HIV Post-exposure Prophylaxis adherence among healthcare workers in a tertiary, peri-urban hospital in Kenya following needle stick and sharp injuries. A retrospective chart review; 2017 – 2022

Abstract

AbstractNeedle-stick and sharp injuries among healthcare workers are among the most common occupational accidents occurring in hospitals. Approximately half of the responsible instruments are contaminated with blood, putting users at risk of infection by blood-borne pathogens such as HIV. Although post-exposure prophylaxis has been shown to reduce the risk of HIV transmission, adherence to therapy remains a well-documented challenge. This study aimed to assess healthcare workers’ adherence to HIV post-exposure prophylaxis following needle-stick and sharp injuries. To assess adherence, a retrospective chart review was conducted on healthcare workers who were started on HIV PEP following a reported occupational exposure due to needle sticks and sharp injuries between February 2017 and June 2022.A total of 136 health care workers had occupational exposure to needle sticks and sharp injuries. The majority of exposures (82.3%) were at a high risk for HIV transmission. The overall adherence rate to the 28-day HIV PEP course was 26%. Healthcare workers were more likely to complete HIV PEP when the source’s HIV status was positive than when it was negative [42.4% vs. 11.8%; p = 0.001]. The drug regimen (TDF/3TC/DTG) was significantly associated with default treatment (aOR, 5.0 (95% CI 2.0 – 11.0) (p= 0.001), compared with patients using the TDF/3TC/ATVr regimen.Seventy-four percent of the healthcare workers who started PEP defaulted the recommended 28-day course. Therefore, strategies to improve adherence and occupational health are required. Few studies in Kenya have assessed the completion rate of PEP among healthcare workers; these findings will contribute to the body of knowledge in this area.