Utilization of Post Exposure Prophylaxis among HIV Exposed Health Care Workers and Nonoccupational Exposure at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2017- 2021 G.C

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Addis Abeba University


Background: -HIV is a major global public health issue, having claimed 38 million lives so far.Ethiopia is one of the most seriously affected countries in sub-Saharan Africa, with many people living with HIV/AIDS. HIV infection in health care facilities has become a significant health problem, especially in resource-poor settings.Health care workers are at risk of many diseases in health setups. There is a small but definite occupational risk of HIV transmission to health care workers. PEP is recommended to prevent the transmission of pathogens after potential exposure and further development of infection.If started soon after exposure, PEP can reduce the risk of HIV infection by over 80%.Although studies have found that awareness of PEP, no publication assesses utilization practice and subsequent follow-up in our institution. Objective: -To evaluate post-exposure prophylaxis (PEP) utilization among HIV-exposed health care workers and nonoccupational exposures at Tikur Anbessa Specialized Hospital (TASH)Antiretroviral Treatment (ART) clinic from January 1, 2017- July 30, 2021. Methods: -We conducted a retrospective cross-sectional study by reviewing the PEP registry book from January 1, 2017- to July 30, 2021, and follow-up data is collected by interviewing the exposed case. Data were entered using SPSS version 26, and descriptive analysis was done. Result: -A total of 353 cases of occupational and nonoccupational exposure were reported to the ARTclinic; PEP was prescribed for 352 subjects with an average of 77 subjects/year. The mean age of the study participant was 27.3 ±7., the majority (57.2%) was male, Most (86.7%) of the exposure was occupational, 27% of occupational exposure was reported by residents, followed by nurses 26.1%. Of the occupational exposure, 30.4% were from different wards, followed by emergency, OPD (17.1%), andoperatingtheater (7. 2%). Of nonoccupational exposure, 48.9% of cases were due to sexual assault. Most (42.7%) of the exposure risk type was EC2 code type followed by EC3 code type (37.6%). The source patient HIV status was unknown in 65.9% for nonoccupational and 30% for occupational exposure. Two drugs (TDF/3TC) regimen was prescribed for 87.8% of cases. Over 90% of the exposures were reported within 24hrs of the incident, and 45.2% of the exposed cases had an adverse reaction. No seroconversions were reported. Conclusion In TASH,the ART clinic risk assessment, PEP initiation followed the national occupational and nonoccupational exposures guideline. The type of regimen selected was a case-by-case analysis, and there was more PEP request among the occupational exposure during the months between July to December. Recommendation We recommend providers should follow the exposed individuals within 48 hours, and ongoing followup, either by telephone call or, if possible, in person, to assess PEP tolerability and adherence.



Post-exposure prophylaxis,HIV transmission,Health care workers