Poster presentation at the 9th annual Canadian Conference on HIV/AIDS Research, in April 2000, in Montreal.

Determinants of Complementary Therapy Use among Young Gay and Bisexual Men Living in Vancouver

Erin Strutt, Keith Chan, Steve Martindale, Mary Lou Miller, Kevin JP Craib, Paula Braitstein*, Martin T. Schechter, Robert S. Hogg

for the Vanguard Project, British Columbia Centre for Excellence in HIV/AIDS
* and the BC Persons with AIDS Society, Vancouver, BC.

Public demand for complementary therapies has escalated in Canada despite the fact that until recently they have been generally unregulated. (1,2) Each year Canadians spend approximately $3.8 billion on complementary therapies. A recent survey by the Fraser Institute revealed that 73% of Canadians have used some form of complementary therapies; half of them had done so in the previous 12 months. In addition, 72% felt that using complementary therapies in conjunction with conventional medicine is better than using either alone. (3) Certain practices once considered alternative ­ such as vitamin use, acupuncture and massage therapy ­ have now become established in mainstream health care.

To characterize the socio-demographic, psychosocial and behavioural characteristics of complementary therapy use among young gay and bisexual men enrolled in an open cohort.

The Vanguard Project

The Vanguard Project is a prospective study of HIV incidence and risk behaviours, which began in May 1995. Eligible participants are men between the ages of 15 and 30 at baseline, living in the Greater Vancouver area, who have not previously tested HIV-positive. The study is open to all men who have sex with men, regardless of whether they self-identify as gay, bisexual or straight.

Recruitment of participants involves outreach at gay community events, use of print materials (such as posters, brochures, condom packages) and recruitment by health care professionals at medical clinics and local physicians' practices.

Since May 1995, over 850 participants have completed confidential, self-administered questionnaires and undergone HIV testing on an annual basis. To date, the questionnaires have elicited information on socio-demographic characteristics, sexual behaviour, substance use and mental health.

Study Design

Eligible participants for this particular analysis were those who completed the questionnaire in the fourth wave of the study. Questionnaire items included demographics, sexual behaviour with both men and women, and psychosocial scales.

For the purpose of this analysis, self-reported data were examined on complementary therapy use within the previous twelve months, including self-reported visits to alternative health care providers (such as naturopaths, traditional healers and religious and spiritual leaders).

Types of complementary therapies specified in the questionnaire included dietary supplements (such as vitamins, minerals, meal replacements and protein supplements); herbal medicinal therapies (such as St. John's Wort, Chinese herbs and homeopathy); and other complementary therapies (such as acupuncture, massage therapy and meditation).

Statistical Analysis

Contingency table analysis was used to compare characteristics of men reported complementary therapy use in the previous year versus those who did not. Step-wise logistic regression was used to identify independent predictors of complementary therapy use. All reported p-values are two-sided.

Of the 352 men who completed the questionnaire in the fourth wave of the study, 292 (83%) reported some form of complementary therapy use in the previous year.

Univariate analysis (Table 1)

Participants who used complementary therapies were less likely to live in unstable housing (2.8% vs. 8.6%; p=0.048), less likely to be Aboriginal (6.6% vs. 20.7%; p<0.001), and less likely to use injection drugs (5.9% vs. 15.0%; p=0.026).

Participants who used complementary therapies were more likely to have at least a high school education (86.8% vs. 73.7%; p=0.012), more likely to be employed (93.4% vs. 72.9% p<0.001), more likely to be Caucasian (77.0% vs. 60.3%; p=0.008) and more likely to currently be having sex with men only (91.7% vs. 83.0%; p=0.043).

Multivariate analysis (Table 2)

Being non-Aboriginal (AOR=2.65; 95% CI:1.09-6.45) and employed (AOR=4.18; 95%CI: 1.90-9.22) were independently associated with complementary therapy use.

A recent study in the United States investigated the predictors of complementary therapy use in a cross-sectional, randomly selected cohort of the general public. (4) Sixty-eight percent had used complementary therapies. Usage was concentrated among educated, Caucasian, middle-class people between the ages of 25 and 49.

Our data indicate that complementary therapy use is very common among young gay and bisexual men in the Greater Vancouver region, and usage is concentrated among men who are employed and non-Aboriginal.

The authors gratefully acknowledge the staff, participants and Community Advisory Board of the Vanguard Project; participating doctors and HIV testing clinics; and the

National Health Research Development Program, Health Canada, for project funding. Poster designed by Steve Martindale, with assistance from Michael Zarowny.

1. Sibbald, Barbara. New federal office will spend millions to regulate herbal remedies, vitamins. CMAJ 1999; 160: 1355-7.
2. Johnson, Terry. MDs sceptical as BC gives stamp of approval to traditional Chinese medicine. CMAJ 1999; 161: 1435-6.
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3. Buske, Lynda. Looking for an Alternative. CMAJ 1999; 161(4): 363.
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4. Astin, John A. Why Patients Use Alternative Medicine. JAMA 1998; 279 (19): 1548-53.
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