HIV post-exposure prophylaxis: In-take, completion rates and reasons for non-completion among health care workers at a regional referral hospital

Abstract

Abstract
Background: Worldwide, 19.2% of healthcare workers (HCWs) get occupationally exposed to Human
immune deficiency virus (HIV) annually, resulting in approximately 1,000 new HIV infections but the use
of HIV post-exposure prophylaxis (PEP) is largely undocumented. We aimed at assessing the prevalence
of ever taking PEP, completion rates and the self-reported reasons for non-completion among HCWs.
Methods: In a cross-sectional study, we randomly selected and enrolled 206 HCWs from records of HCWs
at a large Regional Referral Hospital between March and October 2020, which included medical staff,
cleaners and medical students. Participants’ socio-demographic, medical, PEP initiation and completion
information was obtained using a self-administered questionnaire. Comparison of “ever taking PEP” and
completing PEP across gender, health cadre, age, religion and marital status categories of the HCWs was
done using Pearson’s chi square test in STATA 15.0 software.
Results: Majority of HCWs were aged above 35years (41.8%), female (54.4%) and qualified medical
workers (64.6). Overall, 37.4% (95% CI: 30.9 – 44.2) reported to have ever taken PEP, of whom 72.7% (95%
CI: 61.5 – 81.7) completed their mandatory 28days of treatment. Reasons for PEP non-completion were:
drug side effects (81%), the source patient testing HIV negative (14.3%) and not finding reason to
complete the treatment (4.7%).
Conclusion: The prevalence of ever taking PEP is high, indicating a high rate of HCW occupational
exposure to HIV. About a third of HCWs, majorly females, married and above 35-year-old do not complete
PEP treatment, with the major reason being drug-related side effects. To avoid potential HIV seroconversion, counselling on adverse events and sensitization of HCWs on good occupational safety and
infection control measures, and dangers of PEP non-completion should be emphasized.