## 4 Discussion
On the other hand, almost half (44.68%; \(p\) = 0.14 \(>\) 0.05) of the respondents did not know if HIV PEP services were available in their own hospital, although this did not significantly differ from the 55% that knew of PEP services' availability. This finding is lower than 60% of the participants who were unaware of the availability of PEP guidelines [12]. This indicates a poor adherence to reporting procedure and implies that the respondents will not report occupational exposures in time, increasing the risk of HIV infection transmission amongst HCW. Adherence to the reporting protocols and guidelines is fundamental for the prevention of the accidental acquisition of HIV infection in healthcare settings. Furthermore, it assists with the proper immediate management of the exposed individual in the control and prevention of the infection. Among the respondents, 84% did not know a place to seek HIV PEP in their own hospital, which was significantly lower than those who knew (16%) (\(p\) < 0.0001). This result means that when there is a need for PEP service, nurses will experience delays as they do not know the exact place to access PEP services. According to [23], this is a reason why many HCWs are not reporting occupational exposures, as they are not sure where to report. This finding highlights the implications of the increased risk of unknown ongoing HIV transmission among HCWs. Therefore, a need to continuously train, inform. and support HCWs regarding HIV in general to strengthen their practice in managing occupational exposure to HIV infections is recommended. Health care workers who recognize the presence of occupational HIV risk are motivated to practice universal infection control measures. Comparison between the knowledge of HIV PEP and work experience revealed that those with five years and less experience are less knowledgeable compared to those with higher than 5 years' experience in responding to the question that HIV Post Exposure Prophylaxis is a short-term medical therapy to prevent the spread of HIV infection (Chi-170.024; \(p\)-0.0039) and, as immediate first aid after exposure to hazardous blood and body fluids, health care workers should wash the affected area with clean water and soap (Chi-47.06067;0.0001). On the positive side, most of the study respondents knew the preferred time delay to take PEP (55.32%), and the results found a strong association with gender for this response (Chi-12.27; \(p\)-0.00216 \(<\) 0.05). These results are far better than (5.3%) those reported in eastern Ethiopia [15]. It is advisable to provide HIV PEP within an hour to 72 h following exposure, since the efficacy of HIV PEP depends on the time that it is initiated [24]. Although 39.36% had knowledge of the recommended drugs for HIV PEP, it was disturbing to realize that 24.47% of the nurses left the question unanswered and 36.17% answered incorrectly with a significant difference (\(p\) = 0.03 \(<\) 0.05). The HIV PEP involves the use of ART drug combinations with some specific instructions relating to their side effects, use, and route of administration. The poor knowledge of recommended HIV PEP drugs implies that nurses do not have adequate knowledge of the benefits, use, route, and completion of course for the effectiveness and side effects of the drugs, and implies that nurses could stop them when they experience side effects. The literature shows that many HCWs stop taking ARTs before finishing the course and choose not to follow up as they are supposed to.