Occupational exposure to HIV among nurses at a major tertiary hospital: Reporting and utilization of post-exposure prophylaxis; A cross-sectional study in the Western Cape, South Africa

Background: While treatment for HIV has greatly improved patient outcomes, health care workers, including nurses, remain at high risk of occupational exposure. The risk of exposure is a continuous concern in the South African health system that is overburdened by multiple stressors, including the highest HIV caseload in the world. The aim of this study was to estimate the prevalence of occupational exposure to HIV, reporting and utilization of post-exposure prophylaxis, knowledge, attitudes towards HIV post-exposure prophylaxis and infection control practices amongst nurses at a tertiary hospital in the Western Cape, South Africa. Methods: A cross-sectional study was conducted at Tygerberg hospital from the 4th to the 16th February 2019. Participants were front line nurses working in randomly selected wards. A self-administered questionnaire was used to collect data from participants. Results: Of the 160 participants who took part in the survey, 17 reported occupational exposure to HIV (prevalence 10.6%, 95% CI 6.7–16.6), and of the 17 exposed, 10(58.8%) reported needlestick injuries. From those who were exposed, only 10 (58.8%) reported the incidents and went on post-exposure prophylaxis. However, only 6 out of the 10 completed their treatment. Half (50%) of the participants had inadequate knowledge on HIV post-exposure prophylaxis, 83.3% had adequate attitudes towards HIV post-exposure prophylaxis and 75% had adequate infection control practices. Conclusion: One out of every nine nurses had occupational exposure to HIV at a major tertiary hospital with poor reporting and utilization of post-exposure prophylaxis. The high proportion of needle stick injuries highlights the need for better infection control training. Similarly, the low levels of HIV post-exposure prophylaxis knowledge show the need for structured intervention and in-service training for health care workers.