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Occupational exposure to HIV among nurses at a major tertiary hospital: Reporting and utilization of post-exposure prophylaxis; A cross-sectional study in the Western Cape, South Africa.

ABSTRACT: BACKGROUND:While treatment for HIV has greatly improved patient outcomes, health care workers, including nurses, remain at high risk of occupational exposure. The risk of exposure is a continuous concern in the South African health system that is overburdened by multiple stressors, including the highest HIV caseload in the world. The aim of this study was to estimate the prevalence of occupational exposure to HIV, reporting and utilization of post-exposure prophylaxis, knowledge, attitudes towards HIV post-exposure prophylaxis and infection control practices amongst nurses at a tertiary hospital in the Western Cape, South Africa. METHODS:A cross-sectional study was conducted at Tygerberg hospital from the 4th to the 16th February 2019. Participants were front line nurses working in randomly selected wards. A self-administered questionnaire was used to collect data from participants. RESULTS:Of the 160 participants who took part in the survey, 17 reported occupational exposure to HIV (prevalence 10.6%, 95% CI 6.7-16.6), and of the 17 exposed, 10(58.8%) reported needlestick injuries. From those who were exposed, only 10 (58.8%) reported the incidents and went on post-exposure prophylaxis. However, only 6 out of the 10 completed their treatment. Half (50%) of the participants had inadequate knowledge on HIV post-exposure prophylaxis, 83.3% had adequate attitudes towards HIV post-exposure prophylaxis and 75% had adequate infection control practices. CONCLUSION:One out of every nine nurses had occupational exposure to HIV at a major tertiary hospital with poor reporting and utilization of post-exposure prophylaxis. The high proportion of needle stick injuries highlights the need for better infection control training. Similarly, the low levels of HIV post-exposure prophylaxis knowledge show the need for structured intervention and in-service training for health care workers.

SUBMITTER: Kabotho KT

PROVIDER: S-EPMC7156052 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Occupational exposure to HIV among nurses at a major tertiary hospital: Reporting and utilization of post-exposure prophylaxis; A cross-sectional study in the Western Cape, South Africa.

Kabotho Katlego Tebogo KT Chivese Tawanda T

PloS one 20200414 4

<h4>Background</h4>While treatment for HIV has greatly improved patient outcomes, health care workers, including nurses, remain at high risk of occupational exposure. The risk of exposure is a continuous concern in the South African health system that is overburdened by multiple stressors, including the highest HIV caseload in the world. The aim of this study was to estimate the prevalence of occupational exposure to HIV, reporting and utilization of post-exposure prophylaxis, knowledge, attitud ...[more]

PMID: 32287263

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Project description:IntroductionPre-exposure prophylaxis (PrEP) is a safe and effective prevention strategy to reduce women's risk of HIV in pregnancy and postpartum. Effective PrEP protection requires daily PrEP adherence, but little is known about maternal PrEP continuation and factors that influence PrEP use.MethodsThe PrEP in pregnancy and postpartum (PrEP-PP) study enrolled consenting pregnant, HIV-negative women at first antenatal care (ANC) visit with follow-up through 12 months postpartum. Eligible and consenting women and girls ≥16 years received HIV prevention counselling and were offered PrEP. Interviewers collected socio-demographic and behavioural data from participants at each visit. We analysed the proportion of women who initiated PrEP and the proportion who continued PrEP after 3 months with associated correlates by estimating the prevalence ratio adjusting for a priori confounders.ResultsBetween August 2019 and October 2021, we enrolled 1201 pregnant women (median gestation 21 weeks; age 26 years); 84% of women initiated PrEP at their first ANC visit (n = 1014); 55% were married or cohabiting. Overall, 66% of women on PrEP returned for a repeat prescription at 1 month; 58% returned at 3 months (n = 493 of 844). Almost one-half of women on PrEP reported a side effect at 1 month, mostly nausea/vomiting. Women on PrEP in the first and second trimesters had higher odds of reporting side effects (aOR 2.61; 95% CI 1.17-5.84) versus postpartum women. Women who reported side effects continued with PrEP less than those who did not report side effects (aPR = 0.87; 95% CI 0.77-0.97). Women with ≥1 previous pregnancy (aPR = 0.76; 95% CI 0.57-1.01) or were postpartum (aPR 0.85; 95% CI 0.75-0.97) were less likely to continue PrEP compared to women who were primigravid or pregnant. Women who reported having an HIV+ partner (aPR = 1.45; 95% CI 1.13-1.85) or high HIV risk perception (aPR = 1.20, 95% CI = 1.01-1.41) were more likely to continue on PrEP than those who had HIV-negative partners or low risk perception.ConclusionsPrEP initiation and early continuation were high in this setting, compared to other studies in women. Being postpartum and experiencing side effects were associated with lower PrEP continuation, presenting opportunities for counselling on early transient side effects. Interventions for postpartum women on PrEP are needed.

Dataset Information

Occupational exposure to HIV among nurses at a major tertiary hospital: Reporting and utilization of post-exposure prophylaxis; A cross-sectional study in the Western Cape, South Africa.

Publications

Occupational exposure to HIV among nurses at a major tertiary hospital: Reporting and utilization of post-exposure prophylaxis; A cross-sectional study in the Western Cape, South Africa.

Similar Datasets

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