Assessment of knowledge, attitude and practice of post exposure prophylaxis for HIV among nurses at Jigme Dorji Wanghuck National Referral Hospital, Bhutan

Abstract

Nurses are managing huge number of patients infected with human immunodeficiency virus (HIV), which made them highly vulnerable to HIV infection through occupational exposure such as needle stick injuries and splashing of blood/bodily fluids on mucosal surface. This made the practice of post exposure prophylaxis (PEP) for HIV crucial among nurses. Therefore, our study aimed to assess knowledge, attitude and practice of PEP for HIV among nurses in Bhutan. A cross-sectional study was conducted among 221 registered nurses working at Jigme Dorji Wangchuck National Referral Hospital, Bhutan between April and June 2017. A structured self-administered questionnaire was used to collect data and analysed using SPSS version 21. Majority (80.1%) of our participants had poor knowledge regarding PEP for HIV. Although half (51.1%) of our participants had heard about PEP, only 3 (1.4%) attended a formal training on PEP for HIV. However, a significant proportion of nurses (92.3%) had positive attitude towards PEP for HIV. Out of 221 respondents, 95(43%) had been exposed to needle stick injuries and splashing of blood/bodily fluids while managing patients. Despite significant number of exposures, only 2 (2.1%) of them took PEP and completed 28 days of prophylaxis. Lack of protective barriers at work place (56.8%) and poor knowledge on personal protective equipment (14.7%) were major perceived causes of exposure among study participants. No PEP service (30.2%) and lack of support to report incidents (22.6%) were two major reasons leading to failure of PEP practice among exposed individuals. Despite positive attitude exhibited by majority of our respondents, the level of knowledge and practice of PEP for HIV among nurses was very low. Therefore, a formal training on PEP and 24 hours accessible PEP service with proper guidelines are recommended to improve the overall knowledge and practice of PEP against HIV among nurses.

HIV/AIDS post‐exposure prophylaxis knowledge and uptake among health professionals in Africa: Systematic review and meta‐analysis

“…According to this systematic review and meta‐analysis, the estimated pooled uptake of HIV/AIDS PEP among healthcare providers in Africa with a random‐effects model was 40.09% (95% CI: 30.14–50.04). This study is similar with study conducted in Pakistan (35.3%) [62,64], but higher than studies conducted in Bhutan (2.1%) [63] and Portugal (1.8%) [64]. This might be due to variations in sociodemographic characteristics, knowledge level and accessibility of the drug.…”

“…Funnel plot with pseudo 95% confidence limits F I G U R E 8 Sensitivity analysis of pooled prevalence of knowledge for each study being removed one at a time similar with study in Pakistan (35.3%) [62,64], but higher than studies conducted in Bhutan (2.1%) [63] and Portugal (1.8%) [64]. This might be due to variations in sociodemographic characteristics, knowledge level and accessibility of the drug.…”

Assessment of Knowledge, Attitude, Practice and Associated Factors Towards Post-Exposure Prophylaxis for HIV/AIDS among Health Professionals in Health Centers Found in Harari Region, Eastern Ethiopia

“…Regarding immediate measures taken after exposure, half of the respondents in the current study reported that they washed the exposed area with water and soap and one-fourth washed the exposed area with alcohol and iodine, whereas a study conducted in Debre Markos revealed that 68.6% of respondents washed the wound with soap and water and 14.9% squeezed and washed with alcohol. 7 In the present study, almost one-tenth of the study participants did not use PEP, which is lower when compared with a study conducted in Botswana (74.8%), 10 a study in Bhutan (97.9%) 15 and a study from Debre Markos town (56.7%). 7 This might be due to differences in the number of those individuals who were exposed and in general due to the difference in the number of the study participants and the difference in the percentile calculation…”

“…12 In the current study, less than half of the respondents had poor knowledge, which is slightly higher than a study conducted among HCWs in public health institutions in Debre Markos town (36.1%), 7 a study conducted in Gondor, northwest Ethiopia (36.9%) 13 and a study conducted in Hiwot Fana Specialized University Hospital in Harar (17%), 14 but much lower than the study conducted in Nigeria (57%) 6 and a study conducted at Jigme Dorji Wangchuck National Referral Hospital, Bhutan (80.1%). 15 This could be due to the difference in the knowledge assessment like the availability of PEP service and training in this survey and also a difference in the study setting and the difference in health professionals involved in the study.…”

“…7 The study in Bhutan however showed that the major reasons were the absence of PEP service (30.2%) and lack of support to report incidents (22.6%). 15 Whereas a study from Jimma reported that 33.8% of the respondents were unaware of the existence of PEP service and protocol, 23.2% had a lack of understanding on the value of reporting exposures, and 32.2% had a fear stigma and discrimination. 22 Reasons for the observed differences of findings between different research results could be due to the differences in the level of awareness between the different population, economic status, qualification of the study population and time difference of the studies, sample size differences, and study setting difference (most of the literature compared with the current study were conducted in a hospital).…”