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

Abstract

BackgroundAdequate 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.MethodsA cross-sectional study was conducted in November 2014 involving 154 consecutively recruited clinical medical students (4th-6th 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).ResultsFor 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.ConclusionsOverall, 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.

Knowledge, attitude and practice of needle stick injury and post exposure prophylaxis in undergraduate medical students

“…9.14 Poor knowledge of healthcare workers on the PEP guidelines has been mentioned in few studies carried out previously. 11,12,15,16 In a study by Aminde though mentioned that 27% of medical students indeed knew the ideal PEP guidelines. 16 This observation was further supported by the findings of Saleem which observed that 33% postgraduate students and 19% doctors had exact knowledge on PEP and also the time of initiation of PEP.…”

“…11,12,15,16 In a study by Aminde though mentioned that 27% of medical students indeed knew the ideal PEP guidelines. 16 This observation was further supported by the findings of Saleem which observed that 33% postgraduate students and 19% doctors had exact knowledge on PEP and also the time of initiation of PEP. 12,13 These findings perhaps implies a positive correlation between the years of clinical experience with the knowledge on PEP guidelines.…”

“…2,11,14 In contrast to our finding, a study carried out by Aminde stated that 34% of their students knew the ideal regimen of 3 drugs as per their country guidelines for HIV PEP. 16 When asked about the reasons for not using the PEP against HIV, approximately 50% students replied that they were unaware of the existence of PEP whereas many interns replied the fear of the side effects that discouraged them from receiving PEP. Also students had no idea about the time to do HIV-ELISA test following a NSI.…”

“…On enquiring regarding the immediate measures taken following NSI, 48% students stated as washing with soap and water, similar to the findings cited in other similar studies. 2,11,14,16 When asked about the factors that contributes to NSI, almost 50% students opined that it is the high patient load whereas 30% students answered it as the casual approach of the healthcare workers towards the NSI. When asked about Hepatitis B vaccination, it was realized that only 60% of our students were vaccinated against Hepatitis B virus which was below par in as compared to 90% of the medical students in study by Saleem.…”

Assessment of knowledge and usage of HIV post exposure prophylaxis among healthcare workers in a regional hospital in Ghana

“…About 90% of our respondents knew that when a percutaneous injury occurs, the site must be washed with soap under running water and over half knew that mucous membranes should be flushed with copious amounts of water. Other studies such as Agaba et al 17 , Aminde et al 5 and Bairy et al 7 also documented a high percentage of respondents (over 95%) having adequate knowledge for the first aid for exposure but in contrast, lower levels of knowledge (about 40%) were reported by Lamichanne et al 13 and Foster et al 12 This means that the level of importance given to PEP in the various study sites are different as first aid after exposure is one of the most important elements in HIV infection prevention as far as HCWs exposure is concerned.…”