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Volume 13, Issue 4 (1-2024)
cmja 2024, 13(4): 74-83 |
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Zarshenas F, Najibi S M, Dehghan A, Amiri S, Hashempur M H. Traditional and Complementary Medicine Use in HIV/AIDS Patients in Fasa City: A Cross-Sectional Study. cmja 2024; 13 (4) :74-83
URL: http://cmja.arakmu.ac.ir/article-1-967-en.html
URL: http://cmja.arakmu.ac.ir/article-1-967-en.html
Fatemeh Zarshenas1 
, Seyede Maryam Najibi2 , Aziazallah Dehghan1 , Sadegh Amiri3 , Mohammad Hashem Hashempur 4
, Seyede Maryam Najibi2 , Aziazallah Dehghan1 , Sadegh Amiri3 , Mohammad Hashem Hashempur 4
1- Non Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
2- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
3- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
4- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran , hashempur@gmail.com
2- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
3- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
4- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran , hashempur@gmail.com
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INTRODUCTION
Due to the chronic nature of HIV/AIDS, the complexity of treatment methods, and the challenges associated with following treatment instructions, as well as the side effects of drugs, a significant percentage of patients seek alternative approaches like traditional and complementary medicine to control these side effects and improve their personal and social quality of life (5). Studies indicated the use of traditional medicine and herbal medicines for HIV/AIDS patients. In South Africa, traditional medicine healers play a crucial role in providing healthcare for a significant portion of patients living with HIV in countries with a high HIV/AIDS burden (19, 20). Moreover, the results of a systematic review revealed that, on average, 60% of people with HIV/AIDS use complementary and alternative medicine (18). One of the most common reasons for using to complementary and alternative medicine in these patients is to prevent or alleviate symptoms related to HIV/AIDS, reduce side effects associated with conventional HIV treatments, and enhance their overall quality of life (22).
Given the increasing prevalence of HIV/AIDS worldwide and in the country, the rising cost of treatment, and the growing public interest in complementary medicine for general population health and chronic diseases, healthcare providers should formulate new policies to promote traditional and complementary medicine for these patients. Designing an appropriate policy for complementary medicine depends on understanding the extent of the public's use of this treatment method, the types of usage, and the characteristics of the people who use it. Therefore, the aim of this study is to investigate the use of traditional and complementary medicine among people with HIV/AIDS in Fasa city.
METHODS
This research comprises a cross-sectional study conducted on 96 patients with HIV/AIDS at the Behavioral Diseases Counseling Center in Fasa. Data collection involved the use of two questionnaires. The first, a researcher-made questionnaire consisting of 30 questions, was employed to determine the level of traditional medicine usage. To establish its validity, the questionnaire was reviewed by 9 traditional medicine experts. Additionally, a reliability check was conducted with 20 patients completing a pilot test, resulting in a Cronbach's alpha of 0.86.
To assess the quality of life of HIV/AIDS patients, the World Health Organization's standard questionnaire (WHOQOL-HIV) was used. This questionnaire includes 6 domains and 29 items, covering physical (4 items), mental (5 items), independence level (4 items), social relations (4 items), environment (8 items), and personal beliefs (4 items).
The sample size was determined through a census of all clients at the Behavioral Diseases Counseling Center in Fasa. Inclusion criteria for patients in the study were: 1) a definitive diagnosis of HIV/AIDS, and 2) consent to participate. The exclusion criterion was clear cognitive and verbal impairment.
Data analysis employed descriptive statistics, logistic regression, chi-square, and independent t-tests. Statistical significance was set at p-values less than 0.05. The Statistical Package for the Social Sciences software version 15 (SPSS Inc., Chicago, IL, USA) was used for the analysis.
RESULTS
Out of the 96 participants, a significant majority (78.125%) reported the use of traditional medicine. Marital status demonstrated a significant relationship with the use of traditional medicine, whereas variables such as gender, education, disease stage, family dimension, and age did not exhibit any significant relationships with traditional medicine use.
Among those using complementary medicine, the most prevalent types were cupping (52%) and the use of medicinal plants (40%), with a slight difference in frequency. The majority of participants, more than 80%, had visited an infectious disease doctor fewer than 5 times in the previous year. Notably, 80.3% of traditional medicine users were introduced to these practices through family and friends.
Interestingly, most participants did not alter their medication use when using traditional medicine. A positive history of traditional medicine usage was common, often attributed to personal experiences or the positive outcomes observed in relatives. Additionally, most participants reported no negative history with traditional medicine such as exacerbation of the disease and believed that medicinal plants have no complications at all. 73.9% of them considered the cost of traditional medicine and medicinal plants to be moderate and relatively appropriate.
Concerning overall health status, 71.9% of all patients, including 72% of traditional medicine users, evaluated their health as average to good. Notably, chamomile and thyme were the most popular herbs, with chamomile often used for relaxation and mental relief, while thyme was commonly used to enhance overall body health and for various other reasons.
CONCLUSION
In this study, the utilization of traditional medicine among HIV/AIDS patients was found to be 78%, which is higher than the average in the world in similar studies. This discrepancy may be attributed to variations in the target population. Notably, a significant proportion of patients in our study became acquainted with traditional and complementary medicine through family and friends. This is contrasts with findings from Brown's study, where most HIV/AIDS patients received information about traditional and complementary medicine from doctors (MD), the Internet, and friends (32). Another study reported patients being more familiar with these practices through the media (31). This divergence could be influenced by cultural and social disparities between countries and the primary healthcare (PHC) network system. In Asian countries, including Iran, stronger family ties may contribute to the variance.
Overall, the prevalence of complementary medicine usage among HIV/AIDS patients is relatively high, with cupping and medicinal plants emerging as the most commonly employed traditional and complementary methods. It is crucial for relevant authorities to consider the location for providing cupping services and ensuring the consideration of health guidelines regarding disease transmission. Family and friends play a pivotal role in encouraging patients to embrace traditional and complementary medicine. Therefore, given the widespread use of these practices, there is a pressing need for appropriate policies and practical responses to ensure that safe, timely, and high-quality traditional medicine services are accessible to the population.
Ethical Considerations
The study protocol was reviewed by the Medical Ethics Committee of Fasa University of Medical Sciences and approved with code 94181. The design questionnaire was completed by the patients and the patients were assured that their information would not be disclosed.
Funding
There is no funding support.
Authors’ Contribution
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work
Conflict of Interest
Authors declared no conflict of interest.
Acknowledgments
We are grateful to all the persons for scientific consulting in this paper.
Due to the chronic nature of HIV/AIDS, the complexity of treatment methods, and the challenges associated with following treatment instructions, as well as the side effects of drugs, a significant percentage of patients seek alternative approaches like traditional and complementary medicine to control these side effects and improve their personal and social quality of life (5). Studies indicated the use of traditional medicine and herbal medicines for HIV/AIDS patients. In South Africa, traditional medicine healers play a crucial role in providing healthcare for a significant portion of patients living with HIV in countries with a high HIV/AIDS burden (19, 20). Moreover, the results of a systematic review revealed that, on average, 60% of people with HIV/AIDS use complementary and alternative medicine (18). One of the most common reasons for using to complementary and alternative medicine in these patients is to prevent or alleviate symptoms related to HIV/AIDS, reduce side effects associated with conventional HIV treatments, and enhance their overall quality of life (22).
Given the increasing prevalence of HIV/AIDS worldwide and in the country, the rising cost of treatment, and the growing public interest in complementary medicine for general population health and chronic diseases, healthcare providers should formulate new policies to promote traditional and complementary medicine for these patients. Designing an appropriate policy for complementary medicine depends on understanding the extent of the public's use of this treatment method, the types of usage, and the characteristics of the people who use it. Therefore, the aim of this study is to investigate the use of traditional and complementary medicine among people with HIV/AIDS in Fasa city.
METHODS
This research comprises a cross-sectional study conducted on 96 patients with HIV/AIDS at the Behavioral Diseases Counseling Center in Fasa. Data collection involved the use of two questionnaires. The first, a researcher-made questionnaire consisting of 30 questions, was employed to determine the level of traditional medicine usage. To establish its validity, the questionnaire was reviewed by 9 traditional medicine experts. Additionally, a reliability check was conducted with 20 patients completing a pilot test, resulting in a Cronbach's alpha of 0.86.
To assess the quality of life of HIV/AIDS patients, the World Health Organization's standard questionnaire (WHOQOL-HIV) was used. This questionnaire includes 6 domains and 29 items, covering physical (4 items), mental (5 items), independence level (4 items), social relations (4 items), environment (8 items), and personal beliefs (4 items).
The sample size was determined through a census of all clients at the Behavioral Diseases Counseling Center in Fasa. Inclusion criteria for patients in the study were: 1) a definitive diagnosis of HIV/AIDS, and 2) consent to participate. The exclusion criterion was clear cognitive and verbal impairment.
Data analysis employed descriptive statistics, logistic regression, chi-square, and independent t-tests. Statistical significance was set at p-values less than 0.05. The Statistical Package for the Social Sciences software version 15 (SPSS Inc., Chicago, IL, USA) was used for the analysis.
RESULTS
Out of the 96 participants, a significant majority (78.125%) reported the use of traditional medicine. Marital status demonstrated a significant relationship with the use of traditional medicine, whereas variables such as gender, education, disease stage, family dimension, and age did not exhibit any significant relationships with traditional medicine use.
Among those using complementary medicine, the most prevalent types were cupping (52%) and the use of medicinal plants (40%), with a slight difference in frequency. The majority of participants, more than 80%, had visited an infectious disease doctor fewer than 5 times in the previous year. Notably, 80.3% of traditional medicine users were introduced to these practices through family and friends.
Interestingly, most participants did not alter their medication use when using traditional medicine. A positive history of traditional medicine usage was common, often attributed to personal experiences or the positive outcomes observed in relatives. Additionally, most participants reported no negative history with traditional medicine such as exacerbation of the disease and believed that medicinal plants have no complications at all. 73.9% of them considered the cost of traditional medicine and medicinal plants to be moderate and relatively appropriate.
Concerning overall health status, 71.9% of all patients, including 72% of traditional medicine users, evaluated their health as average to good. Notably, chamomile and thyme were the most popular herbs, with chamomile often used for relaxation and mental relief, while thyme was commonly used to enhance overall body health and for various other reasons.
CONCLUSION
In this study, the utilization of traditional medicine among HIV/AIDS patients was found to be 78%, which is higher than the average in the world in similar studies. This discrepancy may be attributed to variations in the target population. Notably, a significant proportion of patients in our study became acquainted with traditional and complementary medicine through family and friends. This is contrasts with findings from Brown's study, where most HIV/AIDS patients received information about traditional and complementary medicine from doctors (MD), the Internet, and friends (32). Another study reported patients being more familiar with these practices through the media (31). This divergence could be influenced by cultural and social disparities between countries and the primary healthcare (PHC) network system. In Asian countries, including Iran, stronger family ties may contribute to the variance.
Overall, the prevalence of complementary medicine usage among HIV/AIDS patients is relatively high, with cupping and medicinal plants emerging as the most commonly employed traditional and complementary methods. It is crucial for relevant authorities to consider the location for providing cupping services and ensuring the consideration of health guidelines regarding disease transmission. Family and friends play a pivotal role in encouraging patients to embrace traditional and complementary medicine. Therefore, given the widespread use of these practices, there is a pressing need for appropriate policies and practical responses to ensure that safe, timely, and high-quality traditional medicine services are accessible to the population.
Ethical Considerations
The study protocol was reviewed by the Medical Ethics Committee of Fasa University of Medical Sciences and approved with code 94181. The design questionnaire was completed by the patients and the patients were assured that their information would not be disclosed.
Funding
There is no funding support.
Authors’ Contribution
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work
Conflict of Interest
Authors declared no conflict of interest.
Acknowledgments
We are grateful to all the persons for scientific consulting in this paper.
Type of Study: Research |
Subject:
Traditional medicine
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