Indigenous Knowledge and Food-Based Coping Mechanisms for ART Side Effects: A Qualitative Inquiry

Sustained adherence to antiretroviral therapy (ART) is critical for managing HIV, yet side effects and food insecurity present significant barriers in resource-limited settings. While the role of formal support is recognized, the use of indigenous knowledge and food-based coping mechanisms remains an underdocumented facet of self-management. This study explored how individuals in Ghana utilize local foods and cultural knowledge to manage ART side effects and support adherence.

A qualitative descriptive study was conducted at the Cape Coast Teaching Hospital. Through semistructured in-depth interviews (n = 20) and one focus group discussion (n = 5) with adults on ART for at least 6 months, we collected rich, experiential data. Participants were purposively sampled, and data collection continued until thematic saturation was achieved. Thematic analysis was employed to identify patterns and themes related to food-based coping strategies.

Analysis revealed that participants strategically employed indigenous knowledge, using specific local foods as active agents to manage side effects. Ginger tea was used to combat nausea, while avocado and groundnuts served as a protective stomach buffer. The timing of medication was often deliberately aligned with meals, with participants delaying doses if food was unavailable to avoid distress. These practices were deeply pragmatic, relying on affordable staples like gari (cassava flour) and yams, and were seamlessly integrated into daily routines. While these strategies demonstrated significant patient agency and resilience, they were also born from necessity, often representing suboptimal adaptations to food insecurity and poverty.

Indigenous knowledge provides a crucial, culturally resonant toolkit for managing ART side effects and facilitating adherence. Healthcare systems should move beyond generic instructions to formally recognize, validate, and integrate these patient-derived strategies into adherence counseling and peer support, fostering a more holistic and effective model of HIV care that bridges biomedical and indigenous knowledge systems.