Alternative medicine use in HIV-positive men and women: demographics, utilization patterns and health status

Between 1995 and 1997, 1,675 HIV-positive men and women using complementary and alternative medicine (CAM) were enrolled into the Bastyr University AI DS Research Center's Alternative Medicine Care Outcomes in AIDS (AMCOA) stu dy. Funded by the National Institutes of Health (NIH) Office of Alternative Medicine (OAM) and National Institute of Allergy and Infectious Diseases ( NIAID), the AMCOA study collected information on participant demographics, health status and use of conventional and CAM therapies. Participants from 46 states completed a baseline questionnaire, while additional clinical inf ormation (such as CD4 count and HIV-RNA viral load) was obtained from labor atory records. AMCOA participants reported using more than 1,600 different types of CAM therapies (1,210 CAM substances, 282 CAM therapeutic activitie s and 119 CAM provider types) for treating HIV/AIDS. Approximately two-thir ds (63% n = 1,054) of the AMCOA cohort reported using antiretroviral drug t herapy (ART) during the six-months previous to completing the baseline ques tionnaire, while 37% (n = 621) indicated they were not using ART. Of those not using ART, 104 subjects reported never having used any conventional med ications for their HIV and 12 subjects used only non-prescription diarrhoea medications. The most frequently reported CAM substances were vitamin C (6 3%), multiple vitamin and mineral supplements (54%), vitamin E (53%) and ga rlic (53%). CAM provider types most commonly consulted by the AMCOA cohort were massage therapists (49%), acupuncturists (45%), nutritionists (37%) an d psychotherapists (35%). CAM activities most commonly used were aerobic ex ercise (63%), prayer (58%), massage (53%) and meditation (46%). The choice of CAM therapies among the AMCOA cohort does not appear to be solely based on scientific evidence of efficacy of individual therapies. The majority of AMCOA subjects could be characterized as using integrated medicine, since an overwhelming proportion of the cohort consult with both conventional and CAM providers and use both conventional and CAM medications, yet few subje cts reported that their conventional and CAM providers work as a team. Thes e data and this cohort set the stage for conducting studies of health statu s changes associated with specific CAM therapies.