Traditional Health Practices in HIV Management: Perceptions of Patients, Providers, and Traditional Healers in Durban, South Africa 公开

Appelbaum, Hannah Rose (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/xs55mc691?locale=zh
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Abstract

Local cultural norms and Western medicine (WM) can collide for people living
with HIV (PLHIV) in the era of antiretroviral therapy (ART). This situation can be
observed in South Africa's province of KwaZulu-Natal (KZN), where patients receiving
ART-most of whom are of Zulu culture-are often discouraged from consulting
Traditional African Medicine (TAM) by their WM providers out of concern for harmful
drug interactions with ART. The aim of this study is to understand the current
intersection of TAM and WM by exploring the beliefs and perceptions of health care
providers, PLHIV and traditional healers, for the ultimate purpose of providing a safe and
effective standard of care for individuals balancing both approaches. In-depth interviews
(IDIs) were conducted with five WM practitioners (doctors, nurses, counselors) and six
patients receiving ART from Sinikithemba Clinic (McCord Hospital, Durban). Three
focus group discussions (FGDs) were conducted with traditional healers and one with
PLHIV receiving ART. Interviews with patients and traditional healers were conducted
outside of McCord Hospital, in Zulu, and by local Zulu researchers with no affiliation to
McCord. Results show that there is a complex intersection of beliefs towards the
concurrent use of TAM and ART amongst PLHIV. Both health care providers and
patients possess implicit knowledge regarding TAM and explicit awareness and
knowledge regarding ART for HIV management. Further, TAM and ART were
perceived to serve distinct purposes among patients in this study population, indicating in
particular that TAM use is not necessarily a departure from ART, nor viewed as an
alternative treatment, nor always taken as medication (ingested or inhaled). Sometimes
TAM use means receiving counseling from a traditional healer, or having the traditional
healer consult with ancestors to determine the cause of illness. Visions of a collaborative
system of healthcare delivery differed between Western health care providers and
traditional medical providers, particularly as they relate to HIV treatment and care.
Future research should explore ways to create a dialogue among stakeholders for the
purposes of education, understanding, collaboration, and mutual respect in this realm.
Large-scale research is needed to further understand the use of TAM in this context.


Table of Contents



Table of Contents

I. Introduction……………………………1
a. Definition of Terms …………......7

II. Review of Literature..…………..8

III. Project Content
a. Methods…………………………......22
b. Results………………………………….39

IV. Discussion, Conclusions and Recommendations …………59

V. References……………………………72

VI. Appendices
a. Appendix A - Patient FGD Guide…..i
b. Appendix B - Patient IDI Guide…….v
c. Appendix C - Provider IDI Guide…..ix
d. Appendix D - TAM Practitioner Guide……xiii
e. Appendix E - Informational sheet provided
to patients on behalf of McCord Hospital…xvii




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