Beyond Conventional Medical Treatment of HIV/AIDS in Anambra State: Approaches to Enhancing Overall Well-Being

Beyond Conventional Medical Treatment of HIV/AIDS in Anambra State: Approaches to Enhancing Overall Well-Being

Obi Kamsochukwu Ego

DOI : https://dx.doi.org/10.47772/IJRISS.2024.806219

Received: 27 May 2024; Revised: 18 June 2024; Accepted: 22 June 2024; Published: 22 July 2024

ABSTRACT

The Anambra State HIV/AIDS epidemic is a complicated issue that goes beyond standard medical therapy. Despite advances in ART and clinical care, people continue to experience stigma, discrimination, mental health difficulties, socioeconomic inequality, and limited access to comprehensive support services. Thus, the purpose of this project is to examine nutritional approach, naturopathic approach, community involvement and peer support approaches to improving the well-being of HIV/AIDS patients in Anambra State. Three research questions guided the study. This study adopted a causal comparative research design. The study was carried out in Awka South Local Government Area of Anambra State. The population of this study comprised of all healthcare providers in the 91 health centres in Awka South LGA of Anambra State. The multi-stage sampling procedure was used to draw 40 healthcare providers from four communities in Awka South LGA. A structured questionnaire titled “Beyond Conventional Medical Treatment Questionnaire” (BCMTQ) was developed by the researcher. Descriptive statistics of mean was used to analyze data to answer the research questions. The findings found that healthcare practitioners in Anambra State agree on nutritional approaches, naturopathic approach and community involvement and peer support approaches to improving the wellness of HIV/AIDS patients. Based on the findings, healthcare professionals were advised to regularly sensitize community engagement initiatives, peer-led programs, and support networks in order to foster connections, reduce stigma, improve social support, and empower people living with HIV/AIDS to actively participate in their care and community life.

Keywords: Conventional Medical Treatment, Nutritional Support, Counselling Approach Naturopathic Apporoach, Community Engagement and Overall Well-being

INTRODUCTION

HIV/AIDS, also known as the human immunodeficiency virus, is one of the most serious medical conditions in the world. In low- and middle-income nations like Nigeria, the disease burden persists as a significant public health issue even with the availability of antiretroviral therapy (ART) during pregnancy and breastfeeding, promotion of mitigations, raised awareness, and a notable improvement in treatment coverage (Osuolale, Salako, Musa, & David, 2020). Around 38 million people worldwide were HIV positive as of 2020, with 1.7 million of those people being youngsters under the age of 15 (Osuolale et al., 2023). It was estimated that HIV/AIDS-related illnesses will claim the lives of approximately 600,000 people globally in 2020 (US Government Global, 2021). However, because to the availability of comprehensive universal treatment, including ART, the proportion of HIV-positive children in Sub-Saharan Africa who survive into adolescence and later adulthood is rising (National Agency for the Control of AIDS, NACA, 2021).

About 2 million individuals in Nigeria are living with HIV (PLHIV) as of 2019, and 45,000 people have died from AIDS-related causes (UNAIDS, 2020). Teenagers (ages 10 to 19) accounted for nearly 200,000 of the HIV infections, or 7% of all HIV cases in Nigeria (UNAIDS, 2020). Anambra has the highest HIV prevalence in South-East Nigeria and ranks sixth nationally (NACA, 2021). Only 44,808 of the 98,960 persons living with HIV are actively getting treatment, and only 58% of those individuals are aware of their status, according to the NACA study. Notable are the steadily declining rates of new infections—46 percent between 2021 and 2023—and AIDS-related mortality—32 percent between 2021 and 2023. The good news is that the introduction of anti-viral therapy (ART) has meant that HIV is no longer a death sentence.

Although antiretroviral therapy (ART), one of the most important conventional medical treatments for the illness, has proven essential, there is a rising recognition of the importance of holistic approaches to enhancing the overall health of those who are affected. HIV/AIDS is no longer a fatal illness but rather a chronic condition that may be managed because to the development of antiretroviral therapy (ART). A growing number of patients are getting life-saving prescriptions as a result of Anambra State’s efforts to expand access to ART medicines (Ayuk, Oguonu, Ikefuna, & Ibe, 2014). However, co-morbidities, stigma, discrimination, and treatment adherence still affect how well conventional medical therapy work.

Anambra State’s HIV/AIDS treatment demands are expanding and becoming more integrated beyond the scope of standard medical therapies. This covers a variety of activities other than antiretroviral medicine prescriptions, such as community engagement, nutritional support, emotional support, and human rights development (Osuolale et al., 2023). For this article, the following non-traditional strategies were considered: peer support, community participation, mental health and psychological assistance, nutritional support, and counseling.

Nutritional Approach: Adequate nutrition supports immune function, helping to maintain CD4 cell counts and reduce the risk of opportunistic infections. Essential nutrients, including protein, vitamins (such as vitamin C, vitamin D, and vitamin E), minerals (such as zinc and selenium), and omega-3 fatty acids, play vital roles in supporting immune response, reducing inflammation, and slowing disease progression (Aurpibul, Oberdorfer, Choeyprasert, & Louthrenoo, 2016). The authors continued that HIV/AIDS can lead to changes in body composition, including wasting, loss of lean body mass, and alterations in fat distribution (lipodystrophy). Specific nutrition interventions, such as high-calorie, high-protein, and nutrient-dense diets, can help manage weight, preserve lean muscle mass, improve body composition, and address metabolic abnormalities associated with HIV/AIDS and certain antiretroviral medications.

Research indicates that lowering HIV-related morbidity and death rates requires adequate nutrition education (NE) to be given in conjunction with antiretroviral therapy (ART) and nutritional supplements (Grobler, Siegfried, & Visser, 2013). Numerous studies have demonstrated the importance of making healthy dietary choices in enhancing the anthropometric status and quality of life (QoL) of adults living with HIV (ALH) (Bello, Gericke, MacIntyre, & Becker, 2019). Adequate nutrition is needed by HIV-infected individuals to maintain a healthy life, to strengthen immunity and resistance against opportunistic infections, and to reduce muscle wasting.

Naturopathic approaches: Naturopathic medicine is a distinct system of primary health care that emphasizes prevention and the self-healing process through the use of natural therapies. It emphasizes the use of natural modalities; such as nutrition, lifestyle counseling and botanical medicine to promote wellness and treat illness. According to Angolu (2015), naturopathic medicine is a system of primary healthcare that emphasizes prevention, the self-healing process, and the use of natural therapies. Hsu, Pencharz, Macallan and Tomkins (2015) explained that some aspects of how naturopathic medicine may be applied: 1) certain herbs and plant-based remedies may have immune-supporting properties; 2) supplements like vitamins, minerals, and other nutrients can play a role in supporting immune function and overall health; 3) stress management, adequate sleep, regular exercise, and other lifestyle factors can significantly impact immune function and overall health; and 4) techniques such as meditation, mindfulness, and relaxation exercises can help manage stress, improve mental well-being, and support overall health. The study of Hsu et al., (2015) further highlighted that naturopathy incorporates various therapies, including:

Herbal Medicine: The use of plant-based treatments to improve health and alleviate symptoms;

Nutrition and Dietary Supplements: Emphasizing a balanced diet and the use of vitamins, minerals, and other supplements to support immune function and overall health.

Mind-Body Practices: Techniques such as yoga, meditation, and acupuncture that aim to reduce stress and promote mental well-being.

Lifestyle Counseling: Guidance on healthy living practices, including exercise, sleep, and stress management.

Naturopathy can play a supportive role in:

Reducing Side Effects of ART: Certain herbal remedies and nutritional supplements may help mitigate the gastrointestinal, neurological, and metabolic side effects of ART.

Boosting Immune Function: Nutritional support and specific herbal therapies may enhance immune system function, providing additional support to the body’s fight against infections

Improving Mental Health: Mind-body practices like meditation and yoga have been shown to reduce stress, anxiety, and depression, which are common among individuals living with HIV/AIDS

Enhancing Quality of Life: Holistic approaches that include lifestyle modifications and stress reduction techniques can improve overall quality of life and well-being

However, it is crucial to consult with healthcare professionals before starting any new treatment regimen, as naturopathic approaches should be used as complementary to conventional medical care. It is essential for patients to work closely with a healthcare team that includes both conventional medical doctors and qualified naturopathic practitioners to ensure comprehensive care and minimize risks and potential interactions between treatments (Duggal, Chugh & Duggal, 2012). Naturopathic medicine encompasses a range of non-conventional and holistic approaches to healthcare that focus on treating the whole person, addressing the root causes of illness, and promoting optimal health and well-being. It emphasizes natural therapies, such as diet, lifestyle changes, botanical medicine, and other natural remedies. Among patients living with HIV/AIDS, naturopathic approaches can offer complementary support to conventional medical treatments, addressing various aspects of health, immune function, symptom management, and overall quality of life.

Community Engagement and Peer Support Approach: Peer support and community participation seem to be essential components of any strategy for enhancing the wellbeing of HIV patients. Through the creation of a feeling of community, solidarity, and shared experience, peer support programs and community engagement can significantly improve the lives of people living with HIV/AIDS by empowering them, lowering stigma, encouraging treatment adherence, and improving their overall quality of life (Itiola & Agu, 2018). Peer support and community involvement provide an all-encompassing approach to HIV care that addresses the greater social, cultural, and structural variables of health in addition to the therapeutic environment (Entonu & Agwale, 2017).

These approaches acknowledge the importance of real-world experiences, social connections, and social capital to create positive environments that promote healing, self-determination, and collaboration among people living with HIV/AIDS. They do this by acknowledging the innate strength, resilience, and wisdom of communities (Martelli & Hayirli, 2018). In addition to conventional medical treatment, an evaluation of a person’s health state in light of contemporary healthcare principles is conducted. According to Osuolale et al. (2023), it shows the patients’ state of physical, psychological, social, and emotional health. Along with the illness itself, it considers a host of other variables, including the disease’s psychological, emotional, and social effects.

The process of assessing quality of life makes it possible to assess therapies from the viewpoint of the patients (Olsen, Koitzsch, Tesfaye, & Holm, 2013). The goal of contemporary HIV management has been to enhance the quality of life for those living with HIV. (PLHIV). Therefore, the health-related standard of life (HRQL) measure may be used as a substitute to routine medical medical assessment to comprehensively analyze the whole impact of HIV infection on the lives of people living with HIV (PLHIV). This will also assist in educating decision-makers about the diverse needs of marginalized communities. Lack of knowledge on the HRQL of young people that have HIV is a serious problem in Nigeria.

Additionally, a variety of approaches, each with certain limitations, have been used in previous studies by a number of researchers to assess the quality of life of HIV/AIDS patients. Those authors have talked on how HIV/AIDS affects teenagers’ quality of life. While some writers highlighted the disease’s detrimental effects on life, others showed how the illness positively affects young people’s quality of life. Anambra State’s HIV/AIDS pandemic highlights how important it is to offer complete, integrated care. By eschewing conventional medical therapies in favor of holistic approaches that address the many needs of those affected, Anambra State may pave the way for a more resilient, inclusive, and supportive community response to HIV/AIDS (Osuolale et al., 2023). Through continued advocacy, research, and collaboration, there is hope for a future where every individual living with HIV/AIDS in Anambra State can experience enhanced overall well-being and improved quality of life.

Statement of the Problem

Anambra State’s HIV/AIDS epidemic is a complex issue that requires more than just conventional medical care. The implementation of comprehensive strategies that address the various and complex components of HIV/AIDS treatment is critically needed, even while significant progress has been made in improving access to antiretroviral therapy (ART) and clinical management of the disease (Atilola & Stevanovic, 2013). People living with HIV/AIDS in Anambra State confront a multitude of interrelated problems despite the availability of conventional medical therapies, including stigma, discrimination, mental health concerns, socioeconomic inequities, and restricted access to comprehensive support services (Entonu & Agwale, 2005).

This complex context highlights the limitations of a purely scientific approach and highlights the need to study and implement creative, culturally acceptable, and community-based initiatives to enhance the overall health of HIV/AIDS patients. The lack of a comprehensive and integrated approach to care in Anambra State jeopardizes patients’ quality of life and psychosocial well-being, as well as impeding the efficacy of medical treatments, resulting in subpar treatment outcomes and perpetuating the cycle of marginalization and vulnerability among impacted communities.

Further, Anambra State’s present HIV/AIDS care system contains gaps and deficiencies that must be corrected quickly. Service fragmentation, a lack of psychological support, a lack of community participation, and a lack of integration of traditional and alternative therapeutic techniques are all examples. These flaws must be addressed as part of a collaborative effort to enhance and modify the healthcare system’s response to the pandemic. As a result, the pressing issue at hand is the need to move beyond traditional medical treatment paradigms and develop all-encompassing, inclusive, and patient-centered approaches to addressing the various needs, difficulties, and goals of people living with HIV/AIDS in Anambra State holistically.

Specifically, the study seeks to:

1. Investigate nutritional approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State.
2. Examine naturopathic approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State.
3. Determine the community engagement and peer support approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State.

Research Questions

1. What are the nutritional approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State?
2. What are the naturopathic approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State?
3. What are community engagement and peer support approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State?

Theoretical Underpinnings

Bio-Psycho-Social Model of Health

The Bio-Psycho-Social Model of Health is proposed by George Engel in the 1970s, it emphasizes the interaction and interdependence of biological, psychological, and social factors in the understanding and management of health and illness. This framework acknowledges the complex and dynamic nature of health outcomes, highlighting the importance of addressing not only the biomedical aspects but also the psychological, social, cultural, and environmental dimensions that influence individual and community wellbeing (Hari, Dwi & Dany, 2018).

The Bio-Psycho-Social Model of Health is a comprehensive framework that combines biological, psychological, and social factors to understand health, illness, and healthcare delivery. It offers a more integrated approach to health and well-being, focusing on the interplay between biological, psychological, and social factors. The model consists of three core components: biological factors, which include the nature of the body, disease pathology, biological interactions, psychological factors, which include the mind-body connection, behavioral patterns, and coping and adaptation (Henningsen, 2015). Social factors, which include socio-economic, cultural, environmental, and structural factors, emphasize the importance of interpersonal relationships, social support systems, community networks, and cultural contexts in influencing health behaviors, treatment adherence, and overall quality of life (Ghaemi, 2010). Healthcare systems and policies also play a role in shaping health outcomes and access to care. The Bio-Psycho-Social Model of Health provides a holistic, multidimensional, and contextually grounded perspective that recognizes the complexity of factors influencing health and well-being (Deter, 2012). By integrating biological, psychological, and social dimensions, it guides personalized, patient-centered, and holistic approaches to healthcare delivery, management, and promotion.

METHODS

Research Design: This study adopted a causal comparative research design.

Study Area:  Government Area of Anambra State, located in the eastern part of Nigeria in September 2016. The population figure of the local government is put at about 189,654 people. (National Population Commission, 2016 Report). The study population includes all young persons in the local government area that according to the National Population Commission 2016 report is estimated at 30% of the total population. The prevalence rate of HIV/AIDS in Anambra State as of 2014 stands at 8.7% (Chukindi, 2014) which is the highest in the South East region and fourth highest in the country (National Agency for Control of Aids), 2021). However, the prevalence rate of HIV in the state, as well as the seeming poor rate of uptake of HCT services, justifies the choice of Anambra State, with particular reference to Awka-South LGA for this study.

Population: The population of this study comprised of all healthcare providers in the 91 health centres in Awka South LGA of Anambra State (https://hfr.health.gov.ng/facilities/hospitals-list?page=155)

Sampling Procedure: The multi-stage sampling technique was adopted. In stage one, simple random sampling technique was used to select 4 out of the 9 communities in Awka South LGA. These communities include: Amawbia, Awka, Nibo and Okpuno. Each of these communities comprise of at least 5 primary healthcare centres (https://hfr.health.gov.ng/facilities/hospitals-list?page=155). In stage two, simple random sampling technique was used to select 8 healthcare providers in each of these communities. This means that a total of 40 healthcare providers was sampled and participated in the study.

Instrument: A structured questionnaire was developed by the researcher. The questionnaire was comprehensive, culturally sensitive, and designed to capture a wide range of perspectives. The questionnaire was titled “Beyond Conventional Medical Treatment Questionnaire” (BCMTQ). This questionnaire was divided into two sections; A and B. Section A comprised of demographic information of the respondents while section B was sub-divided into three clusters. Cluster I contained items on nutritional approach; cluster II contained items addressing the naturopathic approach; cluster III addresses items on community engagement and peer support approach to enhancing the wellbeing of patients with HIV/AIDS.  The instrument was structured on a 4-point Likert scale of Strongly Agree (SA), Agree (A), Disagree (D) and Strongly Disagree (SD) with values 4, 3, 2 and 1 respectively.

Data Analysis: Descriptive statistics of mean was used to analyze data to answer the research questions while standard deviation was used to determine the homogeneity or heterogeneity of the respondents’ mean. The criterion mean score was the basis for decision making; a threshold of 2.50 formed the benchmark for decision making. Any mean score below 2.50 benchmark is rated disagreed while mean scores above 2.50 is rated agreed.

RESULTS AND DISCUSSIONS

Table 1: Respondents’ ratings on nutritional approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State

Data presented in Table shows that all items 1 – 4 with their respective mean scores of 2.66, 2.95, 3.18 and 3.41 were rated agreed. The cluster mean of 3.05 summarized that healthcare providers agreed on all items as regards nutritional support and counselling approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State. The standard deviation scores ranging from 0.54 – 1.06 means that the respondents’ mean scores were closely related.

Table 2: Respondents’ ratings on naturopathic approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State?

Data presented in Table 2 shows that all items 5 – 9 with their respective mean scores of 2.81, 3.14, 3.17, 2.85 and 2.65 were all rated agreed by the respondents. The cluster mean of 2.92 summarized that healthcare providers agreed on naturopathic approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State. The standard deviation scores ranging from 0.68 – 1.04 means that the respondents’ mean scores were closely related.

Table 3: Respondents’ ratings on community engagement and peer support approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State

Data presented in Table 3 shows that item 12 with mean score 2.02 was rated disagreed while items 10, 11 and 13 with their respective mean scores of 3.41, 3.18 and 2.77 were rated agreed. The cluster mean of 2.85 summarized that healthcare providers agreed on community engagement and peer support approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State. The standard deviation scores ranging from 0.54 – 0.99 means that the respondents’ mean scores were closely related.

DISCUSSION OF FINDINGS

The finding in research question one revealed that healthcare providers agreed on all items as regards nutritional support and counselling approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State. This means that there is a shared recognition among healthcare providers about the critical role of nutritional support and counseling in the overall care and management of patients with HIV/AIDS. This consensus underscores the significance of addressing nutritional needs and providing tailored guidance to enhance patients’ well-being and quality of life. This finding agreed with the finding of Malama and Ndhlovu (2023; Tesfay, Javanparast, Gesesew, Mwanri and Ziersch (2021) that people living with HIV/AIDS became more aware of their nutritional status and dietary needs. Counselling sessions contribute to overall health maintenance by guiding participants on food choices to prevent or alleviate health issues like vomiting, diarrhoea, and high blood pressure.

The finding in research question two revealed that healthcare providers agreed on naturopathic approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State. Healthcare providers acknowledge that naturopathic treatments can complement conventional HIV/AIDS therapies. They recognize that integrating both approaches can offer a more holistic and comprehensive care model for patients. This findings supported that of Omale and Ugwu (2011) that agreeing on the naturopathic approach suggests that healthcare providers appreciate the importance of treating the whole person, addressing not only the physical symptoms but also the mental, emotional, and social aspects of health. By endorsing the naturopathic approach, healthcare providers affirm the principle of patient-centered care, recognizing that patients should have access to a range of treatment options and the autonomy to make informed decisions about their health.

The finding in research question three revealed that healthcare providers agreed on community engagement and peer support approach to enhancing the wellbeing of patients with HIV/AIDS in Anambra State. The unanimous agreement among healthcare providers underscores a shared acknowledgment of the vital role that community engagement and peer support play in the comprehensive care and management of patients with HIV/AIDS. This consensus emphasizes the importance of fostering connections, building networks, and leveraging community resources to support individuals affected by HIV/AIDS. This finding was in line with the finding of Burton, Elliott, Cochran and Love (2018) and Reed, Howe, Doyle and Bell (2018) that community engagement reflects a commitment among healthcare providers to fostering collaborative partnerships, building bridges between healthcare settings and communities, and leveraging community assets to enhance care delivery. It underscores the value of teamwork, coordination, and shared responsibility in addressing the multifaceted needs and challenges faced by patients with HIV/AIDS.

CONCLUSION

The study “Beyond Conventional Medical Treatment of HIV/AIDS in Anambra State” highlights the importance of integrating complementary strategies such as nutritional support, naturopathic approaches, community engagement and peer support to improve the well-being of individuals living with HIV/AIDS. Healthcare providers agree on the significance of these approaches, recognizing the interconnected needs of patients with HIV/AIDS.

RECOMMENDATIONS

Based on the findings of the study, the following recommendations were made:

1. The Anambra State government should develop and implement programmes to improve access to nutritional support and counseling services, including training for healthcare providers, awareness campaigns, and community-based initiatives to promote proper nutrition and dietary management among individuals living with HIV/AIDS
2. The Anambra State government should expand the availability and accessibility of mental health and psychosocial support services within HIV/AIDS care settings, including screening, counseling, support groups, and referrals to specialized services, to address the emotional, psychological, and social well-being of patients.
3. Healthcare professionals should frequently sensitize community engagement initiatives, peer-led programs, and support networks to foster connections, reduce stigma, enhance social support, and empower individuals living with HIV/AIDS to actively participate in their care and community life.

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