Determinants of post exposure prophylaxis uptake following occupational exposure to HIV in Matabeleland South Province, 2018.

Abstract

Occupational exposures to blood borne infections such as HIV represent a major risk factor for health care workers. Post-exposure prophylaxis reduces the likelihood of HIV infection after potential exposure and can reduce the risk of HIV infection by over 80%. In Matabeleland South Province, a preliminary review showed a low uptake of PEP among health care workers. A study to determine the factors associated with uptake of PEP among HIV exposed health workers was carried out in Matabeleland South Province. An unmatched 1:1 case-control study was conducted. A case was defined as a health care worker in Matabeleland South Province who was occupationally exposed to HIV in 2018 and did not commence on HIV PEP.A control was a health care worker in Matabeleland South Province, occupationally exposed to HIV in 2018, and commenced on HIV PEP. An interviewer-administered questionnaire was used to collect data from 186study participants. Epi. InfoTM7.2.2.6 was used to generate frequencies, medians and proportions and to explore associations between exposures and PEP uptake. A total of 93 cases and 93 controls were recruited into the study. Females constituted 51% of the study participants. Forty-seven (51%) of the 93health workers who took PEP had good knowledge on PEP compared to 23% who did not take PEP. Having a history of previously occupational exposures (aOR=2.62, 95% CI 1.29-5.33), having a perceived risk of HIV infection at the workplace (aOR=0.28, 95% CI 0.14-0.54) and having been trained on PEP (aOR=0.42, 95% CI 0.22-0.81) were independent factors associated with uptake of PEP. Twenty-one(36%) of the 58 health workers who did not complete the PEP course highlighted side effects of the medication as the major reason for non-completion of PEP. The study revealed significant knowledge gaps regarding PEP among those who did not take PEP. Health workers’ perception of the risk of HIV acquisition at the workplace and training of health care workers on PEP play an important role in uptake of PEP services. Side effects of PEP contribute to non-adherence to the medication. Having a health system that offers a comprehensive package of counselling, follow up and accessible PEP services may increase uptake of PEP services.