Rediet Teshome Ayele^1,, Wondwossen Amogne Degu², Henok Baharu Wodajeneh¹, Samson Bassa Gaga¹

Background: HIV is a major global public health issue, having claimed 38 million lives so far. HIV infection in health care facilities has become a major health problem, especially in resource- poor setting. Health care workers are at risk of many diseases in health setups. There is a small but definite occupational risk of HIV transmission to health care workers. Post exposure prophylaxis is recommended to prevent transmission of pathogens after potential exposure and further development of infection. If started soon after exposure PEP can reduce the risk of HIV infection by over 80%. Although studies have found that awareness of PEP, so far there is no publication assesses utilization practice and subsequent follow up at Tikur Anbessa Specialized Hospital. Objective: The objective of this study was to evaluate post-exposure prophylaxis (PEP) utilization among HIV-exposed health care workers and non-occupational exposures.Methods: A retrospective cross-sectional study was conducted by reviewing the PEP registry book from January 1, 2017- July 30, 2021 and follow up data is collected by interviewing the exposed case. Data were entered using SPSS version 26 and descriptive analysis was done. Result: A total of 353 cases of occupational and non-occupational exposure were reported to the ART clinic; PEP was prescribed for 352 subjects with an average of 77 subjects/year. The mean age of the study participant was 27.3 ±7, the majority (57.2%) was male, Most (86.7%) of the exposure was occupational, 27% of occupational exposure was reported by residents, followed by nurses 26.1%. Of the occupational exposure, 30.4% were from different wards, followed by emergency OPD (17.1%), and operating theater (7. 2%). Of non-occupational exposure, 48.9% of cases were due to sexual assault. Most (42.7%) of the exposure risk type was EC2 code type followed by EC3 code type (37.6%). The source patient HIV status was unknown in 65.9% for non-occupational and 30% for occupational exposure. Two drugs (TDF/3TC) regimen was prescribed for 87.8% of cases. Over 90% of the exposures were reported within 24hrs of the incident, and 45.2% of the exposed cases had an adverse reaction. No sero-conversion was reported.Conclusion: At the TASH ART clinic, PEP antiretroviral drugs were prescribed for both occupational and non-occupational HIV exposures. The utilization rate of PEP has been decreasing annually. In TASH, the ART clinic risk assessment and PEP initiation followed the national occupational and non-occupational exposure guidelines. The selection of the regimen was based on a case-by-case analysis, with the two-drug regimen TDF/3TC being the most commonly used. PEP was initiated within 72 hours of exposure. While most cases completed the full PEP regimen, documentation on follow-up and adverse reactions was inadequate.

Post exposure prophylaxis, Occupational, Non-occpational, Healthcare workers, HIV exposure, Tikur Anbessa Hospital