Keeping Secrets: the hush-hush use of alternative medicines in HIV-positive patients

The doctor-patient relationship can be extremely important in directing treatment and lifestyle decisions among patients, particularly those that are HIV-positive. However, there is little research out there which actually examines the way in which people perceive their personal relationship with their doctors, nor the implications this may have for the types of treatment the patients seek and receive. Recently, Social Science & Medicine published an in-depth qualitative study with HIV-positive migrants from Zimbabwe, Zambia and South Africa living in London on just this topic.

The majority of the 70 participants expressed that they had faith in their HIV clinicians and the types of medication that were prescribed to them. However, it was found that just under half of the participants also used “non-biomedical” treatments, which included herbs from traditional healers in Africa and African herbal medicines available in London. The treatments were reported to be used for boosting immunity, increasing sex drive, and as a nutritional supplement.
 
Unfortunately, only a few participants actually talked to their clinicians about the non-biomedical treatments that they were using. The participants stated that this was sometimes because doctors simply never asked, but also because they believed that the use of less reputable treatments would be looked down upon. In an effort to avoid embarrassment, the participants reported keeping their personal practices to themselves.
 
Some patients did not attempt to ask questions because they felt their doctors had “more important things to do” than address their personal concerns. In instances where the patients actually asked questions about alternative treatments, many of the participants reported that their doctors used complex medical jargon which was difficult to decode.  
 
Many of the participants believed that their non-biomedical treatments were irrelevant, as they did not treat their sickness but were believed to affect elements of their well-being, like sex drive. However, the study notes that there is always the possibility that the active ingredients in non-biomedical treatments will react with the antiretroviral medications, perhaps negatively, which highlights the importance of doctor-patient communication.
 
The study concluded that doctors need to more openly acknowledge the immense amount of treatments that exist outside of biomedical science, and be aware of their potential physiological and psychological benefits to their users. The researchers also call for doctors to more proactively seek to communicate with their patients about their use of such treatments without fear of criticism, to prevent any negative reactions associated with the combination of medications and promote a more open relationship.
 
The use of alternative medicine and traditional remedies is just one example of the interesting and important aspects of our cultures, backgrounds, beliefs and religions that make us unique. Acknowledging and respecting all of our differences is extremely important and a huge trust-booster in the health care system.