Assessment of Complementary and Alternative Medicine Use Among Individuals with HIV: A Systematic Review and Recommendations for Future Research

Despite numerous studies that measure complementary and alternative medicine (CAM) use among individuals with human immunodeficiency virus (HIV), there is currently no agreed upon “gold standard” in terms of the best way to assess CAM use. The purpose of the current study was to review measures of CAM use within the empirical literature and answer the following questions: (1) How is CAM use assessed in research with HIV-positive individuals?, (2) What is the quality of these instruments?, and (3) Has the quality of these instruments improved over time? A systematic review of studies was undertaken and specific review criteria were used to guide the inclusion of studies. Specifically, articles were included that were published in English and in a peer-reviewed journal between 1997 and 2007, recruited HIV-positive study participants and assessed CAM use. An initial set of 159 studies met these inclusion criteria. Preliminary results suggest that, though the quality of the measures of CAM use has improved over time, CAM assessment among HIV-positive populations continues to be problematic. For example, authors from only 14 studies reported that they assessed the psychometric properties of their CAM instrument and, among these, only 2 provided reliability and validity data. CAM assessment – regardless of the specific study population – is a complex and challenging task. However, CAM instruments will not become more refined over time in the absence of rigorous psychometric evaluation. Future research must assess the reliability and validity of the instrument and report this data in a clear and nuanced manner.