School
School of Public Health
Document Type
Dissertation
Department (new version)
Public Health
Date of Award
2003
Degree Name by School
Doctor of Public Health (DrPH) School of Public Health
Abstract
The objectives of this study are two-fold: (a) to assess the association between use of CAM and HIV clinical disease indicators; and (b) to assess the association between patient's self-perceived health status (POH) and clinical disease indicators. Clinical disease indicators were measured per CD4+ T-cell count, viral load, number of infections, CDC stage, and Karnofsky Performance Scores (KPS). This was a cross-sectional study including 391 HIV-positive women ages 18–50 years, living in Alabama and Georgia. Participants included 84% African Americans ( n = 327), 15% Caucasians ( n = 58), and 1% other races ( n = 6). A written survey examining POH, use of CAM, and other sociodemographic variables were used and trained interviewers collected data via face-to-face interview. Clinical disease indicators were abstracted from clinic medical records. About 60% of study participants reported using at least one CAM. About 16% reported using herbs, 22% used dietary supplements, 27% practiced religious healing, 10% used bodywork (e.g. message and yoga), and 1% practiced some type of psychic healing. Vitamin supplements were the most commonly used CAM, where 36% of women in our study reported using vitamins. Women reporting CAM use tended to be older (≥35 years, p = 0.059), were more educated (>high school, p = 0.002), had no health insurance coverage ( p = 0.04), and had longer disease duration (≥4 years, p = 0.002) compared to those who did not report CAM use. When examining the association between CAM use and clinical disease indicators, higher number of infections (≥3), were found to be associated with CAM use ( p = 0.028). No significant association was found with other clinical indicators such as CD4+ T-cells, viral load, CDC score, and KPS. Vitamin supplements were identified as the most commonly used CAM among this population (∼36%). Similar to CAM users, vitamin users had significantly higher education levels ( p = 0.012), higher income ( p = 0.002), and longer disease duration ( p = 0.044). A trend towards more vitamin use was noted among Caucasian compared to African American women ( p = 0.09). When examining the association between vitamin use and clinical disease indicators, women who used vitamins had lower viral load levels ( p = 0.011) and higher number of infections ( p = 0.003). Multivariate logistic regression analysis was conducted to eliminate any potential confounders. None of the significant associations with CAM users were eliminated during the regression analysis. CAM users were more educated (>high school, OR = 2.34) and had longer disease duration (≥4 years, OR = 2.21) than women who did not use CAM. CAM users were about twice as unlikely to have health insurance coverage as non-CAM users (OR = 0.49). Regarding clinical disease indicators, women who used CAM were approximately twice as likely to have a higher number of infections as non-CAM users (OR = 0.58). Vitamin users had a higher education level (>high school, OR = 2.34), were more Caucasian than African American women (OR = 0.41), and had longer disease duration (≥4 years, OR = 1.87) than non-vitamin users. Income and clinical indicators (viral load and number of infections) were eliminated during the regression analysis. We concluded that CAM use was prevalent among women living with HIV/AIDS. Longitudinal studies and clinical trials are needed to investigate the effectiveness of CAM use, potential drug interactions and side effects of CAM. (Abstract shortened by UMI.)
ProQuest Publication Number
ProQuest ID
3086781
ISBN
978-0-496-34571-7
Recommended Citation
Mikhail, Isis S., "Perception of health, HIV clinical disease status, and the use of complementary and alternative medicines among a cohort of HIV-positive women" (2003). All ETDs from UAB. 7230.
https://digitalcommons.library.uab.edu/etd-collection/7230
Comments
DrPH