Uptake of human immunodeficiency virus post exposure prophylaxis and associated factors among healthcare workers in Dar es salaam, Tanzania

Abstract

ABSTRACT Background: Human immunodeficiency virus (HIV) infection is one of the diseases of public health concern. Occupational exposures result in 4% of all HIV infection among health care workers (HCWs). HIV post-exposure prophylaxis (PEP) guidelines exists for post-exposure management. There is limited up-to-date comprehensive data on the uptake of HIV PEP and the associated factors among healthcare workers in Dar es Salaam, Tanzania. We assessed the specific factors associated with HIV post exposure prophylaxis among HCWs in this locale. Objectives: The study aimed to determine the uptake and associated factors with HIV PEP among HCWs in tertiary hospitals in Dar es salaam, Tanzania for the year 2022/2023. Materials and Methods: A healthcare facility-based cross-sectional study involving 302 HCWs was conducted at the national referral hospital and the three regional referral hospitals in Dar es salaam, Tanzania. Data was collected through an interviewer-administered questionnaire. Modified Poisson regression analysis was done to identify factors associated with HIV PEP uptake. Results: We recruited 302 participants. The HIV PEP uptake was 14.6%. Reasons for not initiating or completing the dose included medication side effects (46.6%), source patient testing negative (37.2%), and feeling that the 4-week dose was unnecessary (16.3%). Ages 31 years and greater (adjusted prevalence ratio (aPR)=0.37; 95% CI: 0.20-0.65), and being female (aPR=0.09; 95% CI:0.04-0.22) were associated with a lower PEP uptake. Hailing from the surgery department (aPR=2.95; 95% CI:1.17-7.48) and a positive attitude towards HIV PEP (aPR=6.41; 95% CI: 1.15-35.62) is associated with a higher PEP uptake. Conclusions and Recommendations: This study demonstrates that the utilization of HIV PEP following occupational exposure among HCWs is low. These results provide a basis for improving the HCWs attitude towards HIV PEP by normalizing the use of PEP, by leadership endorsement, and by addressing myths and misconceptions. Also, further studies covering different regions as well as private hospitals are needed for comparison and to get a more accurate bigger picture.