       Document 0004
 DOCN  M9640004
 TI    Determinants of nontraditional therapy use in patients with HIV
       infection. A prospective study.
 DT    9604
 AU    Singh N; Squier C; Sivek C; Nguyen MH; Wagener M; Yu VL; Infectious
       Diseases Section, Veterans Affairs Medical Center,; Pittsburgh, PA, USA.
 SO    Arch Intern Med. 1996 Jan 22;156(2):197-201. Unique Identifier :
       AIDSLINE MED/96136001
 AB    BACKGROUND: The popularity and use of nontraditional therapies among
       patients with human immunodeficiency virus (HIV) infection has grown
       enormously. DESIGN: A prospective, longitudinal cohort study of 56
       patients aged 23 through 68 years with HIV infection followed up at the
       HIV clinic at a university-affiliated Veterans Affairs Medical Center.
       OBJECTIVE: To assess the demographic and psychologic characteristics of
       patients who seek nontraditional remedies, and their impact on disease
       progression and mortality from HIV. METHODS: A standardized,
       self-administered questionnaire to assess the incidence and type of
       nontraditional therapies used by patients with HIV. Data on
       demographics, medical status, physical functioning (Karnofsky
       performance score), CD4 lymphocyte counts, depression (Beck Depression
       Inventory), coping (inventory of coping with illness scale),
       psychological and/or emotional stress (Profile of Mood States scores),
       and compliance with prescribed therapy were prospectively assessed on
       all patients at baseline and every 6 months. RESULTS: Thirty percent of
       patients reported using nontraditional therapies. Nontraditional therapy
       users were significantly older than patients who did not use such
       therapies (44 vs 38 years, P = .03); with 94% of patients who used
       nontraditional therapy being older than 35 years compared with 56% of
       conventional therapy users (P = .005). Alternative therapy use did not
       correlate with race, education, HIV-risk group affiliation, duration of
       HIV seropositivity, stage of HIV disease, CD4 cell count, or Karnofsky
       performance scores. Nontraditional therapy users reported greater
       community-based acquired immunodeficiency syndrome group support (P =
       .06), greater perceived social support (P = .08), and significantly
       higher recreational or street drugs use (P = .02). Depression, adaptive
       coping, and emotional stress were not different between nontraditional
       and conventional therapy users; however, nontraditional therapy users
       were significantly more assertive (P = .04). On follow-up, CD4 cell
       count, HIV disease progression, physical functioning, or mortality were
       similar between the two groups. CONCLUSIONS: Recourse to nontraditional
       therapy is common among patients with HIV. Because of the possibility of
       untoward effects and potential adverse drug interactions associated with
       nontraditional therapy, HIV care givers should be aware of its use in
       their patients and take a history of nontraditional therapy first.
       Patients who choose nontraditional remedies do so not because they are
       depressed or emotionally disturbed, but rather because they seek greater
       control of the outcome of their disease. However, no beneficial effect
       on disease progression, CD4 cell count, or mortality was observed in
       these patients when compared with patients receiving only conventional
       medical therapy.
 DE    Adaptation, Psychological  Adult  Affect  Aged  *Alternative Medicine
       Assertiveness  Hospitals, Veterans  Human  HIV Infections/*PSYCHOLOGY
       Male  Middle Age  Prospective Studies  Quality of Life  Questionnaires
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

