HIV post-exposure prophylaxis adherence due to needle stick and sharp injuries

Abstract

Background: Needle stick and sharp injuries (NSSIs) amongst healthcare workers (HCWs) are among the most common occupational accidents in hospitals. Approximately half of the responsible instruments are contaminated with blood, putting users at risk infection from blood-borne pathogens such as HIV. Although post-exposure prophylaxis has been shown to reduce the risk of HIV transmission, adherence to therapy is a well-documented challenge. Aim: To assess healthcare workers adherence to HIV post-exposure prophylaxis following Needle stick and sharp injuries. Method: A retrospective chart review was conducted on HCWs who were started on HIV PEP following a reported occupational exposure due to NSSIs between February 2017 and June 2022 to assess adherence. Result: A total of 136 HCWs had occupational exposure to NSSIs. The majority of the exposures (82.3%) were high risk for HIV transmission. Overall adherence to the 28-day HIV PEP course was 26%. HCWs were more likely to complete HIV PEP when the source's HIV status was positive compared to when it was negative [ 42.4% vs 11.8%; p = 0.001]. The drug regimen (TDF/3TC/DTG) was significantly associated with defaulting treatment (aOR; 5.5 (95% CI 2.16 - 14.02) (p= 0.001), compared with patients using the TDF/3TC/ATVr regimen. Conclusion: 74% of HCWs who started PEP defaulted the recommended 28-day course. Possible strategies for improving adherence and occupational health are required. Contributions: Few studies in Kenya have assessed the completion rate for PEP among HCWs; these findings will contribute to the body of knowledge in this area.