Pilot study about the use of unconventional therapies (UT)in 223 HIV positive persons at the Infectious diseases department of Niguarda Hospital, Milan
Adamoli R.* Moioli M.C. **, Poletto M. ***, Caggese L.**,Giannelli F.**, Durante A.*, Hagl D.* Rossi F.*, Breglia M.*, Cremonesi F.***
* Centro Poiesis-Gruppo Exodus, Milano;
** Divisione Malattie Infettive Ospedale Niguarda, Milano;
*** A.L.A., Associazione Lotta Aids, Milano
Presented at the “Convegno Nazionale AIDS e sindomi correlate”. 21-23 November - Milan, Italy. (Abstract O.70)

Objective
To obtain preliminary data about UT use in Persons living with Hiv and Aids (PLwHA)

Method
An anonymous self-compiled questionnaire had been proposed to all PLwHA, arriving to the Infectious Disease department of Niguarda Hospital, Milan from 16/4 to 15 june 1996.

Results
In the two considered months 717 visits on 410 patients were carried out.
The questionnaire was correctly compiled by 54% of these 410 patients (223 persons: 38,5% women and 61,5% men). They had to specify their condition of asymptomatic, symptomatic or in aids patient. These data were then crossed and corrected with answers to other questions regarding opportunistic diseases and previous or current infections (see table 1). The comparison between patients’ perception (ans/tab.1) and corrected data (corr./Tab.1) points out that many persons have great difficulties to recognize themselves as Aids patients, even if they suffered heavy opportunistic diseases, such as Toxoplasmosis, Tbc, PCP etc. 51,4% of persons feel in good or excellent health conditions,43,2% discrete, 5,4% bad or very bad. 50% of them use antiretroviral drugs (95% regularly). 36% took informations about UT in the past; 86% are now interested in receiving informations.

Tab. 1
% Asymptomatic % Symptomatic % Aids
Risp. Corr. Risp. Corr. Risp. Corr.
Global 66.8 57.15 26.9 19.05 6.3 23.8
Users 60.4 52.8 30.2 15.1 9.4 32.1
Users 69 58.6 25.8 20.4  5.2 21
Risp= participants answers Corr= our correction of data
Tab.2
CD4/mm3 as declared by participants (%)
<=100 101-250 251-500  > 500
Global 22.3 24  40.1 13.6
Users 27.3 20.5 47.7  4.5
Users 20.4 25.4  37.3  16.9
Among the 223 persons who compiled the questionnaire, 26% (57, 40% women, 60% men), used in the past or are now using UT: 67% of them contemporarily uses conventional drugs (61% are using at the moment antiretroviral drugs). 70% of them communicate to their doctor that they are using UC and 49% are followed by a doctor of UT. 90% of UT users take them regularly; 97% says to take advantages ; 94% is moderately satisfied/very satisfied (73% is moderately satisfied also in regard to conventional therapies).
The medium cost of UT per month is 0 in 20% of cases, < 50.000 in 23%, 50.000/100.000 in 31%, 101.000/200.000 in 13%, >200.000 in 13%..
47 among the before mentioned 57 persons are at the moment using UT, also in combination:34% multivitamins,27% homeopathy, 25% nutrition, 11% phytotherapy, 9% tibetan medicine and 7% ayurvedic medicine. In 28% of cases UT have been suggested by other PLwHA, in 25% by practitioners of UT, in few cases by other people. 19% got informations about UT by pubblications.
Other studies found a higher percentage of users (52% in De Francesco et al. in XI ICA 1996, Vancouver, abs. Th D.5124; 48% in Hollander et al. Atti III colloquio Europeo di Etnofarmacologia” Genova 1996) Different results are connectable to objective factors ( they “take pictures “ of different situations) and also to methodological factors. For instance, in consideration to the fact that both conventional and unconventional practitioners prescribe vitamins with different posology and aims, we decided to put them in a separate part of the questionnaire: we could distinguish persons taking vitamins because of hospital prescription and persons using them as UT. A compared analysis of our results and the previously mentioned studies will be done in the final report.

Conclusions
The study pointed out that PLwHA use UT, in a significative percentage; that almost the totality is interested in receiving more informations about UT; that persons combine conventional and unconventional therapies;that they don’t easily communicate UT use to their conventional practitioner; that almost all users think to take advantages from them, that less than half of them is followed by an unconventiuoanal practitioner, that they generally don’t feel a conflict in combining conventional and unconventional therapies.
These data and other studies suggest that other epidemiological studies (of safety and efficacy) are necessary. It would also be important that Italian health authorities show a propositive and continuative interest in this field.Finally we believe in the importance of a good collaboration between conventional and unconventional doctors.

Reference: Roberto Adamoli, Centro Poiesis del Gruppo Exodus, V.le Marotta 18/20 Milano, tel. 02/2140344-2150428, fax 02-26412801, e-mail poiesis @www.exodus.it. WebSito: www.exodus.it/poiesis