Frank van Leth

Associate Professor Health Sciences

Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini


Journal article


M. Molemans, Ria Reis, F. Shabalala, Njabuliso Dlamini, Nelisiwe Masilela, Njabulo Simelane, Christopher Pell, Ariel Chao, Donna Spiegelman, E. Vernooij, F. van Leth
BMC Complementary Medicine and Therapies, 2023

Semantic Scholar DOI PubMedCentral PubMed
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APA   Click to copy
Molemans, M., Reis, R., Shabalala, F., Dlamini, N., Masilela, N., Simelane, N., … van Leth, F. (2023). Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini. BMC Complementary Medicine and Therapies.


Chicago/Turabian   Click to copy
Molemans, M., Ria Reis, F. Shabalala, Njabuliso Dlamini, Nelisiwe Masilela, Njabulo Simelane, Christopher Pell, et al. “Reasons for Using Traditional and Complementary Care by People Living with HIV on Antiretroviral Therapy and Association with Interrupted Care: a Mixed Methods Study in Eswatini.” BMC Complementary Medicine and Therapies (2023).


MLA   Click to copy
Molemans, M., et al. “Reasons for Using Traditional and Complementary Care by People Living with HIV on Antiretroviral Therapy and Association with Interrupted Care: a Mixed Methods Study in Eswatini.” BMC Complementary Medicine and Therapies, 2023.


BibTeX   Click to copy

@article{m2023a,
  title = {Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini},
  year = {2023},
  journal = {BMC Complementary Medicine and Therapies},
  author = {Molemans, M. and Reis, Ria and Shabalala, F. and Dlamini, Njabuliso and Masilela, Nelisiwe and Simelane, Njabulo and Pell, Christopher and Chao, Ariel and Spiegelman, Donna and Vernooij, E. and van Leth, F.}
}

Abstract

The use of traditional, complementary, and alternative medicine (TCAM) can lead to delays and interruptions in the HIV continuum of care. This study explores reasons for TCAM use in people living with HIV on antiretroviral therapy (ART) in Eswatini and compares interrupted care between different types of TCAM users. Data were collected using surveys in the MaxART study (a test-and-treat trial) between 2014 and 2017 to assess the exposure, namely visiting a TCAM provider. Additionally, visit dates were retrieved from clinic records to assess the outcome, interrupted care. Open-ended questions were analysed with qualitative content analysis (n = 602) and closed questions with bivariable and multivariable analysis (n = 202). Out of 202 participants, 145 (72%) never used TCAM, 40 (20%) ever used, and 17 (8%) is currently using TCAM (diviners, herbalists, and religious healers). No differences in interrupted care were found comparing never (reference category), past (Odds Ratio: 1.31, 95% confidence interval: 0.63–2.72), and current users (1.34, 0.47–3.77), while adjusting for gender, time since HIV diagnosis, and time on ART. Contextual factors affecting the choice for TCAM were the influence of family, advice from the health facility, and religious beliefs. Individual factors include trust in biomedical care, type of illness, no need for additional care, and practical reasons such as financial means. In conclusion, individual and contextual factors influence the choice for TCAM. Interrupted care does not differ between never, past, and current users.