title: Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation.
abstract: OBJECTIVE
  To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)-infected participants of the Women's Interagency HIV Study.
  
  
  METHODS
  Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non-CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. MAIN OUTCOME AND EXPOSURES: Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period.
  
  
  RESULTS
  One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non-CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non-CAM users.
  
  
  CONCLUSIONS
  Female CAM users initiated HAART regimens earlier than non-CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression.
authors.affiliation: Georgetown University Medical Center, Washington, DC, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Merenstein
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Michael F
authors.initials: MF
authors.lastname: Schneider
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Goparaju
authors.forename: Kathleen
authors.initials: K
authors.lastname: Weber
authors.forename: Anjali
authors.initials: A
authors.lastname: Sharma
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Levine
authors.forename: Gerald B
authors.initials: GB
authors.lastname: Sharp
authors.forename: Monica
authors.initials: M
authors.lastname: Gandhi
authors.forename: Chenglong
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001294:Attitude to Health; D000529:Complementary Therapies / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013997:Time Factors; D016387:Women's Health
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