‘These people who dig roots in the forests cannot treat HIV’: Women and men in Durban, South Africa, reflect on traditional medicine and antiretroviral drugs

ABSTRACT

Relatively few empirical investigations of the intersection of HIV biomedical and traditional medicine have been undertaken. As part of preliminary work for a longitudinal study investigating health-seeking behaviours among newly diagnosed individuals living with HIV, we conducted semi-structured interviews with 24 urban South Africans presenting for HIV testing or newly enrolled in HIV care; here we explored participants’ views on African traditional medicine (TM) and biomedical HIV treatment. Notions of acceptance/non-acceptance were more nuanced than dichotomous, with participants expressing views ranging from favourable to reproachful, often referring to stories they had heard from others rather than drawing from personal experience. Respect for antiretrovirals and biomedicine was evident, but indigenous beliefs, particularly about the role of ancestors in healing, were common. Many endorsed the use of herbal remedies, which often were not considered TM. Given people’s diverse health-seeking practices, biomedical providers need to recognise the cultural importance of traditional health practices and routinely initiate respectful discussion of TM use with patients.

KEYWORDS:

• Traditional medicine
• traditional healing practices
• South Africa

Acknowledgements

The authors gratefully acknowledge the clients who shared their experiences and insights with study team members, the Medical Research Council (HPRU) staff, interviewers, and transcribers who worked on the Pathways Study, and the volunteers and staff at Ibis Reproductive Health who assisted with data management and coding.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by grants from the National Institute of Mental Health (NIMH) (R01-MH08356 and R01 MH083561-03S1; Principal Investigator: Susie Hoffman, DrPH) and a centre grant from the NIMH to the HIV Center for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University [P30-MH43520; Principal Investigators: Anke A. Ehrhardt (1987–2013)/Robert H. Remien, Ph.D. (2013–2018)]. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMH or the MRC HIV Prevention Research Unit (HPRU).