Factors affecting utilization of HOV post exposure prophylaxis among nurses and mid wives in mulago hospital, Uganda.
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INTRODUCTION: Exposure to the human immunodeficiency virus (HIV) in hospital settings is a major concern for health care workers particularly in developing countries because of the high prevalence of HIV in many poorer regions of the world. The prevalence of HIV/AIDS among Ugandan adults aged between 15-49 years is estimated at 6%. The highest (9%) HIV prevalence in Uganda is found in the central region and kampala. Mulago hospital located in kampala, is a national referral, research and teaching hospital, receives substantial number of HIV/AIDS patients seeking specialized and basic health care. Nurses and mid-wives in mulago hospital are therefore at high risk of exposure to HIV/AIDS through needle stick injuries and percutaneous exposure. Mulago hospital has respondent to the problem by establishing protocols and facilities for HIV post exposure prophylaxis. However it is not well documented whether nurses and midwives are familiar with or utilize HIV post exposure prophylaxis. The purpose of this study was to identify factors affecting utilization of HIV Post exposure prophylaxis among nurses and midwives in mulago hospital. METHODOLOGY: A Descriptive correlational study was conducted to determine the factors affecting utilization of HIV post exposure prophylaxis among nurses and midwives in mulago hospital who were in direct management f patients. A sample size for this study was 100. A Self administered questionnaire was used to collect data. RESULTS: The incidence of occupational exposures is high, mucous membrane 57(47.6%), needle stick injuries 51(51%). The most common response given by the participants was recapping of needles 68(17.5%) as the most likely situation when a needle stick injury could occur. However, 59(59%) of the participants recapped needles. Seventy four (74.0%) stated they were aware that mulago hospital bas a policy on reporting needle stick injuries. Fifty five (55.0%) stated that they had not sought advice about HIV PEP and 15(15%) utilized HIV PEP services. Fifty eight (58.0%) of participants stated that after exposure, ARV drugs should be started immediately. Fifty seven (39.6%) did not know which antiretroviral drugs are recommended for HIV PEP. Seventy four (74.0%) did not know the recommended duration for HIV PEP. Sixty two percent (62%) of the participants knew about the HIV PEP programme at mulago hospital and 55(55.0%) stated that they had not sought advice about HIV PEP and the reasons they gave was not knowing where and whom to report to, not aware of HIV PEP program and did not want to take ARVs. Other barriers stated were were difficulty in accessing ARV drugs, side effects and tolerability of ARV drugs. Factors discovered from an open ended question as to why the participants in this study did not utilize HIV PEP was unavailability of PEP services at night, weekends and on public holidays, lack of knowledge about PEP and unclear protocol for accessing PEP services. There was a positive statistically significant relationship (r 0.372, p-value 0.000) between knowing where to go for HIV PEP and utilization of HIV PEP. There was a negative statistically significant relationship (r= -0.215, p-value=0.033) between years in nursing practice and utilization of HIV PEP. CONCLUSION: The results of the study showed that nurses and mid-wives at mulago hospital are at a high risk of occupational exposure to potentially HIV infectious blood and body fluids. The majority of the nurses and mid-wives did not utilize HIV PEP because they did not know where to go or who to report to, PEP services were not available at night and on public holidays, lack of knowledge on PEP and the protocol for accessing PEP services was not clear to them. Others said it was not necessary, did not want to take ARVs, and side effects of ARVs prevented them from taking them.