Monday, November 3, 2003

This presentation is part of : Lipodystrophic Symptomatology, Medication Adherence, Depression, CAM Therapies, and Health-Related Quality of Life in Persons with HIV Disease

Correlates of Lipodystrophic Symptoms and Complementary Therapies

Kenn M. Kirksey, RN, PhD, APRN, BC1, Inge B. Corless, RN, PhD, FAAN2, Patrice Kenneally Nicholas, RN, DNSc, MPH, ANP2, Jeanne Kemppainen, RN, PhD, CNS3, and Margaret E. Mueller, RN, MSN4. (1) Department of Nursing, California State University, Fresno, Fresno, CA, USA, (2) Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA, (3) School of Nursing, The University of North Carolina at Wilmington, Wilmington, NC, USA, (4) Department of Nursing, Veteran's Administration Healthcare System/CSU Fresno, Fresno, CA, USA

Persons living with HIV/AIDS are challenged to manage disease and treatment- related symptoms with provider-directed or client-initiated self-care strategies. The use of complementary and alternative medicine in HIV care has increased significantly in recent years. Objective: The primary objective of this study was to identify CAM therapies used as self-care strategies by persons living with HIV/AIDS to manage lipodystrophy-associated symptoms. Design: Using a cross-sectional, descriptive design, data were obtained regarding types, frequencies, perceived effectiveness and sources of information about the CAM therapies used to self-manage HIV disease and treatment-related symptoms. Population, Sample, Setting: Data were collected from three community-based facilities around the USA; California (n=93), Massachusetts (n=50) and Texas (n=22), for a total of 165 subjects. Variables: This paper explores the correlation of CAM therapies and lipodystrophic symptomatology. Methods: The study sample completed an assessment packet that included sociodemographic data, nine investigator-initiated, open-ended questions designed to explore lipodystrophic manifestations and self-care measures used to manage HIV-related symptoms. Findings: The sample included 165 HIV-infected persons between the ages of 21 and 62 years, with a mean age of 42.12 (+ 8.29). The participants were comprised of 125 (75.8%) males and 40 (24.2%) females. Approximately 39% were Caucasian, 30.9% African American, and 26.7% Hispanic. Formal education ranged from 3-20 years, with a mean of 12.20 (+ 2.45) years. The mean CD4+ was 420.66 cells/mm3 (+ 311.07), and the mean viral load was 45951 (+ 99558). Clients used a large number of CAM therapies, with prayer, spirituality, and meditation being among the most frequently reported. Conclusions: Lipodystrophy is a pervasive problem and the sample reported a number of CAM therapies as self-initiated care strategies. Implications: There is clear evidence in the literature about widespread use of these modalities in HIV-infected persons, but studies to explore reasons for use and efficacy are still needed.

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