Human Immunodeficiency Virus Post-Exposure Prophylaxis Among Health Care Workers in Nigeria: A Review on Research Evidence and Practice

Abstract

Background: The prevalence of human immunodeficiency virus (HIV) post-exposure infections among health care workers (HCW) in Nigeria is higher than the national prevalence. Hence, the need to strengthen capacity to opt in for post-exposure prophylaxis among HCWs. The aim of this review is to evaluate the practice of post-exposure prophylaxis (PEP) for HIV infection among HCWs in Nigeria in order to break the cycle of transmissions.

Methodology: A search was made to review articles published on the PubMed® database using "Post-Exposure Prophylaxis"[MeSH], “Occupational Exposure” and HIV, Nigeria, yielding 39 articles. Further search was made in Google Scholar with the key words: “HIV PEP” AND “health workers”, “Nigeria” that produced 76 results, giving rise to a total of 115 articles from 2010 to 2019. After screening, ten studies were eventually included in this study.

Result: The studies reviewed were cross-sectional studies that involved different cadres of HCWs practising at different levels of health care. Majority of the HCWs studied had knowledge of existing protocol for PEP while only a fifth reported undergoing HIV PEP training programs. The practice of PEP was low in the studies. Training on occupational exposures and HIV PEP was found to be significantly associated with high knowledge and practice of HIV PEP in the studies reviewed. The reasons responsible for the low use of HIV prophylaxis among HCWs were lack of written PEP protocols, lack of the antiretroviral drugs, fear of stigmatization, and fear of side effects of the ART.

Conclusion: Training HCWs across different healthcare cadres on the practice of HIV prophylaxis should be routine in all health care facilities.