Open AccessReduced Adherence to Antiretroviral Therapy Among HIV-Infected Tanzanians Seeking Cure From the Loliondo Healer
Author(s) -
Nathan M. Thielman,
Jan Ostermann,
Kathryn Whetten,
Rachel Whetten,
Dafrosa Itemba,
Venance P. Maro,
Brian W. Pence,
Elizabeth Reddy
Publication year - 2014
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/01.qai.0000437619.23031.83
Subject(s) - medicine , odds ratio , confidence interval , tanzania , prospective cohort study , antiretroviral therapy , human immunodeficiency virus (hiv) , logistic regression , cohort , cohort study , immunology , viral load , environmental science , environmental planning
: The predictors for seeking alternative therapies for HIV-infection in sub-Saharan Africa are unknown. Among a prospective cohort of 442 HIV-infected patients in Moshi, Tanzania, 249 (56%) sought cure from a newly popularized religious healer in Loliondo (450 km away), and their adherence to antiretrovirals (ARVs) dropped precipitously (odds ratio = 0.20, 95% confidence interval: 0.09 to 0.44, P < 0.001) after the visit. Compared with those not attending Loliondo, attendees were more likely to have been diagnosed with HIV more remotely (3.8 vs. 3.0 years before, P < 0.001), have taken ARVs longer (3.4 vs. 2.5 years, P < 0.001), have higher median CD4 lymphocyte counts (429 vs. 354 cells/mm, P < 0.001), be wealthier (wealth index: 10.9 vs. 8.8, P = 0.034), and receive care at the private versus the public hospital (P = 0.012). In multivariable logistic regression, only years since the start of ARVs remained significant (odds ratio = 1.49, 95% confidence interval: 1.23 to 1.80). Treatment fatigue may play a role in the lure of alternative healers.