Why do HIV-positive patients on ARV therapy use TM? Experiences of Health workers, traditional healers and patients. A study in 2 provinces of South Africa

Background Despite the increase in the number of people using ART in South Africa, the use of traditional medicine (TM) in combination with ART is challenging. Objectives: To explore perceptions, knowledge and attitudes of patients, health workers and traditional healers about use of traditional medicine and ART. Methods Interviews with 14 participants: six patients on ART and TM; two doctors; 2 professional nurses and 4 traditional healers. Two focus group discussions were held with community health workers who work with HIV positive patients. Data was analysed using a thematic content analysis approach. Findings When patients become sick they use traditional medicine first, when all else fail they come to the health facility. Most patients start using traditional medicine before they are diagnosed with HIV. When they get sick the first point of entry seem to be the traditional healers. Some people prefer using traditional medicine because they want privacy and to remain anonymous. Conclusion Patients have a history of using traditional medicine for chronic conditions prior to their diagnosis with HIV, and they continue using traditional medicine in conjunction with their ARV. This indicates that traditional medicine is an integral part of the “treatment modality” for patients and is used in combination with conventional medicine.