Challenges in HIV post-exposure prophylaxis for occupational injuries in a large teaching hospital in Malawi

Oosterhout, Joep J. G. van; Nyirenda, Mulinda; Beadsworth, Michael; Kanyangalika, Joseph K; Kumwenda, Johnstone; Zijlstra, Eduard E.

doi:10.1258/004947507779951961

Cited by 16 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One survey in Malawi suggested that half of nurses had a needle stick injury within the previous year. 25 This rate is similar to rates in resource-rich settings prior to the widespread adoption of engineered needle-safe solutions. 26 The consequences of outdated needle practices combined with high prevalence rates of HIV, hepatitis B and hepatitis C may be catastrophic.…”

Section: Discussionsupporting

confidence: 52%

Controlling Healthcare-Associated Infections in the International Research Setting

Godfrey

Villa

Dawson

et al. 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 52%

Controlling Healthcare-Associated Infections in the International Research Setting

Godfrey

Villa

Dawson

et al. 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

“…A striking finding of the study is the extent to which health workers test after occupational exposure, which underscores the importance of guidelines, practices and resources designed to protect health workers and provide post-exposure prophylaxis. With the persistence of moral judgements which promote stigma about HIV and sexual contract, it is possible that health workers may find it easier to seek an HIV test after occupational exposure, despite evidence from Malawi showing that access to post exposure prophylaxis is low (Van Oosterhout et al, 2007). The other commonly reported reason for testing – ill health – underscores health workers’ vulnerability and the fact that even they sometimes delay testing until they experience symptoms.…”

Section: Discussionmentioning

confidence: 99%

Negotiating multiple barriers: health workers' access to counselling, testing and treatment in Malawi

et al. 2010

View full text Add to dashboard Cite

Malawi is facing a severe HIV and AIDS epidemic with an estimated 12% of its population living with the virus. Health workers are on the front lines of the HIV epidemic and they face the risk of HIV infection in both their personal and professional lives. This mixed method study aimed to explore the enablers and barriers to HIV counselling and testing and antiretroviral therapy by health workers in Malawi. After qualitative data were collected through in-depth interviews with health workers in the Mchinji and Nsanje districts, a survey questionnaire was constructed and administered to 906 health workers in eight districts in Malawi. A majority (76%) of health workers surveyed reported having undergone HIV testing and counselling, of whom 74% reported repeat testing. A striking result of the study is that 22% of health workers reported testing after occupational exposure to HIV. The proportions of respondents reporting that they tested after experiencing symptoms, or self-testing for HIV were 11% each. The in-depth interviews and the survey revealed multiple challenges that health workers face to accessing HIV testing, counselling and treatment, including fear of a positive result, fear of stigma and lack of confidentiality. Additional barriers included health workers’ personal acquaintance with those conducting testing, along with their perception of being “role models” which could exacerbate their fears about confidentiality. Given health workers’ critical role in HIV delivery in Malawi, there is need to develop solutions to help health workers overcome these barriers.

show abstract

“…A study in Kenya found that only 4% of HCWs accessed PEP following needle stick injuries [12]. Fear of disclosure and reluctance to test may be major obstacles to HCWs access to HIV testing and counseling (HTC) and other related services [13, 14]. Being infected with HIV can be a source of personal and professional shame for a health worker, and may also invoke fear of losing one's job and damaging future career prospects [14–16].…”

Section: Introductionmentioning

confidence: 99%

HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HIV testing services in Ethiopia

Kebede

Abate²,

Mekonnen³

2013

Pan Afr Med J

View full text Add to dashboard Cite

IntroductionHIV is still an enormous global burden and it is also causing loss of huge health care workers (HCWs) on the already limited human resource capacity in health care services in Sub-Saharan Africa. Variety of methods of accelerating HIV testing is required to increase the rate of HIV testing and expand treatment services. Therefore, this study was aimed to find out the prevalence, feasibility and options of HIV self-testing practices in Ethiopia.MethodsA cross-sectional study design triangulated with qualitative method was conducted from February to May, 2012. The data was collected using a semi-structured pretested questionnaire and in-depth interview, at government and private health centers or clinics and hospitals. During the data collection all the available healthcare workers (HCWs) which encompass the internship students including: Medical, Health Officer, Nurses, Midwives and Laboratory students, and health professionals working in the selected health institutions were involved.ResultsA total of 307 HCWs were included in the analysis and we found that 288(94.4%) of them were ever tested for HIV, of which majority 203 (70.5%) were tested by themselves though 244(80%) of the HCWs had motivation or interest to be tested by themselves. Generally, of the ever tested only 85(29.5%) were tested by the help of health care providers/counselors other than self. Regarding the place where the HCWs had the test, majority 136 (69.4%) tested by themselves at the health facility and the rest were tested at their home, office, market and church. The main reason stated for self-testing was the need for confidentiality for the test result, which was mentioned by 205(82%). Moreover, 35(14.0%) claims lack of time to access the ordinary counseling and testing services.ConclusionThis study depicts high rate of HIV self-testing practice among HCWs. This shows that HIV self-testing can be considered as one pillar to increase the HIV-testing services and a means for the HIV prevention and control policy, through increasing HIV testing uptake and awareness of HIV status. However, the implementation may require the role of different stakeholders and decision makers with further study to extend the options.

show abstract

Challenges in HIV post-exposure prophylaxis for occupational injuries in a large teaching hospital in Malawi

Cited by 16 publications

References 4 publications

Controlling Healthcare-Associated Infections in the International Research Setting

Controlling Healthcare-Associated Infections in the International Research Setting

Negotiating multiple barriers: health workers' access to counselling, testing and treatment in Malawi

HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HIV testing services in Ethiopia

Contact Info

Product

Resources

About