Patterns, Determinants, and Perceptions of Traditional Medicine Use Among People Living With HIV/AIDS on ART in Rural Ethiopia

Abstract

Background

Traditional medicine (TM) remains widely used in Ethiopia, even among people living with HIV/AIDS (PLHIV) who are enrolled in antiretroviral therapy (ART). Despite improved ART accessibility, concomitant use of TM poses risks of herb–drug interactions, treatment failure, and toxicity. However, little evidence exists pertaining to TM use among PLHIV from semiurban and rural settings in Ethiopia. This study was conducted to assess the prevalence, types, reasons, and factors associated with TM use among PLHIV on ART.

Methods

A mixed-methods cross-sectional study was conducted in 2022 among 331 adults on ART. Structured, pretested questionnaires were used for quantitative data, analyzed with SPSS, and logistic regression identified predictors of TM use. Qualitative data were collected from 11 purposively selected patients via in-depth interviews and thematically analyzed to complement quantitative findings.

Results

The prevalence of TM use after initiating ART was 64.4%, while 28.7% reported use within the past 6 months. Herbal medicines were the most common forms (77.9%), Demakese (Ocimum lamiifolium), garlic (Allium sativum), ginger (Zingiber officinale), and black cumin (Nigella sativa) being frequently used. Spiritual therapies such as holy water (Tsebel) and Zemzem water were also reported. The main reasons for TM use were treatment of opportunistic infections or symptom relief (84%), immune boosting (36.6%), general well-being, and faith-based motivations. Factors significantly associated with TM use included age ≥ 61 years (AOR = 5.08, 95% CI: 1.01–25.45), history of opportunistic infection (AOR = 6.82, 95% CI: 3.02–15.39), viral load 50–1000 copies/mL (AOR = 6.66, 95% CI: 1.30–34.06), being on third-line ART regimens (AOR = 4.43, 95% CI: 1.32–14.91), presence of comorbidities (AOR = 3.97, 95% CI: 1.86–8.48), and trust in traditional healers (AOR = 3.68, 95% CI: 1.80–7.54). Qualitative findings revealed that TM use was shaped by accessibility, cultural beliefs, dissatisfaction with modern care, family influence, and religious guidance.

Conclusion

Despite expanded ART access, TM use remains common among PLHIV in rural Ethiopia, mainly for symptom relief and immune support. Cultural and religious beliefs, opportunistic infections, comorbidities, and limited counseling drive this practice. Strengthening patient education, training healthcare providers, and raising awareness of TM in HIV care are essential to reduce potential adverse outcomes.