Utilization of Complementary and Alternative Medicine (CAM) and Its Associated Factors Among Men Who Have Sex with Men Living with HIV (MSMLWH) on ART in Yogyakarta: A Cross-Sectional Study

CAM among MSM on ART

Abstract

Background

Many people living with HIV (PLWH) use ART for health maintenance, but long-term adherence is often interrupted by CAM therapies. While CAM can alleviate symptoms, it may interfere with the effectiveness of ART. This study aims to investigate CAM use among MSMLWH on ART, addressing a significant issue due to the high HIV cases among MSM in 2024.

Method

A quantitative cross-sectional study surveyed 161 MSMLWH on ART from February to April 2024. Questionnaires covering demographics, medication adherence, and CAM use were distributed at two public health centers and hospitals in Yogyakarta, Indonesia, with data analyzed using descriptive statistics, Chi-Square, and binary logistic regression tests.

Results

About 89,4% of MSMLWHs in the study tend not to open their HIV status, 64% didn't use alcohol, 62,7% consistently used condoms during sex, and 73,3% only had one sexual partner in the last three months. They didn't experience discrimination (75,8%) when 80,7% accessing the TLD regimen and 82,6% reported no significant side effects while using their ART. Although 89.4% received education about adherence, and 82.6% understood U=U messages, only 22.4% had good ART adherence. In addition, 68.9% reported using CAM, with oral/edible CAM (herbal medicines/vitamins/supplements) being the most common(92,8%). Furthermore, binary logistic regression identified poor ART adherence (AOR:2.61; 95%CI: 1.16 to 5.89; p=0.021) and alcohol use (AOR:2.36; 95%CI: 1.02 to 5.46; p=0.046) as the most associated factors with CAM use.

Conclusion and Recommendation

The study found that 68.9% of MSMLWH used CAM alongside ART, which is linked to low ART adherence and alcohol use. It highlights the need to strengthen health behavior and ART programs in Indonesia to educate MSMLWH about ART benefits, including adherence, TasP, and U=U. It also emphasizes the importance of raising awareness about factors like alcohol that can reduce ART effectiveness. Further research is needed to explore how CAM affects ART effectiveness, either enhancing or hindering it.