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

Tr Puoane,J Uwimana,Wr Folk,Gd Hughes,Q Johnson

doi:10.4314/ajtcam.v9i4.6

Abstract

The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART). The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART), using an exploratory qualitative design in two provinces of South Africa: an urban township health facility in the Western Cape, and a rural district hospital in KwaZulu-Natal (KZN) with antennal HIV rate of 32% and 28%'respectively. In-depth interviews were conducted with 14 participants: six HIV patients on ART and using Traditional Medicine(TM), two doctors, two nurses and four traditional healers. Two focus group discussions -one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using TM in conjunction with ART and/or Cotrimoxazole prophylaxis. Patients preferred not to disclose THP to health professionals because of lack of support and understanding. Patients utilize THP because of family expectations, privacy and confidentiality, especially when they have not disclosed their HIV status. Healthcare professionals had strong negative opinions about THP, especially for HIV-positive patients. Traditional healers supported the patient's rationale for THP use. This study revealed a need to better understand factors involved in patients' choosing to use THP concurrently with ART.

Highlights

Medicinal plants have been used in most indigenous cultures and African countries for hundreds of years
Participants were patients who had indicated that they were using both ARV and TM in the first phase of the study, professional nurses and doctors working at health facilities from the two research sites, traditional healers that were identified by Community Health Workers (CHWs), and CHWs working closely with HIV Positive patients
We had rehydrated him and he got better and for a week he seemed deteriorating until we discovered that his family was bringing traditional medicine for him to drink while in hospital” “I had one patient who last year when she was told that she is HIV positive started using traditional medicine and her CD4 count went up, but she is presenting with symptoms that are more of Pneumo–cysticarinne Pneumonia (PCP) so I really need to be convinced that TM works.”

Summary

Introduction

Medicinal plants have been used in most indigenous cultures and African countries for hundreds of years. The World Health Organization (WHO) estimates that presently 80% of the population of developing countries relies on traditional healing practices, primarily traditional medicine, using herbs, as a primary source of healthcare (WHO), 1993). These traditional practices have been overshadowed by modern Western medicine. The WHO defines traditional medicine as the knowledge, skills, and practices that are indigenous to different cultures and that are used for the prevention or treatment of disease (WHO, 2002). Despite the use of THP being widely accepted and used in African countries, there are some healthcare providers that are still suspicious of traditional remedies and practice because of its interaction with conventional Western medicine (Ernst et al, 1998 & Fugh-Berman 2000). The use of traditional medicine among individuals with HIV disease has been reported in previous studies (Langlois-Klassen et al, 2007; Peltzer et al 2010a, Peltzer et al 2010b & Babb et al 2007)

Methods

Results

Discussion

Conclusion