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Post Exposure Prophylaxis for HIV among Health Care Workers

Knowledge and Practice of Post Exposure Prophylaxis for HIV among Health Care Workers in Mission Hospitals in Enugu Urban

CHAPTER ONE

                                             INTRODUCTION        

BACKGROUND OF STUDY                           

Approximately, 3 million health workers are exposed to precautious exposure to blood borne virus each year of which approximately 5,000 contact HIV infections. However, more than 90 percent of these infections are occurring in low income countries due to high prevalence of HIV implicating more patients to be HIV positive. This increases the incidence of HIV exposure for health care workers (Bosena & Chernet, 2008). To curb the impending danger resulting from occupational exposure to HIV, the centre for disease control (CDC) recommended treating exposure with post exposure prophylaxis. Post exposure prophylaxis is a short term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or non-occupationally (WHO, 2013). PEP is most likely to be effective if it is started within hours of exposure and not later than 72 hours and outcomes may be compromised as the time from exposure increases. The efficacy of post exposure prophylaxis is also related to the specific PEP regimen and the exposed health care workers adherence to the PEP regimen. There are inadequate levels of knowledge on occupational HIV post exposure prophylaxis among health care workers (Monera & Ncube, 2012). It is important that health care workers who are at potential risk of exposure to HIV/AIDS are aware of the procedures to follow and where their first point of contact should be if an exposure occurs but prevention of exposure remains the most effective measure to reduce the risk of HIV transmission to health workers. The use of universal precaution guidelines in workplace has shown to reduce the incidence of occupational exposure to blood borne infections like HIV. Despite these precautions, occupational exposures still occur and apparently are under-reported in some institutions (Alenyo, Fualal & Jombwe, 2007). These exposures need to be followed up with post exposure prophylaxis to prevent such occupational hazards as HIV/AIDS. Okafor and Ugwu (2009) revealed that many doctors, nurses and laboratory scientists do not practice post exposure prophylaxis following exposure and this is likely to add to the burden of HIV in the society. Within the health sector, Post exposure prophylaxis should be provided as part of a comprehensive universal precautions package that reduces staff exposure to infectious hazard at work and there should be a 24 hours accessible formal post exposure prophylactic centre with proper guidelines. Researches had been conducted on the awareness of PEP for HIV among health care workers but few on the practice. Therefore, the researcher wishes to undertake both knowledge and practice of post exposure prophylaxis for HIV among health care workers in mission hospitals in Enugu urban,

STATEMENT OF PROBLEM

Access to HIV care and treatment has improved over the past several years but safety standards and precautions have not improved in the same proportion leading to increased risk of exposure to and transmission of HIV through occupational injury, mainly through needle stick injury.   World Health Organisation WHO (2008) estimated that 0.5 percent of health care workers globally is exposed to HIV annually, corresponding to an expected 1000 new HIV infections from occupational exposure. As the prevalence of HIV continues to increase, the number of patients with HIV within the hospital increases and immediate management of exposures to HIV become increasingly important.        This study therefore seeks to find out the knowledge and practice of post exposure prophylaxis for HIV among health care workers in missions hospitals in Enugu urban.

OBJECTIVES OF THE STUDY

–        To determine the knowledge of health care workers in mission hospitals in Enugu urban on HIV post exposure prophylaxis.

–        To determine their practice of post exposure prophylaxis for HIV.

–        To ascertain the factors influencing the utilization of post exposure prophylaxis for HIV among health care workers in mission hospitals in         Enugu urban.

SIGNIFICANCE OF THE STUDY                  

The findings of this study if communicated will help to; Enlighten health care workers on steps to take when they encounter needle stick injury, Increase health care workers practice of post exposure prophylaxis for HIV having known the implication and Serve as a reference for further studies on the knowledge and practice of post exposure prophylaxis for HIV among health care workers.

RESEARCH QUESTIONS

  • What do health workers in mission hospitals in Enugu urban know about post exposure prophylaxis for HIV?
  • How do health workers in mission hospitals practice post exposure prophylaxis for HIV?
  • What are the factors that influence the use of post exposure prophylaxis for HIV among health workers in mission hospitals in Enugu urban?

SCOPE OF STUDY

The scope of the study is limited to health workers in mission hospitals in Enugu urban.

OPERATIONAL DEFINITION OF TERMS

Knowledge of post exposure prophylaxis – the state of knowing the set of comprehensive services to prevent HIV infection in exposed individual within the period of 72 hours.

Practice of post exposure prophylaxis– is utilizing the set of comprehensive services to prevent HIV infection in exposed individuals within the period of 72 hours.

Health workers – they are doctors, nurses and medical laboratory scientists working in mission hospitals in Enugu urban.

Post exposure prophylaxis – refers to a set of comprehensive services to prevent HIV infection in exposed individuals within the period of 72 hours.

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