Concurrent use of Antiretroviral and African traditional medicines amongst  people living with HIV/AIDS (PLWA) in the eThekwini Metropolitan  area of KwaZulu Natal.

Mncengeli Sibanda,Manimbulu Nlooto M, Panjasaram Naidoo
Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu Natal (Westville Campus),
Private Bag X54001, Durban 4000. South Africa.

Abstract
Background:People living with HIV/AIDS (PLWA) often use African Traditional Medicines (ATM) either alone or in combination with Western medicines including Antiretrovirals (ARV).

Objective:To explore the prevalence of concurrent Antiretrovirals (ARV) and African Traditional medicines (ATM) use and  determine the effects of any concurrent use on the CD4+ Lymphocyte count and Viral Load (VL) of PLWA in the eThekwini  Metropolitan area.

Methods: A descriptive and exploratory study was carried out on 360 patients. Information was gathered on patients socioeconomic characteristics, ATM usage, outcome measures of HIV disease progression (CD4+ Count, VL). The data was analysed using descriptive statistics, univariate and multivariate analyses.

Results: 4.98% (14/281) of the patients used ATM and ARV concurrently during the study period. Over 65% (185/281) reported ATM use before diagnosis with HIV whilst 77.6% (218/281) reported previous ATM use after their HIV diagnosis but  before initiation with ARV. Place of residence (p=0.004), age (p<0.001) and education level (P=0.041) were found to be significantly and positively correlated with ATM use. There were no statistically significant changes in mean plasma CD4+ Count and  inconclusive effects on VL during the period of the study in the group taking ARV alone when compared with the group using ARV and ATM concomitantly.

Conclusion: Concurrent ARV and ATM use is quite low (4.98%) when compared to ATM use before HIV diagnosis and after  HIV diagnosis but before initiation with ARV. This may point to efficient pre-counselling efforts before ARV initiation by health  care professionals. This study also demonstrated that there were no significant differences in the CD4+ and inconclusive effects
on VL, between patients taking both ARV and ATM concomitantly and those using ARV alone.

Keywords:African traditional medicines, AIDS; ARV; complimentary medicines, Drug-Herb interactions, Herbal medicine,HIV;
Indigenous medicine, Medical Pluralism, South Africa