Complementary Therapy Use in HIV/AIDS
Mulkins, Andrea, Morse, Janice M., Best, Allan, Canadian Journal of Public Health
Objective: To examine the social psychological aspects of complementary therapy use in HIV/AIDS health care and to identify what happens in a person's illness management process when incorporated into their care for HIV-related symptoms.
Methods: Grounded theory research method guided sampling, data collection and analysis with 21 males at various AIDS service organizations.
Findings: A grounded theory model Finding a Way to Live was developed. Participants experienced a six-stage process whereby the HIV served as a precondition for a profound self-transformation; a commitment to and rediscovery of the meaning of life.
Complementary therapies, referred to as 'tools' by the participants, were cited as an integral part of how people living with HIV found wellness within their illness. The type of therapy, meanings attached to them, intention for and frequency of use corresponded to where individuals were in the six-stage process. As participants began to experience personal growth, the nature of the therapies shifted from those being highly tangible and focusing on the physical self to those facilitating inner awareness, such as meditation.
Conclusions: The process of integration was a complex, ongoing process wherein complementary therapies were an integral part of facilitating learning, self-discovery and ultimately, healing.
Due to the unpredictable and chronic course, the severity of the symptoms and the debilitating side-effects of HIV/AIDS, as well as the limited efficacy of experimental treatments, those with HIV/AIDS work proactively to optimize their health during the illness. As a consequence, many with HIV/AIDS seek alternative modes of healing to supplement medical treatment and optimize or maintain health as long as possible.
The use of complementary therapies (CTs) is becoming increasingly widespread1,2 and includes such therapies as acupuncture, massage, meditation, yoga, homeopathy, herbal nutrition, and selfhelp groups.3 While the issue of efficacy of such therapies is stimulating research, such inquiry is beyond the scope of this article. Rather, we are interested in the process of seeking CTs, the reasons for integrating complementary therapy (CT) and the role that they play in the lives of those with HIV/AIDS, and the changing patterns of their use over the course of the disease.
Grounded theory is used when little is known about the topic; the purpose of the research is to both explore and create midrange theory; and the phenomena of interest is a process, changing over time.4,5 Grounded theory provides us with a lens into the phenomena from the perspective of the participants, yet at the same time enables us, through theoretical development, to obtain results that are applicable beyond the initial sample and useful to practice.
Setting and sample
The sample consisted of 21 gay, Caucasian males who had been experiencing symptoms of HIV infection and identified themselves as using CT for HIV-related concerns. The initial sample was obtained from various AIDS Service Organizations in a Canadian city with a population of 2 million and was purposefully solicited to meet the theoretical goal of the study. Participant characteristics included: age, 22-59 years; education, high school completion to some post-secondary or trade school preparation; average annual income, $12,500-$25,000. Most participants lived on some form of disability insurance or social assistance. Religious affiliations for 16 participants were varied. Time from diagnosis ranged from 2 months to 14 years, and, at the time of the interviews, participants reported being at various stages of the disease, many experiencing HIV-related symptoms.
Permissions were obtained from University ethics committees and from the recruitment sites. Informed consent was obtained from each participant prior to commencement of the interview.
Participants were interviewed individually in counseling rooms at various agencies throughout the period May to October 2000. …