Concurrent use of traditional medicine and ART: Perspectives of patients, providers and traditional healers in Durban, South Africa

Abstract

The concurrent use of traditional African medicine (TAM) and allopathic medicine is not well understood for people living with HIV (PLHIV) in the era of antiretroviral therapy (ART). This cross-sectional, qualitative study examines perceptions of the concurrent use of TAM and ART among: (1) patients receiving ART at the Sinikithemba HIV Clinic of McCord Hospital, in Durban, South Africa; (2) allopathic medical providers (doctors, nurses and HIV counsellors) from Sinikithemba; and (3) local traditional healers. Data were collected through in-depth interviews and focus group discussions with 26 participants between July and October, 2011. Patients in this study did not view TAM as an alternative to ART; rather, results show that patients employ TAM and ART for distinctly different needs. More research is needed to further understand the relationship between traditional and allopathic approaches to health care in South Africa, to improve cultural relevance in the provision and delivery of care for PLHIV, and to pragmatically address the concerns of health care providers and public health officials managing this intersection in South Africa and elsewhere.

Keywords: HIV/AIDS; South Africa; antiretroviral therapy (ART); qualitative research; traditional African medicine.

Figure 1

Patients’ reasons for TAM use at different stages of ART Note: *indicates patient failing ART regimen (vL>1000 copies/mL) after 5+ months of treatment. P1, P2, etc. each represent a distinct patient who reported ever using TAM in his or her lifetime. P1 indicates that she used TAM for HIV and non-HIV related reasons at different stages.