PG-4 Self-reported occupational exposure to HIV and Knowledge, Attitude to Post Exposure Prophylaxis among Health Care Workers in Federal Capital Territory, Abuja, Nigeria
Authors: Iwodi Clementina , Olayemi Olayemi , Adetunji Adeyosola , Edokwe Chidozie , Okuma James , Peters Samuel , Dakum Patrick , Ekong Ernest 
Published: April 2019

Background:
Health care workers (HCW) face major occupational exposures to the human immune deficiency virus (HIV) and other blood borne infectious agents. Not much is known about factors that predict correct and effective practice of management of such exposures. This study was conducted to determine the prevalence and types of self-reported occupational exposures to HIV among HCWs, and factors that influence the practice of managing such exposures by the HCWs. With PEPFAR emphasizing epidemic control, the HCW must know how to prevent occupational exposure.

Methods:
A cross-sectional study was conducted among HCWs in 20 health care facilities providing primary, secondary, tertiary and private care services in Federal Capital Territory, Abuja, Nigeria in June 2018. Data was collected using self-administered questionnaire on occupational exposures in the last 12 months and situations the exposures occurred. Results were summarized in percentages, median and interquartile range (IQR).

Results:
A total of 88 HCWs who had at least one occupational exposure completed the survey, of which 37 (42.0%), 18 (20.5%), 16 (18.2%) and 17 (19.3%) were from primary, private, secondary and tertiary health care facilities respectively. Majority of the HCWs were females 58 (67.4%), 61 (71.8%) were aged 18–39 years and 33 (37.9%) were nurses. The median number of patients seen daily by HCWs was 30 (IQR 20–60) and the median number of years in clinical practice was 9 (IQR 4–14).
Of 88 HCWs who had at least one occupational exposure, 51 (57.0%) had experienced at least one occupational injury in the past 12 months, 70 (82.4%) were screened and followed up for HIV after occupational exposure. Among those who did not screen for HIV, half of them had assumed the patient was HIV negative or of no risk.
Thirty-seven (43%) of HCWs had experienced exposure through needle stick injury, 20 (23.3%) had splashing of blood or bodily fluid on mucosal surfaces, 23 (26.7%) had both needle stick injury and splashing of blood or bodily fluid on mucosal surfaces and 6 (7.0%) had other exposures.
Exposures were experienced during the following circumstances: Setting up IV line (25, 31.6%), during surgery (22, 27.8%), giving injections (23, 29.1%), collecting blood samples (31, 39.2%), recapping needles (23, 29.1%), during delivery (28, 35.4%), others (4, 5.1%).
Eighty-one (94.2%) of the HCWs had heard about Post Exposure Prophylaxis (PEP) for HIV, while only 49 (55.7%) had PEP for 28 days.

Conclusions:
Majority of HCWs had experienced at least one occupational exposure during the past 12 months, with the highest frequency being needle stick injuries and/or splashing of blood or bodily fluid on mucosal surfaces. There is the need for improved knowledge of the risk of HIV transmission and provision of health education on occupational exposure. This will strengthen healthcare workers' practices to manage occupational exposure. Keywords: HIV, Occupational exposure, Health care workers.