Background
Methods
Design
Sampling procedure and recruitment
Ethical approval
Outcome measures
The Revised Sign and Symptom Checklist for Persons with HIV Disease
Traditional, complementary and alternative medicine (TCAM) measure
HIV knowledge and patient-provider variables
Internalized AIDS stigma
Health Beliefs
Statistical analysis
Results
Demographics
Variable | N = 618 | % |
---|---|---|
Sex
| ||
Male | 180 | 29.1 |
Female | 438 | 70.9 |
Age in years
| ||
18–29 | 167 | 27.0 |
30–39 | 269 | 43.5 |
40–49 | 121 | 19.6 |
50 and above | 61 | 9.9 |
Marital status
| ||
Never married | 433 | 71.0 |
Currently married | 73 | 12.0 |
Cohabitating | 68 | 11.1 |
Divorced/separated | 14 | 2.3 |
Widowed | 22 | 3.6 |
Highest education
| ||
None | 42 | 6.8 |
Primary | 447 | 72.7 |
Secondary | 122 | 19.8 |
Post-secondary | 4 | .7 |
Ethnicity
| ||
Zulu | 612 | 99.0 |
Other | 6 | 1.0 |
Religious affiliation
| ||
African/traditional | 58 | 9.4 |
Christian (Protestant churches) | 88 | 14.2 |
Christian (Catholic) | 40 | 6.5 |
Apostolic | 57 | 9.2 |
Zion Christian Church | 167 | 27.0 |
Other | 102 | 16.5 |
No religion | 106 | 17.2 |
Residence
| ||
Rural village | 285 | 46.3 |
Informal settlements (slums) | 30 | 4.9 |
Urban/metropolitan areas | 47 | 7.6 |
Township | 150 | 24.4 |
Farm | 104 | 16.9 |
Employment situation
| ||
Housewife, home maker | 86 | 14.1 |
Unemployed | 383 | 63.0 |
Employed | 117 | 19.2 |
Pensioner, student, disabled | 22 | 3.6 |
Main source of household income
| ||
Formal salary | 182 | 29.4 |
Contribution by adult members | 115 | 18.6 |
Government grant | 138 | 22.3 |
Grants/donations by private welfare organizations | 87 | 14.1 |
No income (other than social grant) | 45 | 7.3 |
Other | 51 | 8.3 |
Health information
Variable | N = 618 | % |
---|---|---|
Time since HIV diagnosis | ||
≤ 1 year (2007/8) | 454 | 75.2 |
1–2 years (2006) | 61 | 10.1 |
> 2–3 years (2005) | 30 | 5.0 |
> 3 years (2004–1995) | 59 | 9.8 |
CD4 count (cells/uL)
| ||
1–49 | 135 | 22.7 |
50–99 | 145 | 24.4 |
100–149 | 128 | 21.5 |
150–199 | 150 | 25.3 |
200 + | 36 | 6.1 |
Number of HIV symptoms (range 0–55) | Median = 5.00 | Interquartile range = 12.00 |
HIV disease & HIV treatment related knowledge (better informed than most) | 509 | 82.9 |
Information involvement score
| ||
4.0 | 345 | 56.7 |
3.0–3.9 | 255 | 41.9 |
< 3.0 | 9 | 1.5 |
Degree of trust in medical provider score
| ||
100 | 380 | 62.1 |
75–99 | 207 | 33.8 |
0–74 | 25 | 4.1 |
Discrimination by health care provider
| 17 | 2.8 |
Decision involvement score
| ||
4.0 | 281 | 46.8 |
3.0–3.9 | 300 | 49.9 |
< 3.0 | 20 | 3.3 |
Use duration in weeks | Cost in Rand/month | Health care provider aware of use | |||
---|---|---|---|---|---|
n | % | M (SD) [range] | M (SD) [range] | n (%) | |
Total TCAM use
a
| 317 | 51.3 | |||
1. Herbal therapies
| 183 | 29.6 | |||
1a. Herbal therapies | 177 | 28.6 | 12.1 (9.0) [1–48] | 128 (189) [0–1000] | 18 (10.2) |
1b. Cannabis | 23 | 3.7 | 38.1 (37.5) [1–140] | 37.3 (90.5) [0–400] | 0 |
2. Religious healing
| 217 | 35.1 | |||
2a. Spiritual practices or prayer | 208 | 33.2 | 18.3 (10.1) [1–48] | 0 | 69 (39.2) |
2b. Faith healing methods | 78 | 12.4 | 9.7 (9.5) [1–42] | 24.4 (109.0) [0–500] | 9 (18.4) |
3. Physical/body-mind therapy
| 47 | 7.5 | |||
3a. Exercise | 29 | 4.6 | 12.6 (9.2) [1–28] | 1.1 (3.3) [0–10] | 8 (30.8) |
3b. Massage | 7 | 1.1 | 8.5 (10.9) [1–24] | 10.0 (17.3) [0–30] | |
3c. Therapeutic touch | 6 | 1.0 | 10.0 (9.6) [2–24] | 0 | |
3d. Meditation | 5 | 0.8 | 24.0 [24-24] | 0 | |
4. Micronutrients (vitamins, minerals & multivitamin)
| 266 | 42.9 | 16.5 (9.3) [1–48] | 7.2 (69.1) [0–800] | 227 (85.3) |
5. Over-the-counter drugs
| 77 | 12.5 | 5.1 (6.4) [1–21] | 4.3 (13.2) [1–99] | 7 (10.9) |
Univariate analyses | Multivariate analyses | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Herb use | TCAM use | Herb use | TCAM use | |||||||
% | OR (95% CI) | P | % | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | |
Sex
| ||||||||||
Male (n = 180) | 29.9 | 1.00 (reference) | 42.9 | 1.00 (ref) | 1.00 (ref) | |||||
Female (n = 438) | 29.3 | 0.97 (0.66–1.42) | .86 | 54.8 | 1.61 (1.13–2.30) | .008 | 1.23 (0.63–2.61) | .501 | ||
Age in years
| 1.00 (0.98–1.02) | .89 | 0.99 (0.97–1.01) | .25 | ||||||
Educational level
| ||||||||||
None (n = 42) | 21.4 | 1.00 (ref) | 45.2 | 1.00 (ref) | 1.00 (ref) | |||||
Primary (n = 446) | 28.9 | 1.49 (0.69–3.21) | .305 | 48.4 | 1.14 (0.60–2.15) | .692 | 0.99 (0.33–3.03) | .996 | ||
Secondary/postsecondary (n = 126) | 35.7 | 2.04 (0.90–4.64) | .090 | 65.1 | 2.26 (1.11–4.59) | .025 | 2.62 (0.77–8.87) | .122 | ||
Residence
| ||||||||||
Urban (n = 227) | 16.3 | 1.00 (ref) | 40.5 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | ||||
Rural (n = 388) | 37.6 | 3.00 (2.06–4.66) | .000 | 58.0 | 2.03 (1.45–2.83) | .000 | 1.53 (0.84–2.79) | .1.64 | 1.56 (0.84–1.99) | .157 |
Religion
| ||||||||||
Christian (main stream) (n = 128) | 21.1 | 1.00 (ref) | 41.4 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | ||||
Charismatic (n = 230) | 27.0 | 1.38 (0.83–2.31) | .220 | 53.5 | 1.63 (1.05–2.52) | .029 | 0.88 (0.44–1.79) | .726 | 1.23 (0.62–2.46) | .597 |
No religion (n = 106) | 42.5 | 2.76 (1.56–4.90) | .001 | 52.8 | 1.59 (0.94–2.66) | .082 | 1.27 (0.53–3.03) | .588 | 1.15 (0.55–1.88) | .224 |
African/traditional (n = 58) | 29.3 | 1.55 (0.77–3.15) | .224 | 32.8 | 0.69 (0.36–1.32) | .263 | 1.30 (0.50–3.25) | .594 | 0.35 (0.12–1.07) | .66 |
Enough money to meet needs
| ||||||||||
Not at all (n = 294) | 43.0 | 1.00 (ref) | 63.2 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | ||||
A little (= 170) | 19.4 | 0.32 (0.21–0.50) | .000 | 48.2 | 0.54 (0.37–0.80) | .002 | 0.53 (0.26–1.09) | .083 | 1.37 (0.76–2.45) | .293 |
Moderately/mostly/completely (n = 140) | 14.0 | 0.22 (0.13–0.36) | .000 | 30.7 | 0.26 (0.17–0.39) | .000 | 0.69 (0.29–1.65) | .404 | 1.14 (0.60–2.17) | .686 |
Main source of household income
| ||||||||||
Formal salary (n = 182) | 29.1 | 1.00 (ref) | 58.2 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | ||||
Contribution by family members (n = 115) | 15.7 | 0.45 (0.25–0.82) | .009 | 25.2 | 0.24 (0.15–0.40) | .000 | 0.61 (0.29–1.31) | .207 | 0.32 (0.14–0.70) | .005 |
Government grant (n = 138) | 39.9 | 1.61 (1.01–2.57) | .045 | 58.0 | 0.99 (0.63–1.55) | .961 | 1.62 (0.82–3.10) | .164 | 0.89 (0.43–1.47) | .745 |
Grants/donations by private welfare (n = 87) | 21.8 | 0.68 (0.37–1.24) | .208 | 44.8 | 0.58 (0.35–0.98) | .040 | 0.50 (0.20–1.24) | .135 | 0.77 (0.19–0.84) | .578 |
No income (other than social grant) (n = 44) | 54.5 | 2.92 (1.49–5.37) | .002 | 88.6 | 5.59 (2.11–14.85) | .001 | 0.24 (0.02–3.72) | .309 | 1.45 (0.21–9.88) | .706 |
Being on a disability grant (chronic illness including AIDS) (n = 128)
| ||||||||||
No | 16.1 | 1.00 (ref) | 27.6 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | ||||
Yes | 32.0 | 2.46 (1.54–3.93) | .000 | 72.7 | 6.98 (4.43–10.99) | .000 | 3.42 (1.65–7.11) | .001 | 7.85 (3.38–18.25) | .000 |
Having a health insurance
| ||||||||||
Yes (n = 64) | 28.1 | 1.00 (ref) | 40.6 | 1.00 (ref) | ||||||
No (n = 548) | 30.0 | 1.09 (0.61–1.94) | .76 | 52.8 | 1.64 (0.97–2.77) | .066 | ||||
CD4 count
| 1.00 (0.99–1.00) | .39 | 1.00 (1.00–1.01) | .049 | 1.57 (0.70–3.55) | .275 | ||||
Time since HIV diagnosis
| ||||||||||
≤ 1 year (n = 460) | 28.9 | 1.00 (ref) | 50.1 | 1.00 (ref) | ||||||
> 1 and more years (n = 151) | 28.7 | 1.01 (0.67–1.52) | .95 | 52.0 | 0.93 (0.64–1.34) | .69 | ||||
Number of clinic visits in past 6 months
| ||||||||||
Never or once (n = 116) | 50.9 | 1.00 (ref) | 69.0 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | ||||
Twice (n = 147) | 21.1 | 0.26 (0.15–0.44) | .000 | 32.0 | 0.21 | .000 | 0.64 (0.26–1.61) | .159 | 0.66 (0.23–1.89) | .443. |
Trice or more (n = 348) | 25.6 | 0.51 (0.33–0.80) | .000 | 53.2 | 0.51 | .003 | 0.51 (0.23–1.12) | .047 | 0.97 (0.39–2.42) | 951 |
Number of HIV symptoms
| 1.00 (0.99–1.02) | .64 | 1.03 (1.01–1.05) | .001 | 2.26 (1.28–3.99) | .005 | ||||
Nagelkerke R Square | .19 | .44 |
Health beliefs
Domain | Variable | Median | Interquartile range |
---|---|---|---|
Perceived benefits (Median = 2.50, Interquartile range = 1.00) | Adherence to TCAM HIV treatment can prolong my life | 4.00a
| 2 |
Adherence to TCAM HIV treatment can decrease the chances of getting worse | 4.00 | 1 | |
Perceived barriers (Median = 3.00, Interquartile range = 1.50) | Dealing with TCAM HIV treatment side effects is stressful | 3.00 | 2 |
TCAM HIV treatment cause annoying side effects | 3.00 | 2 | |
Taking TCAM HIV treatment interferes a great deal with normal activities | 3.00 | 2 | |
Taking TCAM HIV treatment costs a lot | 2.00 | 3 | |
Perceived severity (Median = 2.75, Interquartile range = 0.75) | My current infection with HIV will lead to serious long-term health problems (reverse scored) | 3.00 | 2 |
I will become very sick as a result of my infection with HIV (reverse scored) | 3.00 | 1 | |
Compared to other illnesses, HIV infection is not serious | 3.00 | 2 | |
Whenever I get sick it seems to be serious (reverse scored) | 2.00 | 2 |