Perception and practice of herbal medicine use among people living with HIV in Bushenyi health Centre IV, Western Uganda

Background Herb-drug interactions can affect the outcomes of antiretroviral regimens among people living with HIV. Our study aimed to assess perceptions and practices regarding herbal medicine use among people living with HIV attending Bushenyi Health Center IV in Western Uganda. Methods We conducted a cross-sectional, interview-based survey in September 2025 using a pre-validated questionnaire to assess their perceptions and practices of herbal medicine. Participants who were aged more than 18 years, of both genders, on antiretrovial therapy, and who consented to participate were enrolled. Herbal medicine use was defined as the current use of herbal medicine alongside ART. Binary and multiple logistic regression analyses were applied to identify associations with herbal medicine use. Results Among 375 participants, 108 (29%) were concurrently using herbal medicine with ART. Ginger (21%) and garlic (27%) are the commonly consumed herbal products. General health (75%) and boosting immunity (22%) were common reasons for taking herbal medicine. Sixty five (60%) of herbal medicine users did not disclose their use of herbal medicine to their healthcare providers. Low perceived concern (vs. high; AOR = 2.77; 95% CI 1.13-6.82) was positively associated, while low perceived benefit (vs. high; AOR = 0.06; 95% CI 0.02–0.25) was negatively associated with herbal medicine use. Presence of comorbidities, opportunistic infections, experience of side effects of antiretroviral therapy, and non-antiretroviral therapy medication use were significantly associated with herbal medicine use in unadjusted analysis. Conclusion Our study findings underscore the need for open patient-provider communication through co-designed, participatory education models to engage both people living with HIV and healthcare providers in promoting the safe use of herbal medicines alongside antiretroviral therapy. These models address the disclosure gaps and reduce the risk of potential herb-drug interactions.