COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) USE IN HIV-1 POSITIVE PARTICIPANTS IN THE MULTICENTER AIDS COHORT STUDY (MACS)

LJ Standish, PhD, ND, MS, LAc, JG Kim, B Brumback, PhD, F Sanders, MBA, A Fitzpatrick, PhD, N Polissar, PhD, C Calabrese, ND, MPH

PURPOSE: To describe demographics, clinical markers and use of CAM therapies with HIV-1 seropositive gay and bisexual men in the Multicenter AIDS Cohort Study (MACS)

METHODS: Prospective data collected from HIV-1+ gay and bisexual men enrolled in the MACS cohort who completed visits 26 and 27 (fall 1996 and spring/summer 1997) and reported CAM use. The Bastyr University AIDS Research Center was allowed permission to insert a one-page supplemental survey in section 4 of the MACS questionnaire to document use with CAM therapies and providers. Data were collected from 3 of 4 MACS sites (Baltimore, Chicago and Los Angeles). Demographic (race, dob, income and education) and clinical marker data (CD4+, HIV RNA viral load, MOS-HIV/SF-36, BMI, conditions/symptoms) were provided by the Center for Analysis and Management of Multicenter AIDS Cohort Study (CAMACS). Descriptive statistics are presented by frequency, mean and median ± standard deviation.

RESULTS: 597 participants (82.8% of cohort) reported using CAM for either visits 26 and 27. Of these participants, 385 completed valid surveys for both visits. The average participant was 45 years old with 83.6% (n=480) of the matched sub-population being caucasian and over half of the cohort earning more than $30,000 a year. The majority (n=362, 62.3%) have a baccaleurate degree or equivalent. Among subjects who completed the first survey (n=597), 86.8% had used at least one form of CAM therapy within the previous 6 months. Over 48% of the population had seen a CAM provider. The most frequently used providers were massage therapists (23.1%), chiropractors (13.7%), counselors (21.9%), support groups (11.1%), and acupuncturists (10.9%). Similar use of CAM providers was reported in the matched subpopulation that completed surveys at both visit 26 and 27. CAM treatments were used by 79.9% of the population within the previous 6 months of Visit 26. Frequently used treatments included meditation (20.9%), zinc (18.8%), beta carotene (18.6%) and protein powder (13.2%). Vitamins were the most commonly used treatment, with 71.5% using vitamins A, B, C, E or a multivitamin, 18.9% listing vitamins as their only alternative treatment. In addition, over 134 treatments were added by subjects in the "Other" selection. At visit 26, garlic (n=12), ginseng (n=14), selenium (n=16), Vitamin B-12 injections (n=8), Calcium (n=9) were the most frequently mentioned 'Other' substances. Mean changes for both visits in CD4+ counts were higher in ART users with no CAM (mean=61.02 ±225.85) vs. those using CAM and ART (mean=42.53±203.75). CAM users with no ART had a negative mean change (mean=-27.08±212.84). HIV RNA viral load at visit 26 for ART users with no CAM had a median of 29,314 ± 110,069 copies/ml vs. CAM users with ART median of 43,670 ± 117,499 copies/ml.

CONCLUSION: These data from the MACS cohort concurs with other published literature that CAM use is widespread in HIV/AIDS populations.

Poster Presentation for the International Scientific Conference on Complementary, Alternative and Integrative Medicine Research, April 12-14, 2002, Boston

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