Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa

Puoane, Thandi; Hughes, Gail; Uwimana, Jan; Johnson, Quinton; Folk, William R.

doi:10.4314/ajtcam.v9i4.6

Cited by 32 publications

(32 citation statements)

References 17 publications

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“…This is despite the fact that health information is received by participants mostly from conventional healthcare practitioners. Such non-disclosure of THM use is not peculiar to this study, and has been reported in other studies [37, 39, 40]. However, this is in contrast to findings from studies conducted in Australia [27] and the United States [20], where older women disclosed CAM use to their healthcare providers.…”

Section: Discussioncontrasting

confidence: 70%

Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa

Aboyade

Beauclair

Mbamalu

et al. 2016

BMC Complement Altern Med

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BackgroundVarious studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent among older women living in South African urban areas, placing a heavy burden on the healthcare system. This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional herbal medicine (THM) use among older women self-reporting NCDs from the Prospective Urban Rural Epidemiology study (PURE).MethodA homogenous purposive sampling of PURE participants was used to recruit women who were 50 years or older (n = 250). Descriptive statistics were used to examine the number of NCDs reported by the study sample, health seeking behaviour and practices as well as THM use. Logistic regression was also employed to investigate possible associations between reported conditions and THM use or medical pluralism.ResultsWithin the study sample, 72 % self-reported an NCD. Of those with self-reported NCDs, 46 % had one, and 54 % had two or more NCDs. Those with NCDs usually visited public clinics (80 %), relied on doctors (90 %) and nurses (85 %) for health information, and mostly used conventional medicine (CM) to manage high blood pressure (81 %). About 30 % of those with NCDs indicated using THM, of whom 29 (53 %) reported practicing medical pluralism. Participants with dental problems (OR: 3.24, 95 % CI: 1.30–8.20), headaches (OR: 2.42, 95 % CI: 1.24–4.94), heart burn (OR: 2.30, 95 % CI: 1.18–4.48) and severe tiredness (OR: 2.05, 95 % CI: 1.08–3.99) were more likely to use THM. Anxiety and allergies increased the likelihood to practise medical pluralism by five and 20 times, respectively.ConclusionSelf-reported NCD with co-morbidities was prevalent among the participants in the study. Most of the study participants utilized state-owned clinics and hospitals for the management of their chronic conditions. THM use was not very common. However, among those who used THM, medical pluralism was prevalent. Family history was the most common reason for THM use, with many THM patrons utilizing these for treatment of a health condition. Older black women with anxiety and allergies were more likely to practise medical pluralism.

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Section: Discussioncontrasting

confidence: 70%

Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa

Aboyade

Beauclair

Mbamalu

et al. 2016

BMC Complement Altern Med

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“…Previous studies on the use of TAM in the context of HIV treatment have posited TAM and allopathic medicine as parallel, sometimes polarised approaches whose use depends on multiple factors like availability and access to treatment (Littlewood & Vanable, 2011), and have called for further examination into the motivations for TAM use (Puoane, Hughes, Uwimana, Johnson, & Folk, 2012). The findings here suggested implicit cultural motivators for TAM use that were independent of a patient’s HIV-related health-seeking behaviour(s).…”

Section: Discussionmentioning

confidence: 99%

“…The study design addressed a noted gap in literature by directly involving traditional healers. Other studies (Graham et al, 2012; Mngqundaniso & Peltzer, 2008) have engaged traditional healers and allopathic medical practitioners, but to date and to the best of our knowledge, few in South Africa have engaged doctors, allopathic medical health care providers, and traditional healers in the same study (Puoane et al, 2012). The perspectives of traditional healers contributed immensely to the findings and themes revealed here.…”

Section: Discussionmentioning

confidence: 99%

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Concurrent use of traditional medicine and ART: Perspectives of patients, providers and traditional healers in Durban, South Africa

Belisle

Hennink

Ordóñez

et al. 2014

Global Public Health

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The concurrent use of traditional African medicine (TAM) and allopathic medicine is not well understood for people living with HIV (PLHIV) in the era of antiretroviral therapy (ART). This cross-sectional, qualitative study examines perceptions of the concurrent use of TAM and ART among: i) patients receiving ART at the Sinikithemba HIV Clinic of McCord Hospital, in Durban, South Africa; ii) allopathic medical providers (doctors, nurses, HIV counsellors) from Sinikithemba; and iii) local traditional healers. Data were collected through in-depth interviews and focus group discussions with 26 participants between July and October, 2011. Patients in this study did not view TAM as an alternative to ART; rather, results show that patients employ TAM and ART for distinctly different needs. More research is needed to further understand the relationship between traditional and allopathic approaches to health care in South Africa, to improve cultural relevance in the provision and delivery of care for PLHIV, and to pragmatically address the concerns of healthcare providers and public health officials managing this intersection in South Africa and elsewhere.

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“…While some studies have indicated that THPs lack the biomedical skills and knowledge to diagnose and treat HIV [34,35,44], THPs who are trained in HIV/AIDS have been used to educate patients about the causes and consequences of HIV, and have provided physical and psychosocial community-based HIV care [19,45–47]. A quantitative study conducted among patients consulting THPs in the context of HIV/AIDS found that PLHIV did so owing to several complex health situations [28].…”

Section: Introductionmentioning

confidence: 99%

Traditional health practitioners’ management of HIV/AIDS in rural South Africa in the era of widespread antiretroviral therapy

Zuma

Wight

Rochat

et al. 2017

Global Health Action

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Background: Traditional health practitioners (THPs) have been identified as a key local resource in the fight against human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in South Africa. However, their approaches to the treatment of people living with HIV (PLHIV) have been met with scepticism by some biomedical practitioners amid increasing access to antiretroviral therapy (ART). Objective: In light of this ambivalence, this study aims to document and identify treatment approaches of THPs to the management of illness among PLHIV in the current era of widespread access to ART. Methods: The study was conducted as part of a larger trial of Treatment as Prevention (TasP) in rural northern Kwa-Zulu Natal, intended to treat PLHIV regardless of CD4 count. Nine THPs were enrolled using purposive and snowballing techniques. Repeat group discussions, triangulated with community walks and photovoice techniques, were conducted. A thematic analysis approach was used to analyse the data. Results: Eight of the nine THPs had received training in biomedical aspects of HIV. THPs showed a multilayered decision-making process in managing illness among PLHIV, influenced by the attributes and choices of the THPs. THPs assessed and managed illness among PLHIV based on THP training in HIV/AIDS, THP type, as well as knowledge and experience in the traditional healing practice. Management of illness depended on the patients’ report of their HIV status or willingness to test for HIV. Conclusions: THPs’ approaches to illness in PLHIV appear to be shifting in light of increasing exposure to HIV/AIDS-related information. Importantly, disclosure of HIV status plays a major role in THPs’ management of illness among PLHIV, as well as linkage to HIV testing and care for their patients. Therefore, THPs can potentially enhance the success of ART for PLHIV when HIV status is known.

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Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa

Cited by 32 publications

References 17 publications

Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa

Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa

Concurrent use of traditional medicine and ART: Perspectives of patients, providers and traditional healers in Durban, South Africa

Traditional health practitioners’ management of HIV/AIDS in rural South Africa in the era of widespread antiretroviral therapy

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