Background. Black women make up 12% of the female population in the U.S, yet they account for 66% of new HIV infections. In 2002, AIDS was the most cited reason for death among Black women age 25-34. While prevention remains, a major effort targeting treatment efficacy and modalities for this sub-group need to be better understood.

Purpose. The purpose of this study is to assess whether HIV-positive Black women’s attitudes, subjective norms and perceived behavioral control are related to intention of dietary supplements and spiritual practices use in their HIV treatment.

Method. In phase one, Grounded Theory methods (N= 29) were used to explore salient beliefs surrounding complementary and alternative medicine (CAM) use for treatment of HIV. Based on this qualitative exploration guided by the Theory of Planned Behavior (TPB), we developed and administered a questionnaire to 153 HIV-positive Black women. HIV medication adherence was also assessed among the respondents.

Results. Respondents engaged in CAM behavior to improve their immune function. Respondents also engaged in CAM because it provided a sense of control in their HIV treatment. Forty-five percent of respondents used dietary supplements, while 70% used spiritual practices to treat their HIV. Attitudes, subjective norms, and perceived behavioral control were found to be significant predictors of intention for dietary supplement use, as part of HIV care. Attitudes and perceived behavioral control were found to be significant independent predictors, explaining 70% (p <.0001) of the variance. For intention to engage in spiritual practices, attitudes, subjective norms, and perceived behavioral control were found to be significant independent predictors explaining 77% (p<.0001) of the variance. For HIV medication adherence, there was no significant difference in adherence between those who were users and non-users of dietary supplements or spiritual practices.

Conclusions. The results of this study show that attitudes and perceived behavioral control are the most important predictors of intention to use dietary supplements for treatment of HIV among Black women, while for spiritual practices, all TPB variables are significant predictors of intention. Notably, using dietary supplements or spiritual practices as part of their care did not affect the women’s medication adherence.


School of Public Health

First Advisor

Susanne Montgomery

Second Advisor

Juan Carlos Belliard

Third Advisor

R. Patricia Herring

Fourth Advisor

Helen Hopp Marshak

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

HIV infections -- Treatment; African Americans; Women, Black -- Psychology; Behavior modification -- methodology; Human behavior models; HIV Infections -- therapy; HIV Infections -- psychology; Medicine, African Traditional; Complementary Therapies; Drug Therapy -- psychology; Attitude to Health; Women's Health; African Americans -- psychology; Behavior and Behavior Mechanisms; Models, Theoretical; Regression Analysis.



Page Count

xi; 203

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives