Awareness and knowledge of human immunodeficiency virus post exposure prophylaxis among Nigerian Family Physicians

Knowledge, Attitude, and Practice (KAP) of post exposure prophylaxis for fifth year dental students at a private Egyptian university: a cross-sectional study

BACKGROUND

Health care professionals including dental staff are at greater risk of occupational exposure to life threatened blood-borne pathogens. Occupational exposures will continue to occur despite improved techniques of prevention and using the post exposure prophylaxis (PEP) in these situations are of great importance. Therefore, the aim of this study was to assess the knowledge, attitude, and practice of post exposure prophylaxis for fifth year dental students at a private Egyptian university.

METHODS

This cross-sectional study was conducted among 404 dental students in the fifth year at a private Egyptian university from July 2019 to March 2020. Data were collected using self-administrated questionnaires including personal information, knowledge, attitude, and practice questions.

RESULTS

Our study showed that the total mean knowledge score was (0.45 ± 0.50), for attitude (0.70 ± 0.46), and that for practice (0.45 ± 0.50). There was no gender difference regarding PEP (P > 0.05). A total of 213 (47.5%) dental students believed that PEP should be indicated for any needlestick injury in the workplace. A number of 379 of the students (94%) chose "Yes" when asked if they thought PEP is important. While, 143 students (32.5%) were unaware of the existence of PEP service and protocol when asked about the reasons for not taking PEP after occupational exposure.

CONCLUSIONS

Knowledge and practice of fifth year dental students at a private Egyptian university toward post exposure prophylaxis are not satisfactory. Awareness and curriculum modifications are important regarding PEP.

Predictors of adherence to HIV Post-Exposure Prophylaxis protocol among frontline healthcare workers at the Ho Teaching Hospital, Ghana

BACKGROUND

Human Immunodeficiency Virus (HIV) is a global public health threat, and all frontline Health care workers (HCWs) are at a higher risk of exposure to body fluids from potential HIV patients and to sharp instruments. Though timely Post Exposure Prophylaxis (PEP) decreases the possibility of seroconversion to HIV after occupational exposure, most HCWs rarely adhere to the PEP protocol. This study aims to determine the predictors of adherence to PEP among frontline healthcare workers in the Ho Teaching Hospital, Ghana.

METHODS

A facility-based cross-sectional study was conducted among 199 frontline HCWs. Data were collected using a pretested self-administered questionnaire and analyzed using STATA version 14 software. Binomial logistic regression was performed at the 0.05 level of significance and 95% confidence interval.

FINDINGS

Overall, 17.9% of HCWs adhered to PEP. Frontline HCWs who perceived they had low and very low risk of occupational exposure to HIV transmission were 96% [AOR = 0.04 (95% C.I: 0.00, 0.39) P = 0.006] and 94% [AOR = 0.06 (95% C.I: 0.00, 0.62) P = 0.019] respectively less likely to adhere to PEP. HCWs who received training on PEP were 4 times more likely to adhere to PEP compared to those who had never received it [AOR = 4.24 (1.31, 13.19) P = 0.013].

CONCLUSION

Adherence to PEP protocol among HCWs was low. Therefore, there is a need for interventions to increase the perception of risk of occupational exposure to HIV transmission and to intensify training on PEP among frontline HCWs in the Ho Teaching Hospital. This will go a long way to increase their adherence to PEP.

Assessment of Knowledge, Attitude, Practice and Associated Factors Towards Post-Exposure Prophylaxis for HIV/AIDS among Health Professionals in Health Centers Found in Harari Region, Eastern Ethiopia

BACKGROUND

Healthcare workers are at risk of acquiring human immunodeficiency virus (HIV) infections, because of occupational exposure to blood and other body fluids. Post-exposure prophylaxis (PEP) is a short-term antiretroviral treatment used to reduce the likelihood of viral infection after exposure to the blood or body fluids of an infected person. Timely PEP after exposure to high-risk body fluids in the working area can reduce the rate of transmission of HIV significantly.

OBJECTIVE

To assess the knowledge, attitude, practice, and associated factors towards PEP for HIV/AIDS among health professionals in health centers in the Harari region, Eastern Ethiopia.

METHODOLOGY

A retrospective cross-sectional study was conducted using structured questionnaires from March to April 2019. The collected data were analyzed by using SPSS version 20, and the result was presented in the form of tables and figures.

RESULTS

Of 217 participants, 51.6% were male and 75.2% were in the age group of 20-30 years. One hundred thirty (59.9%) respondents had a year of service less than 5 years, and nearly half (45.2%) of the participants had a Diploma. The study revealed that 35.02% of the participants had inadequate knowledge of PEP. About 32.26% had an unfavorable attitude towards PEP. Of 124 (57.1%) exposed respondents, 54 (68.4%) tried to get PEP service and 49 (90.7%) started to use PEP. Twenty-six (48.1%) respondents started to use PEP within 6 to 24 hours after exposure. Sex, qualification, and attitude status were found to have a significant association with knowledge regarding PEP.

CONCLUSION

The findings of this study indicated that a significant number of health professionals had poor knowledge and poor attitude towards PEP. Occupational exposures were common among health professionals. However, the practice of using PEP was low among health professionals. As a result, health facilities should strengthen and integrate routine PEP services by providing training to all health professionals.

Occupational Exposure to Blood and Body Fluids and Knowledge of HIV Post-Exposure Prophylaxis among Medical and Allied Health Students in Northern Nigeria

Background:

Clinical students are at increased risk of exposure to blood-borne pathogens. However, little has been documented about their exposure to blood and body fluids and their knowledge of post-exposure prophylaxis (PEP) in high-HIV burden settings, such as Nigeria.

Objective:

To determine the prevalence and predictors of BBF exposure and knowledge about PEP among medical and allied health students in northern Nigeria.

Methods:

In a cross-sectional study, 273 clinical students were asked to complete structured questionnaires. The prevalence of BBF exposure was determined. Binary logistic regression was used to determine the independent predictors of BBF exposure.

Results:

The majority of the respondents (98.2%) had heard about PEP; 26.0% (n=71) had adequate knowledge about PEP. 76 (27.8%) of the 273 respondents reported accidental exposure to HIV. 230 (84.2%) respondents had positive attitude toward HIV PEP. Of those who had had accidental exposure to HIV (n=76), only 13% (n=10) received PEP. The level of knowledge about PEP was predicted by previous training (aOR 0.43, 95% CI 0.23 to 0.80 ["no" vs "yes"]), year of training (aOR 4.10, 95% CI 1.60 to 10.47 [6^thvs 4^th year]), course of study (aOR 4.69, 95% CI 2.06 to 10.68 ["allied health" vs "clinical medicine"]) and religion (aOR 5.39, 95% CI 1.40 to 20.71 ["non-Muslim" vs "Muslim"]). Similarly, accidental exposure was independently predicted by respondents’ sex (aOR 2.55, 95% CI1.36 to 4.75 ["female" vs "male"]), age (aOR 2.54, 95% CI 1.06 to 6.15 ["25–29" vs "20–24" years]), ethnicity (aOR 2.15, 95% CI1.10 to 5.14 ["others" vs "Hausa/Fulani"]), course of study (aOR 0.06, 95% CI 0.01 to 0.38 ["allied health" vs "clinical medicine"]), and previous PEP training (aOR 0.39, 95% CI 0.20 to 0.78 ["no" vs "yes"]).

Conclusion:

One in four clinical students reported exposure to BBF. Most students expressed a positive attitude toward PEP, but knowledge and uptake of PEP was sub-optimal. We recommend strengthening training curricula for infection control and prevention and enhancing protocols for timely post-exposure evaluation and follow up for all exposure incidents.

Occupational exposure to blood and body fluids and use of human immunodeficiency virus post-exposure prophylaxis amongst nurses in a Gauteng province hospital

Background

Healthcare facilities in South Africa are confronted by several challenges arising from Human immunodeficiency virus (HIV) and acquired immune diseases syndrome infection pandemic. All categories of nurses continue to experience accidental occupational exposure to blood and body fluids (BBFs) of patients who are HIV-positive. Studies conducted revealed that nurses fail to report the occurrence of the exposures. This represents a serious challenge because they contract HIV infections whilst in the process of helping others.

Objectives

The purpose of this study was to determine the occupational exposures and use of HIV post-exposure prophylaxis (PEP) amongst nurses at the selected tertiary academic hospital, Tshwane district, Gauteng province, South Africa.

Methods

A quantitative descriptive study was conducted with 94 male and female clinical nurses, using a self-administered questionnaire that facilitated collection of biographical data, occupational exposures to BBFs and use of HIV PEP. The data analysis included univariate and bivariate descriptive analyses.

Results

Of the 94 nurses, n = 40 (43%) had been exposed to BBFs, either through sharp or needle prick injuries or splashes but only 16 (46%) of them reported the incident. Nurses were not keen to report accidental occupational exposures to BBFs in their own facility and rather sought HIV PEP outside their workplace. They gave different reasons for their behaviour. For example, ‘I did not know where to report’.

Conclusion

Our study highlights the gaps that exist in reporting occupational exposure to BBFs and obtaining HIV PEP. Therefore, we recommend evaluation of these occupational exposures to BBFs and the management thereof, as well as to address the identified problems.

Knowledge, attitude and practices of medical and health science students on the antiretroviral based HIV post-exposure prophylaxis in an Ethiopian hospital: an institutional based cross-sectional study

Background

HIV/AIDS in resource-limited settings poses a high risk of occupational exposure to healthcare workers due to higher number of HIV infected patients. Hence, antiretroviral based post-exposure prophylaxis (PEP) for HIV is very crucial. The aim of the study was to determine the knowledge, attitudes, and practices of medical and Health science students on antiretroviral based HIV PEP in University of Gondar comprehensive specialized hospital (UOGCSH), Northwestern Ethiopia.

Methods

An institutional-based cross-sectional study was conducted among 220 medical and health science graduating students in UOGCSH from May to July 2015. Data were collected using a self-administered pretested questionnaire. The collected data were analyzed using SPSS software version 22. Results were summarized in frequencies, percentages, and means with standard deviations and presented using tables or figures.

Results

Among the respondents, only sixty-six (30%) of the 220 study participants has had adequate knowledge about HIV PEP. Furthermore, over 90 % of the students had positive attitude towards HIV PEP f. Out of the total respondents, 37/220 (16.8%) were in need of HIV PEP and of these students only 18/37 (48.6%) took PEP. On the other hand, merely 50% of the study subjects completed the full course of HIV PEP, while the rest 50% failed to finish. As to the respondents self-report, the sole reason for starting but failing to complete the full course of HIV PEP was intolerance to the side effects of antiretroviral.

Conclusions

Although majority of the respondents had poor knowledge and practice, they owned a good attitude towards HIV PEP. Therefore, a pre-service intensive training for all students regarding HIV PEP prior to their clinical attachments is mandatory. In addition, potential side effects of ARTs and its managements should be priory informed to the students so as to prevent the associated non-adherence to ultimately reduce the incidence of drug resistance. Moreover, the habit of needle stick injury reporting was found to be poor that needs due improvement and there has been also a pressing need to supply sufficient protective barriers to the students while planning and rendering services.

Prevalence of occupational injuries and knowledge of availability and utilization of post exposure prophylaxis among health care workers in Singida District Council, Singida Region, Tanzania

Background

Infection with Human Immunodeficiency Virus is a serious public health problem that threatens the lives of many people including health care workers. Health care workers are frequently exposed to occupational hazards throughout their careers. Health care workers are at risk of being infected by the virus when caring for patients in health care facilities. Utilization of HIV Post-exposure Prophylaxis (HIV PEP) is very vital once an individual is exposed.

Aim

The aim of this study is to determine the prevalence of occupational exposure, knowledge of, availability and utilization of post exposure prophylaxis among health care workers in Singida District Council, Tanzania.

Methods

A descriptive cross sectional study was conducted from April to May 2013. Health care workers actively treating patients were enrolled from 18 heath facilities in Singida District Council. Data were collected using a self-administered questionnaire, and analysed using Stata version 12.

Results

Out of 239 participants, slightly more than half, 124 (52%) had inadequate overall knowledge of HIV PEP. Of the 239, 121(50.6%) participants experienced occupational exposure. Two leading types of exposure were blood splash 57(47.1%) and needle stick injuries 45 (37.2%),respectively. Among the 121 exposed participants, 83(68.6%) reported the exposure incident, 91(75.2%) had an HIV test, 32 (26.4%), started HIV PEP after testing, 28 (23.1%), completed HIV PEP, and 65 (53.7%) had a follow-up HIV test. About two thirds (159/239), of participants reported that HIV PEP services were available at the time the study was conducted, and 49 (20.5%), reported daily access to HIV PEP service.

Conclusion

The prevalence of occupational exposure among health care workers is high with low utilization of HIV PEP. The majority of healthcare workers had inadequate knowledge of HIV PEP. The findings highlight the need to improve the level of knowledge of HIV PEP and utilization of PEP among this at-high-risk-group in Singida.

Awareness and use of pre-exposure and postexposure prophylaxes among Nigerian university students: Findings from a cross-sectional survey

Despite the recent advances in biomedical preventive strategies, young adults-especially adolescent girls- continue to be disproportionately at risk of acquiring HIV. To avert this trend, it is critical that access to HIV preventive strategies, such as pre-exposure prophylaxis (PrEP) and postexposure prophylaxis be expanded, especially in sub-Saharan Africa, where young adults are known to engage in risky sexual practices. This study examined awareness levels and use of pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) among Nigerian university students.A cross-sectional survey was conducted among 800 students selected using stratified random sampling at 2 Nigerian universities. Descriptive and inferential statistics were used for data analysis on 784 complete responses.The levels of awareness of PrEP and PEP were 18.9% and 25.4%, respectively. Ever tested for human immunodeficiency virus [HIV] (AOR: 1.58; 95% CI: 1.04-2.42) and knowledge of partner's HIV status (AOR: 1.87; 95% CI: 1.25-2.79) were the significant determinants of awareness to PrEP. In contrast, only ever tested for HIV (AOR: 1.50; 95% CI: 1.02-2.19), knowledge of partner's HIV status (AOR: 1.55; 95% CI: 1.07-2.24), ever used condoms (AOR: 1.65; 95% CI: 1.04-2.62), and nude exchanges (AOR: 1.62; 95% CI: 1.13-2.31) were independent determinants of awareness of PEP. Only a few students had seen (5.6%) or used (1.5%) any prophylaxes.The study findings indicate a low level of awareness and use of PrEP and PEP. To ensure no one is left behind in the goal of elimination of new HIV infections, intervention to expand access to these preventive strategies is needed in the study settings.

Awareness and low uptake of post exposure prophylaxis for HIV among clinical medical students in a high endemicity setting

Background

Adequate knowledge and practices on post exposure prophylaxis (PEP) for HIV among health care providers are crucial for HIV prevention. However there is limited data on PEP knowledge and practice from developing countries where the burden of HIV infection continues to increase. We assessed the knowledge of clinical medical students on PEP, their practices in response to occupational exposure to HIV, as well as the determinants of good knowledge on PEP.

Methods

A cross-sectional study was conducted in November 2014 involving 154 consecutively recruited clinical medical students (4^th-6^th year undergraduates). Data were acquired using a structured questionnaire. Knowledge on PEP was assessed using a questionnaire comprising 25 questions and categorized as: good (20 or more correct answers), moderate (13–19 correct answers) and poor (12 or fewer correct answers).

Results

For the 154 students included (57.8 % being male), the mean age was 23.2 ± 2.4 years, and 89 % had heard about PEP for HIV. The majority of students had moderate (61.7 %) and poor (32.5 %) knowledge on PEP. Overall knowledge score increased with increasing level of studies (p < 0.05). Only 10 (6.5 %) had had previous training on PEP, most of whom were senior level students (p = 0.01). Fifty-four students (35.1 %) knew the appropriate duration of PEP and this awareness increased with level of studies (p = 0.001). Of the 81 (52.6 %) who reported occupational exposure to HIV in the past, only 4 (4.9 %) received PEP.

Conclusions

Overall, knowledge on PEP among clinical medical students in this setting was non-optimal with very low uptake PEP. Intensification of HIV curricula to involve PEP as well as continuous medical education programs and workshops are potential avenues to improve awareness in this vulnerable population.

Occupational post-exposure prophylaxis (PEP) against human immunodeficiency virus (HIV) infection in a health district in Cameroon: assessment of the knowledge and practices of nurses

BACKGROUND

Health care providers are at risk of acquiring human immunodeficiency virus (HIV) infection from occupational exposure, with nurses being the most vulnerable. There is no data on the awareness of post-exposure prophylaxis (PEP) among nurses in Cameroon. This study aimed to assess the knowledge, practices of nurses regarding PEP for HIV and their determinants in Cameroon.

METHODS

A cross-sectional study was conducted between April and July 2013, and involved 80 nurses in a rural health district in the North West Region of Cameroon. Data was collected using a structured questionnaire and analysed using the SPSS software version 20.

RESULTS

In all, 73.7% of the participants had poor knowledge about PEP for HIV. Though many (83.8%) had heard about PEP, just 10 (12.5%) had received formal training on PEP for HIV. Only 24 (30%) and 20 (25%) knew the correct drug regimen and duration of treatment respectively. The majority (85%) considered themselves to be at risk of acquiring HIV at work, with 54 (67.5%) having experienced an exposure in the past, mainly while setting up intravenous lines (57.4%), recapping needles (37.0%) and during delivery (24.1%). Of those exposed, ten (18.9%) received PEP, which was started after 24 hours in 50%. In multivariable regression analyses, awareness of hospital policy [OR: 0.043 (0.005-0.404), p-value = 0.006] was associated with Good knowledge on PEP for HIV.

CONCLUSIONS

The knowledge and practice of nurses on PEP for HIV in Cameroon is low. There is urgent need for training programmes and workshops to increase awareness, improve practice, and reduce the risk of HIV acquisition from work related activities among health care providers.

Knowledge, Attitude and Practices toward Post Exposure Prophylaxis for Human Immunodeficiency Virus among Dental Students in India

BACKGROUND

India has the third largest number of people living with human immunodeficiency virus (HIV) and thus, dental practitioners are more likely to encounter such patients for dental management.

AIM

The aim of the following study is to evaluate the knowledge, attitude and practice regarding post-exposure prophylaxis (PEP) for HIV among dental interns and post graduate (PG) students of a dental institution in India.

SUBJECTS AND METHODS

A cross-sectional study was conducted among 128 dental students (64 interns and 64 PG students). Data related to HIV PEP was collected by pre-designed, pre-tested, self-administered questionnaire and difference in responses by education level was assessed by Chi-square test and Z-test (significance level was set at P ≤ 0.05). For statistical analysis, Statistical Package for Social Sciences (SPSS version 16, Chicago IL, USA) was used.

RESULTS

Difference in responses between dental interns and PG students was not statistically significant for majority of questions. All participants had positive attitude toward HIV patients (98.4% [63/64] interns vs. 100% [64/64] PG students). Interns (68.8%, 44/64) and PG students (68.8%, 44/64) were equally aware of the concept of HIV PEP. PG students had better knowledge than dental interns on few questions but overall both of them lacked knowledge about the best timing for commencement of HIV PEP (20.4% [13/64] interns vs. 42.2% [27/64] PG students) (P < 0.01), the antiretroviral drug regimen (48.4% [31/64] interns vs. 43.7% [28/64] PG students) and its duration (23.4% [15/64] interns vs. 25.0% [16/64] PG students), timing of antibody testing to rule out infection to health care worker (23.4% [15/64] interns vs. 35.9% [23/64] PG students) (P = 0.04).

CONCLUSION

As knowledge regarding HIV PEP is found to be inadequate, well-designed educational programs need to be conducted to increase the understanding of dental professionals on this issue.

Knowledge, attitude and practice of dentists towards prophylaxis after exposure to blood and body fluids

BACKGROUND

Post-exposure prophylaxis plays an important role in prevention of bloodborne diseases after occupational exposures.

OBJECTIVE

To evaluate the knowledge, attitude and practice of dentists towards post-exposure prophylaxis.

METHODS

In a cross-sectional study, 140 dentists in Shiraz were selected through a systematic randomized sampling. They filled out a self-made questionnaire including 30 knowledge, 4 attitude and 10 practice questions. Mean of knowledge and percentage of various items of attitude and practice were reported.

RESULTS

The mean±SD knowledge score of dentists was 18.5±6.2. Knowledge had a significant relationship with the level of education (p<0.001), attending infection control seminars (p<0.001), and working in public clinics (p<0.001). A total of 63 (43%) dentists believed that immediate washing of the exposed area has no effect on the prevention of hepatitis and AIDS. Of the studied dentists, 13%, 11%, and 34% believed that prophylaxis after exposure to patients' blood had no effect on prevention of human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C virus infections, respectively. Only 170 (53%) exposed dentists immediately washed the exposed area and only 43 (13.4%) of them evaluated the source patient for risk factors of hepatitis and AIDS.

CONCLUSION

Knowledge, attitude and practice of dentists working in Shiraz towards postexposure prophylaxis are not desirable. Interventions to raise their awareness are therefore warranted.

Outcomes of a Postexposure Prophylaxis Program at the Korle-Bu Teaching Hospital in Ghana: A Retrospective Cohort Study

The risk for occupational exposure to HIV is a serious public health problem that is well characterized in the developed world, but less so in the developing countries such as Ghana. This study was undertaken to examine the characteristics of occupational exposure to HIV and the utilization of a risk assessment system (RAS)-based postexposure prophylaxis (PEP) among health care workers (HCWs) and health care students (HCSs) in the Korle-Bu Teaching Hospital (KBTH). During the study period (January 2005-December 2010), a total of 260 and 35 exposures were reported by HCWs and HCSs, respectively. Ward attendants reported the highest incidence rate of 6.46 of 100 person-years (P-Y). The incidence of high-risk exposures was 0.33 of 100 P-Y (n = 65); 60.0% occurred during a procedure of disposing of a needle and 24.6% during a cannula insertion. A total of 289 of the 295 individuals were administered PEP, of which 181 (62.6%) completed the 6-month follow-up testing schedule and none sero-converted. This shows that with a good RAS in place, it is possible to deploy an effective PEP program in a typical African teaching hospital like the KBTH in Accra, Ghana.