title: Complementary and alternative medicine use and substitution for conventional therapy by HIV-infected patients.
abstract: BACKGROUND
  HIV-infected patients commonly use complementary and alternative medicine (CAM), but it is not known how often CAM is used as a complement or as a substitute for conventional HIV therapy.
  
  
  OBJECTIVE
  To evaluate the prevalence and factors associated with CAM use with potential for adverse effects and CAM substitution for conventional HIV medication.
  
  
  METHODS
  Cross-sectional survey of U.S. national probability sample of HIV-infected patients (2,466 adults) in care from December 1996 to July 1997.
  
  
  METHODS
  Any CAM use, CAM use with potential for adverse effects, and use of CAM as a substitute for conventional HIV therapy. Substitution was defined as replacement of some or all conventional HIV medications with CAM.
  
  
  RESULTS
  Fifty-three percent of patients had recently used at least one type of CAM. One quarter of patients used CAM with the potential for adverse effects, and one-third had not discussed such use with their health care provider. Patients with a greater desire for medical information and involvement in medical decision making and with a negative attitude toward antiretrovirals were more likely to use CAM. Three percent of patients substituted CAM for conventional HIV therapy. They were more likely to desire involvement in medical decision-making (odds ratio, 1.8; 95% confidence interval, 1.0-3.2) and to have a negative attitude toward antiretrovirals (odds ratio, 7.8; 95% confidence interval, 3.0-19.0).
  
  
  CONCLUSIONS
  Physicians should openly ask HIV-infected patients about CAM use to prevent adverse effects and to identify CAM substitution for conventional HIV therapy.
authors.affiliation: Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California-Los Angeles, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA. ahsiao@mednet.ucla.edu
authors.forename: An-Fu
authors.initials: AF
authors.lastname: Hsiao
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Wong
authors.forename: David E
authors.initials: DE
authors.lastname: Kanouse
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Collins
authors.forename: Honghu
authors.initials: H
authors.lastname: Liu
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Andersen
authors.forename: Allen L
authors.initials: AL
authors.lastname: Gifford
authors.forename: Allen
authors.initials: A
authors.lastname: McCutchan
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Bozzette
authors.forename: Martin F
authors.initials: MF
authors.lastname: Shapiro
authors.forename: Neil S
authors.initials: NS
authors.lastname: Wenger
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D014481:United States / Q000453:epidemiology