title: No association found between traditional healer use and delayed antiretroviral initiation in rural Uganda.
abstract: Traditional healer and/or spiritual counselor (TH/SC) use has been associated with delays in HIV testing. We examined HIV-infected individuals in southwestern Uganda to test the hypothesis that TH/SC use was also associated with lower CD4 counts at antiretroviral therapy (ART) initiation. Approximately 450 individuals initiating ART through an HIV/AIDS clinic at the Mbarara University of Science and Technology (MUST) were recruited to participate. Patients were predominantly female, ranged in age from 18 to 75, and had a median CD4 count of 130. TH/SC use was not associated with lower CD4 cell count, but age and quality-of-life physical health summary score were associated with CD4 cell count at initiation while asset index was negatively associated with CD4 count at ART initiation. These findings suggest that TH/SC use does not delay initiation of ART.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. rhorwitz@partners.org
authors.forename: Russell H
authors.initials: RH
authors.lastname: Horwitz
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Tsai
authors.forename: Samuel
authors.initials: S
authors.lastname: Maling
authors.forename: Francis
authors.initials: F
authors.lastname: Bajunirwe
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Haberer
authors.forename: Nneka
authors.initials: N
authors.lastname: Emenyonu
authors.forename: Conrad
authors.initials: C
authors.lastname: Muzoora
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hunt
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Martin
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016488:Medicine, African Traditional / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014454:Uganda; D019562:Viral Load; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents