Complementary & Alternative Care Behavior in HIV+ Latinos in the US-Mexico (Proyecto MAC)
Funded by the National Institute of Health (NIH) National Center for Complementary & Alternative Medicine (NCCAM), R21 AT004676-01A1; PI: María Luisa Zúñiga
The goal of our community-based participatory research study is to identify the nature and extent of complementary and alternative medicine (CAM) use among HIV-positive Latinos in the United States (US)-Mexico border region. HIV-positive Latinos in the US face substantial health disparities when compared to non-Latino Whites, including delayed care entry/entering care with advanced HIV disease and they are disproportionately impacted by HIV-stigma and poor patient-provider communication. CAM use (e.g. herbal therapies, alternative healers, and spirituality/religious practices) may be implicated in disparities (e.g. low antiretroviral therapy (ARVs) adherence). The aims of this study are:
- To assess CAM-specific health care behavior, including bi-national CAM utilization from allied/alternative health personnel (e.g. pharmacists, non-Western medicine healers) among HIV-positive Latinos residing in Tijuana and San Diego.
- To assess use of CAM in the context of HIV treatment utilization and practices, including factors related to delayed entry into HIV care (e.g. HIV stigma); and utilization of and adherence to ARVs among HIV-positive Latinos residing in Tijuana or San Diego.
- To determine perceived barriers to communicating use of CAM and ARV adherence to clinicians among HIV-positive Latinos residing in Tijuana or San Diego, including satisfaction with clinician communication, concern about clinician response to reporting CAM use and perception of ARV efficacy;
- To explore provider and system barriers to culturally-effective communication about CAM and ARV adherence in HIV+ Latinos.
This is a mixed-methods study that will use both qualitative and quantitative methods to meet study aims. Focus groups are currently underway to inform development of a quantitative survey that will be conducted with HIV-positive Latinos recruited in Tijuana and San Diego. In Aims 1-3, we will conduct the quantitative, interviewer-administered survey with 200 HIV+ Latinos (100 from each side of the border). In Aim 4 we will assess clinician perspectives on CAM through qualitative interviews with 20 HIV clinicians on both sides of the border. This study will reduce health disparities in US Latinos by improving culturally-effective clinician communication and will lead to interventions to increase adherence to ARVs and improved health outcomes.