title: Complementary and Alternative Medicine Use for HIV Management in the State of Florida: Medical Monitoring Project.
abstract: OBJECTIVE
  The aims of this study were to describe complementary and alternative medicine (CAM) use and to assess the relationships between CAM use and antiretroviral therapy (ART) adherence and human immunodeficiency virus (HIV) RNA viral load suppression among a sample of persons living with HIV (PLWH) engaged in care in the state of Florida.
  
  
  METHODS
  The Florida Medical Monitoring Project (n = 803) collected repeated cross-sectional data for surveillance of clinical outcomes among PLWH from 2009 to 2010. Past-year CAM use specifically for the management of HIV was measured via self-report. Logistic regression models were conducted to assess the effect of CAM use on ART adherence and viral load suppression, controlling for demographic and clinical factors using backwards stepwise deletion of factors with a p-value of >0.25.
  
  
  RESULTS
  CAM use was reported in 53.3% (n = 428). In bivariate analysis, CAM use was the highest among those 40-49 years of age (61%; p < 0.05), males (56%; p < 0.01), whites (61%; p = 0.001), and those educated beyond high school (59%; p < 0.05). Among those using CAM, 63% and 37% reported one and two or more CAM modalities, respectively. CAM modalities included biologically based therapies (89%), mind-body medicine/manipulative body-based therapies (30%), spiritual healing (23%), energy therapies (6%), and whole medical systems (6%). In multivariable analyses, any CAM use and number of CAM methods used were not associated with ART adherence. Any CAM use was not associated with detectable viral load (adjusted odds ratio [aOR] 0.81; 95% confidence interval [CI] 0.58-1.12; p = 0.20). Those using two or more methods had significantly decreased risk for detectable viral load (aOR 0.60; 95% CI 0.39-0.92; p < 0.02).
  
  
  CONCLUSIONS
  CAM use was not associated with negative effects on ART adherence. CAM users were less likely to have detectable viral load compared with non-users. Future research should focus on CAM use among PLWH not engaged in HIV care and the longitudinal patterns of CAM use and possible effects of long-term health outcomes.
authors.affiliation: 1 Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Kelso-Chichetto
authors.affiliation: 1 Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL.
authors.forename: Chukwuemeka N
authors.initials: CN
authors.lastname: Okafor
authors.affiliation: 2 Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University , Tallahassee, FL.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Harman
authors.affiliation: 3 Social and Behavioral Sciences Program, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL.
authors.forename: Shantrel S
authors.initials: SS
authors.lastname: Canidate
authors.affiliation: 4 Department of Family, Community, and Health System Science, College of Nursing, University of Florida , Gainesville, FL.
authors.forename: Christa L
authors.initials: CL
authors.lastname: Cook
authors.affiliation: 1 Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000453:epidemiology* / Q000628:therapy*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D019562:Viral Load / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: CAM; HIV; adherence