Prevalence and factors associated with risk of HIV occupational exposure and PEP utilization among healthcare workers in Mwanza referral hospitals-Tanzania.

Abstract

INTRODUCTION: It is estimated that about 40 million people are living with HIV/AIDS globally, and of these, two thirds are in sub Saharan Africa. In Tanzania the prevalence of HIV/AIDS among adults is 7%. The increasing number of persons being treated for HIV associated illness makes it likely that more health workers will encounter patients infected with HIV and therefore, they are at high risk of occupational exposure, more so in developing countries with high incidence of blood borne viruses and increased risk of occupational injuries. The use of post exposure prophylaxis (PEP) for HIV reduces the chance of infection. OBJECTIVE: The objective of this study was to study prevalence and factors associated with risk of HIV occupational exposure and PEP utilization among health care workers in Mwanza referral hospitals. METHODS: A Cross sectional study was conducted between January and March 2008 in Mwanza referral hospitals (North west of Tanzania mainland). For quantitative data, a total of 363 health care workers were initially selected by sampling proportionate of size of each hospital and by occupational category in the respective hospitals. Consecutive sampling was done within the different categories (units). Qualitative data were collected from a total of six key informants, three from each hospital selected purposively. RESULTS: The overall prevalence of risk of HIV occupational exposure was 33.9% (95% C1=29.0-38.8). Risk of HIV occupational exposure was high among health care workers in Mwanza regional hospital (Sekou-Toure), (OR 2.44, 95%C1=1.54-3.85). Those working in the departments of surgery and obstetrics were more likely to experience exposure, (OR 1.92, 95%C1=1.19-3.13) and (OR 1.45, 95%C1=0.84-2.50) respectively. The rate of utilisation of PEP services for HIV was suboptional (17.1%95%c1 10.4-23.7). PEP services utilisation was higher among those who worked for forty hours or more per week (OR 5.44, 95%C11.04-28.59). Health care workers who knew the procedures for PEP were more likely to utilize the service (OR 5.88, 95%C1=1.64-20.00). Some of the possible key barriers to utilisation of PEP services for HIV among others were lack of knowledge and information on PEP services for HIV among health care workers, stigma and professional discrimination. CONCLUSION: This study demonstrates that healthcare workers in Mwanza referral hospital are at an increased risk of HIV occupational exposure, and the utilization of PEP services for HIV is suboptimal.