Marseille 2007
| Abstract #485 - An Assessment of the Impact of Traditional Medicine on Quality of Life with HIV/AIDS in rural Zimbabwe | ||||
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Session: 8.1: Traditional and alternative approaches (Parallel) on Monday @ 11.00-12.30 in 5 Chaired by Jonathan Eflord, Marc Egrot Authors: Presenting Author: Dr Tonya Taylor - HIV Center for Clinical and Behavioral Studies , United States |
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| Aim: Study objectives: Zimbabwe is experiencing one of the most severe AIDS epidemics in the world, with one out of four people infected with HIV. For both palliative or pragmatic care and treatment of everyday opportunistic infections, many rely on the traditional system of health and healing, not as a substitute for western therapeutics, but as an alternative explanatory model for the diagnosis and management of sickness and disease. This study examined the use of traditional medicine in the care and treatment of people living with HIV/AIDS and how performative therapeutic rituals impact the meaning and everyday lived experience of this disease. To measure the therapeutic effect of these rituals we assessed their impact on patients quality of life (QoL) using culturally and linguistically modified HIV/AIDS-Targeted and MOS-HIV-30 QoL surveys. This paper presents an analysis of the qualitative (345 examples of the performance of healing, 400 illness narratives and 254 follow up interviews) and QoL data (800 baseline and 508 follow up surveys) that illustrate the impact of traditional medicine on the QoL with HIV/AIDS in rural Zimbabwe. | ||||
| Method / Issue: Methods: 1) Conducted an ethnographic survey of traditional medicine (with video documentation and participant observations); 2) qualitatively surveyed patients illness experience; and 3) quantitatively measured therapeutic outcomes using QoL surveys, with respect to illness severity and sociodemographic characteristics. Participants included: a cohort of 24 spirit mediums, diviners, and faith healers that specialized in the treatment of specific HIV-related opportunistic infections; and a presumptive HIV+ convenience sample of 400 patients/clients presenting with HIV-related opportunistic infections 200 recruited from traditional healers and 200 recruited form three biomedical facilities. | ||||
| Results / Comments: Results: An analysis of 345 examples of the performance of healing and 400 patients illness narratives found that the purposeful enhancement of the therapeutic process with highly charged symbols and ritualized communication transformed the lived experience of HIV infection and the cultural performance of dying. An analysis of 254 paired QoL surveys revealed that the mean scores for overall quality of life with those individuals who used traditional medicine improved significantly from baseline to follow up (49 to 60 with the HAT-QoL; 31 to 42 with the MOS-HIV) while the BCG showed minimal improvement over time (40 to 41 with the HAT-QoL; and 26 to 26 with the MOS-HIV). When reanalyzed for medical pluralism (the use of traditional and biomedicine together) we found that 68% of the participants who used both traditional and biomedicine had higher quality of life outcome measures than those who used either biomedicine or traditional healing exclusively. | ||||
| Discussion: Discussion: Given that traditional healers provide the majority of care and treatment for HIV infection in rural Zimbabwe, how they represent HIV within therapeutic consultations directly affects patients personal meanings and interpretations of the experience of HIV infection. Where there is limited access to biomedicine, traditional healing may prove not only to be the most accessible and affordable avenue for relief, but also the most culturally appropriate approach for improving the quality of life for those dying of AIDS. | ||||
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