Complementary and alternative medicine use among African-Americans with AIDS Open Access

Owen-Smith, Ashli Anthony (2009)

Permanent URL: https://etd.library.emory.edu/concern/etds/nz8060259?locale=en
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Abstract


Abstract
Complementary and alternative medicine use among African-Americans with AIDS
By Ashli A. Owen-Smith
The use of complementary and alternative medicine (CAM), a group of health
care practices that are not considered part of conventional medicine, has
increased in recent years, particularly among individuals with Human Immune
Deficiency Virus (HIV). Assessing the prevalence and predictors of CAM use among
HIV+ populations is important as some CAM therapies may adversely affect the efficacy
of conventional HIV medications. Unfortunately, CAM use is not comprehensively or
systematically assessed among HIV+ populations. Therefore, the aims of the present
study were: (1) evaluate the quality of the current instruments employed in studies
assessing CAM use among HIV+ populations, (2) develop and evaluate a new measure of
CAM use, and (3) use this refined measure to investigate the prevalence and predictors of
CAM use. First, a systematic review was conducted to evaluate the quality of studies that
used CAM instruments among HIV+ study populations. Results indicate that
approximately 20% of studies assessed the reliability and 3% assessed the validity of the
CAM instrument employed. This information was the impetus for the next two data
collection phases with a HIV+ study population. In Phase 1, qualitative data were used
to refine an already-existing CAM measure. In Phase 2, this refined instrument was
implemented with a larger sample. The resulting data were then analyzed to evaluate the
psychometric properties of the instrument and to investigate the patterns and predictors of
CAM use. Results indicate that the revised CAM instrument had adequate internal
consistency (=0.67) and test-retest reliability (r=0.79, p<0.01). The majority of

participants (94%) reported using at least 1 type of CAM therapy in the past 12 months.
In regression models, being female, having a higher income, higher health literacy and
higher HIV viral load were associated with a greater frequency of CAM use while
stronger emotional well-being was associated with a lower frequency of CAM use, even
after controlling for other variables in the model. Findings underscore the need for more
precise assessment of CAM use among HIV+ populations and dissemination of these
research findings to HIV healthcare providers to facilitate more effective doctor-patient
dialogue about CAM use.

Table of Contents

Table of Contents

Introduction

Background and Significance 1-9

Contributions to the Field 9

The Manuscripts 9-10

References 11-15

Manuscript 1: The Assessment of Complementary and Alternative Medicine Use among Individuals with HIV: A Systematic Review and Recommendations for Future Research

Introduction 16-18

Methods 18-22

Results 22-24

Discussion 24-28

References 29-31

Figure 1 32

Table 1 33

Table 2 34-37

Table 3 38-39

Manuscript 2: The Development and Evaluation of a Complementary and Alternative Medicine Use Survey in African-Americans with Acquired Immune Deficiency Syndrome

Introduction 40-43

Methods 43-50

Results 50-54

Discussion 54-57

References 58-61

Table 1 62

Table 2 63

Table 3 64

Table 4 65

Manuscript 3: Prevalence and Predictors of Complementary and Alternative Medicine Use in African-Americans with Acquired Immune Deficiency Syndrome

Introduction 66-68

Methods 68-78

Results 78-82

Discussion 82-87

References 88-91

Table 1 92-93

Table 2 94

Table 3 95

Table 4 96

Table 5 97

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