Evaluation of the frequency of use of herbal drugs with concomitant administration of highly active antiretroviral therapy and its effect on medication adherence in two health care facilities in south western Nigeria

The aim of this study was to evaluate the prevalence of the concomitant use of herbal medicine and anti-retroviral drugs in people living with HIV/AIDs and to evaluate the reasons given by the patients for concomitant administration of highly active antiretroviral therapy (HAART) with herbal drugs in order to establish a possible link between the use of herbal medicines and adherence. A cross sectional study design was utilized via systematic sampling for recruitment of HIV positive individuals receiving their medications in Amuwo-Odofin and Ojo areas in Lagos, Nigeria. Based on the inclusion criteria, 351 HIV positive patients were recruited into the study from the HIV outpatient clinics of two hospitals and had the questionnaires administered to them. 42.7% of the respondents stated that they use herbal medicines. The association for each of the herbal medicines with side effects experienced with the use of ARVs was statistically significant upon cross-tabulation and was a major predictor of herbal drug use. The prevalence of herbal drug use in patients who were adhering to HAART medication was not significantly different from those who were not adhering to medication (p = 0.75 and χ2 = 6.902). The use or lack of use of herbal medicine is not a determinant for adherence. The most profound reason for herb use was to improve treatment. However, herb/drug interaction studies are imperative to ascertain if interactions occurring are beneficial or harmful. The pharmacist must counsel and re-counsel patients on HAART, not to use herbal products with their antiretroviral medications to avoid drug-herb interactions which could be potentially life threatening.