Prevalence and factors associated with herbal medicine use among people living with HIV on Highly Active Antiretroviral Therapy in selected hospitals in Nairobi City County, Kenya

Abstract

Traditional remedies have been used for many years in Africa to treat various ailments before the introduction of conventional medicines into the continent. Concurrent use of traditional herbal medicines with highly active antiretroviral therapy (HAART) is widespread among HIV infected patients. Studies done in different parts of the world show conflicting health outcomes among HIV positive patients using HAART and herbal medicine concurrently. Some reporting better health outcomes while others report increased adverse drug reactions. The extent of THM use is not known in most settings in sub-Saharan Africa Kenya included. This study aimed to determine the prevalence and factors associated with traditional herbal medicines use among HIV infected patients on HAART attending two comprehensive care centers in Nairobi County. A descriptive cross-sectional study was conducted at Kenyatta National Teaching and Referral Hospital and Mbagathi County Hospital. From the two centers a total of 370 participants were selected via systematic sampling. Data was collected using an interviewer-administered semi-structured questionnaire seeking information on herbal medicine use, socio-demographic and economic factors associated with herbal medicine use and the association between herbal medicine use and occurrence of adverse drug reactions. Chi square test was computed for categorical variables to test for association between herbal medicine use and occurrence of adverse drug reactions. All variables observed to be significant at 5% were subjected to logistic regression analysis. The study established that the prevalence of herbal medicine use among PLWH taking HAART was 15.5%. There were 59.7% participants who had good /fair adherence to HAART while 40.3% had poor adherence. The longer the duration between HIV diagnosis and HAART start, the more likely a HIV positive patient was to use herbal medicine (P< 0.05). Patients who had poor adherence were more likely to use herbal medicine. (P<0.05). The use of herbal medicine with HAART increased the odds of side effects (P< 0.05). There was a significant difference in proportion of those with side effects by duration in years between HIV diagnosis and HAART start, P<0.05. Patients who had poor adherence to HAART had significantly higher proportion of side effects as compared to those who had good/fair adherence, 104 (45.7%) and 45 (32.1%) respectively, p <0.05. Out of the patients who had used herbal medicine, 67.3% had never disclosed to the doctor or any health care worker at the CCC about their herbal medicine use. The routes of administration of herbal products by PLWH on HAART were oral 100%, topical 7%, inhalation at 7%, rectal 2% and vaginal 0%. The reasons for preferring herbal medicine is that it is easily accessible (97.8%), more acceptable (97.3%) and also because herbal medicine is cheap (92.9%). The sources of herbal medicine were the herbalist (92.6%), garden (87.1%), friends (80.8%), and pharmacy (50%). Herbal medicine use led to decreased adherence to HAART. After starting HAART, 62% of the patients reported to have experienced side effects. Use of herbal drugs together with HAART increases chances of patients experiencing adverse drug reactions. Further investigations ought to be done to establish the safety, efficacy and drug interactions between herbal drugs commonly used by HIV positive patients and antiretroviral agents used for HIV/AIDS treatment.