Complementary, alternative and traditional medicine in HIV care

Key take-home messages

• Complementary and alternative medicine use among people living with HIV continues to be popular even though there are few methodologically rigorous studies documenting its effectiveness, and studies often report contradictory evidence as to the effectiveness of certain forms of this type of medicine. One systematic review of complementary and alternative medicine literature found that the quality of methods to evaluate outcomes in observational studies is limited with very few using evaluation tools that have been assessed for reliability and validity.
• People living with HIV self-report that complementary and alternative medicine is helpful in improving their quality of life with relatively few risk factors associated with their use. People living with HIV also self-report that complementary and alternative medicine use helps to prevent and alleviate symptoms related to HIV, as well as side effects of treatment.
• While some forms of complementary and alternative medicine do not interact with antiretroviral medications, herbal remedies have the highest potential for contraindications. The highest risk is in countries where complementary and alternative medicine is not regulated and herbal remedies are commonly used. While there is a low risk of interactions between complementary and alternative medicine and antiretroviral drugs, there is a potential that herbal complementary and alternative medicine use can interfere with improving health outcomes as it can affect how antiretroviral drugs are metabolized, creating early inhibition and decreasing the length of drug exposure.
• There is little research on the frequency of complementary and alternative medicine use in Africa and the Caribbean to treat HIV. However, the available research indicates that, in African countries with a strong traditional system of medicine, people living with HIV often seek treatment from traditional healers or take herbal medicines prior to accessing clinical care or starting antiretroviral drugs. Herbal medicine in Africa is used as both primary and secondary treatment for HIV, other infectious diseases and common health problems. In addition, rates of complementary and alternative medicine use measured in African American people living with HIV found similar rates of usage as people living with HIV in Ontario, with high rates of use in conjunction with Highly Active Anti-Retroviral Therapy (HAART).

• Population(s)
  • Ethnoracial communities
  • General HIV+ population
• Engagement and Care Cascade
  • Treatment