THE INTEGRATION OF ALTERNATIVE TREATMENT MODALITIES IN HIV-INFECTION - THE PATIENTS PERSPECTIVE

The relationship between professionals representing conventional treatment (CT) and professionals representing non-conventional therapies (alternative therapy (AT) and/or psychotherapy (PT)) is usually characterized by mutual scepticism and mistrust, the overriding fear being that either side will evoke unjustified hopes or will provide false treatment. We investigated whether patients with HIV infection had unrealistic hopes in non-conventional treatment (non-CT), to what extent they use non-CT, and whether perceived benefit and harm differ between the two modes of treatment. We examined a sample of 100 patients with documented HIV-infection in the out-patient department using a self-developed questionnaire, the Hospital Anxiety and Depression Scale (HAD) and data concerning the HIV status. Fifty-six patients used AT and/or PT. Severity of HIV disease did not differ between users and non-users of non-CT. The most important reasons for the use of AT were 'strengthening the body and resistance; supplementing conventional therapy'. Users of non-CT rated the competence of CT lower than non-users in solving medical problems (VAS-scores 0-100: 65.5+/-17.6 vs 76.3+/-17.7; p = 0.003) and in solving emotional problems (VAS scores 0-100: 35.8+/-21.2 vs 48.2+/-28.9; p = 0.02). Users of non-CT were significantly more anxious 8.4+/-4.8 vs 5.5+/-4.6; p = 0.004) and more depressive (5.7+/-4.5 vs 3.7+/-4.5; p = 0.03) than non-users. Expectations and hopes did not differ between users of AT and non-users: main hopes were a delay of disease progression (76% vs 71%) and an alleviation of symptoms (78% vs 66%). Thus, more than half of HIV-infected patients use non-CT and perceive considerable benefit i.e. a substantial improvement in the quality of life. Non-CT does not evoke unrealistic hopes, it is sought by patients who are needier in psychological, not in clinical terms.