, Ndubani P, et al. Can biomedical and traditional health care providers work together? Zambian practitioners' experiences and attitudes towards collaboration in relation to STIs and HIV/AIDS care: a cross-sectional study. Hum Resour Health. 2006;4:16.PubMedCrossRefGoogle Scholar
  48. 48.
    Peltzer K, Mngqundaniso N, Petros G. A controlled study of an HIV/AIDS/STI/TB intervention with traditional healers in KwaZulu-Natal, South Africa. AIDS Behav. 2006;10(6):683–90.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Mind Research NetworkAlbuquerqueUSA
  2. 2.Syracuse UniversitySyracuseUSA

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