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

Figures & data

Table 1 Socio-Demographic Characteristics of Healthcare Professionals, in Health Centers of Harari Region, Eastern Ethiopia, March–April 2019

Variables	Category	Number	Percent
Age	20–25`	85	39.2
	26–30	96	44.2
	30–35	17	7.8
	36–40	7	3.2
	>40	12	5.5
Sex	Male	112	51.6
	Female	105	48.4
Profession	Physician	12	5.6
	Nurse	77	35.5
	Lab technician	35	16.1
	Public health	31	14.3
	Midwife	37	17.1
	Others	25	11.5
Year of service	0–5	124	57.1
	6–10	61	28.1
	11–15	20	9.2
	>15	12	5.5
Level of qualification	First Degree	92	42.4
	Master Degree	11	5.1
	General Practitioner	12	5.5
	Diploma	98	45.2
	Others	4	1.8
Monthly income	1000–2000	5	2.3
	2001–4000	124	57.1
	4001–6000	51	23.5
	>6000	37	17.1

Table 2 Knowledge About Occupational Exposure, and Universal Precaution and Measures to Be Taken Among Health Professionals in HC in the Harari Region, Eastern Ethiopia, March–April, 2019

Variables	Category	Frequency Yes	Percent
Knowledge about OE*	Heard about the risk of occupational exposure What types of exposure?	209	96.3
	Sharp cut	171	78.8
	Needlestick injury	167	76.9
	Mucosal contact	146	67.2
	Skin cut	121	55.7
Measures to be taken immediately after exposure*	Wash the area with soap and water	89	41.0
	Wash the area with alcohol and iodine	46	21.2
	Check patient and self HIV status	78	35.9
	Squeeze for more bleeding	34	15.6
	Seek PEP	21	9.7
	Report to head person	7	3.2
Knowledge about UP*	Ever heard about UP	207	95.4
	Types of protections Hand washing before and after the procedure	190	87.5
	Use of Protective barrier like a glove, gowns, mask	200	92.1
	Correct handling of sharp materials	143	65.9
	Disinfection and sterilization	106	48.8
	Proper disposal of needles and waste	97	44.7

Note: *More than one answer is possible and percentages totals are based on respondents.

Abbreviations: OE, occupational exposure; UP, universal precaution.

Table 3 Knowledge About PEP Among Health Professionals in Health Centers in the Harari Region, Eastern Ethiopia, March–April 2019

Variables	Response	Frequency	Percent
Heard about PEP	Yes	210	96.7
	No	7	3.3
Know availability in their facility	Yes	158	72.8
	No	59	27.2
Number of drugs to be combined*	Three drug combinations	149	68.6
	Two drug combinations	130	59.9
	One drug only	66	30.4
	More than three combinations	8	3.7
Regimens they know*	TDF + 3TC + EFZ or AZT+3TC+NVP	78	35.9
	TDF or AZT+EFV	40	18.4
	AZT or NVP	19	8.7
	Did not list any drug	80	36.8
Optional period of initiation*	Within 24 hrs.	115	53
	Within 24–72 hrs.	110	50.7
	After 72 hrs.	32	14.7
	Within one week	8	3.7
Duration of treatment	1week	25	11.5
	2weeks	54	24.9
	3weeks	24	11.1
	4weeks	114	52.5

Note: *More than one answer is possible and percentage totals are based on respondents.

Figure 1 Overall knowledge score of health professionals in health centers in the Harari region, Eastern Ethiopia, March–April 2019.

Table 4 Multinomial Logistic Regression Analysis of Knowledge and Associated Factors for Healthcare Professionals Towards PEP in Health Centers in the Harari Region, Eastern Ethiopia, March–April 2019

Variables		Frequency and Percentage of Knowledge Status
Poor Knowledge (Baseline Outcome)
Moderate Knowledge		Poor	Moderate	Good	P-value	RRR(95% CI)
Age	20–25	34 (40.5)	33 (39.3)	17 (20.2)		1
	26–30	35 (38.04)	35 (38.0)	22 (23.91)	0.551	0.79 (0.36–1.71)
	31–35	3 (18.8)	7 (43.8)	6 (37.5)	0.524	1.71 (0.33–8.92)
	35–40	1 (14.3)	4 (57.1)	2 (28.6)	0.75	1.53 (0.11 −21.14)
	>40	1 (10)	5 (50)	4 (40)	0.315	3.41 (0.31–37.5)
Sex	Male	31 (28.7)	51 (47.2)	26 (24.07)		1
	Female	43 (42.6)	33 (32.7)	25 (24.8)	0.038*	0.48 (0.24 −0.96)
Year of service	0–5	48 (39.3)	52 (42.6)	22 (18)		1
	6–10	21 (36.2)	17 (29.3)	20 (34.5)	0.122	0.47 (0.18–1.23)
	11–15	4 (21.05)	9 (47.4)	6 (31.6)	0.555	1.58 (0.35–7.18)
	>15	1 (10)	6 (60)	3 (30)	0.511	2.41 (0.17–33.42)
Qualification	Diploma	44 (44.9)	41 (41.8)	13 (13.3)		1
	BSc degree	29 (32.2)	34 (37.8)	27 (30.0)	0.929	1.04 (0.46–2.32)
	MSc degree	1 (4.8)	9 (42.9)	11 (52.4)	0.196	4.63 (0.45–47.38)
Monthly income	<4000	56 (44.0)	48 (37.8)	23 (18.1)		1
	>4000	18 (21.9)	36 (43.9)	28 (34.2)	0.137	2.04 (0.79–5.23)
attitude	Poor	32 (46.4)	24 (34.8)	13 (18.8)		1
	Good	42 (30)	60 (42.9)	38 (27.1)	0.029*	2.25 (1.09–4.67)
Ever taken training	No	27 (36.5)	29 (39.2)	18 (24.3)
	Yes	47 (34.8)	55 (40.7)	33 (24.4)	0.807	1.09 (0.54–2.23)
Good knowledge
Age	20–25	34 (40.5)	33 (39.3)	17 (20.2)		1
	26–30	35 (38.04)	35 (38.0)	22 (23.91)	0.49	0.71 (0.27–1.87)
	31–35	3 (18.8)	7 (43.8)	6 (37.5)	0.779	1.29 (0.22–7.72)
	35–40	1 (14.3)	4 (57.1)	2 (28.6)	0.78	1.57 (0.07–36.76)
	>40	1 (10)	5 (50)	4 (40)	0.394	3.05 (0.23–39.78)
Sex	Male	31 (28.7)	51 (47.2)	26 (24.07)		1
	Female	43 (42.6)	33 (32.7)	25 (24.8)	0.896	0.94 (0.41–2.19)
Year of service	0–5	48 (39.3)	52 (42.6)	22 (18)		1
	6–10	21 (36.2)	17 (29.3)	20 (34.5)	0.462	1.48 (0.52–4.24)
	11–15	4 (21.05)	9 (47.4)	6 (31.6)	0.113	4.00 (0.71–22.23)
	>15	1 (10)	6 (60)	3 (30)	0.386	3.61 (0.19–66.09)
Qualification	Diploma	44 (44.9)	41 (41.8)	13 (13.3)		1
	BSc degree	29 (32.2)	34 (37.8)	27 (30.0)	0.029*	2.93 (1.12–7.69)
	MSc degree	1 (4.8)	9 (42.9)	11 (52.4)	0.002*	40.32 (3.68–441.28)
Monthly income	<4000	56 (44.0)	48 (37.8)	23 (18.1)		1
	>4000	18 (21.9)	36 (43.9)	28 (34.2)	0.831	1.11 (0.40–3.12)
Attitude status	Poor	32 (46.4)	24 (34.8)	13 (18.8)		1
	Good	42 (30)	60 (42.9)	38 (27.1)	0.019*	2.89 (1.19–7.02)
Ever taken training on PEP	No	27 (36.5)	29 (39.2)	18 (24.3)		1
	Yes	47 (34.8)	55 (40.7)	33 (24.4)	0.913	0.95 (0.40–2.22)

Note: *Significant association.

Table 5 Attitudes of Health Professionals Towards PEP, in Health Centers of Harari Region, Eastern Ethiopia, March–April 2019

Questions	Response	Frequency	Percent
HIV would be acquired occupationally	Agree	193	88.9
	Disagree	20	9.2
	Neutral	4	1.8
You are one of those, at risk of acquiring HIV occupationally	Agree	173	79.7
	Disagree	33	15.2
	Neutral	11	5.1
Universal precaution methods are protective from occupational exposure to HIV/AIDS	Agree	165	76.0
	Disagree	37	17.1
	Neutral	15	6.9
Occupational exposure is avoidable by universal precaution and PEP.	Agree	136	62.6
	Disagree	52	23.9
	Neutral	29	13.4
ARV drugs are effective after occupational exposure to prevent HIV/AIDS.	Agree	125	57.3
	Disagree	75	34.6
	Neutral	17	7.8
PEP initiation after 72 hours of exposure would be effective	Agree	83	38.2
	Disagree	125	57.6
	Neutral	9	4.2
Staffs should start PEP even if they are not willing to have an HIV test after occupational exposure	Agree	127	58.5
	Disagree	59	27.2
	Neutral	31	14.3

Table 6 Multiple Logistic Regression Analysis of Attitude and Associated Factors for Healthcare Professionals Towards PEP in Health Centers in the Harari Region, Eastern Ethiopia, March–April 2019

Variables		Attitude Status
		Good	Poor	P-value	AOR(95% CI)
Age	20–25	48 (59.2)	33 (40.7)		1
	26–30	71 (75.5)	23 (24.5)	0.07	2.01 (0.94–4.28)
	31–35	11 (64.7)	6 (35.3)	0.53	0.64 (0.16–2.57)
	35–40	6 (85.7)	1 (14.3)	0.97	0.95 (0.08–11.20)
	>40	7 (58.3)	5 (41.7)	0.248	0.37 (0.07–1.99)
Sex	Male	76 (71.0)	31 (28.9)		1
	Female	67 (64.2)	37 (35.5)	0.303	0.69 (0.35–1.38)
Year of service	0–5	77 (64.7)	42 (35.3)		1
	6–10	41 (68.3)	19 (31.7)	0.553	1.32 (0.53–3.27)
	11–15	15 (75)	5 (25)	0.71	1.31 (0.31–5.45)
	>15	10 (83.3)	2 (16.7)	0.337	2.73 (0.35–21.39)
Qualification	Diploma	67 (68.3)	31 (31.6)		1
	BSc degree	58 (63.0)	34 (36.9)	0.06	0.45 (0.19–1.03)
	MSc degree	18 (81.8)	4 (18.2)	0.252	3.97 (0.37–42.16)
Monthly income	<4000	78 (62.4)	47 (37.6)		1
	>4000	65 (74.7)	22 (25.3)	0.227	1.71 (0.71–4.09)
Knowledge status	Poor	42 (56.7)	32 (43.2)		1
	Moderate	60 (73.2)	22 (26.8)	0.033*	2.29 (1.07–4.91)
	Good	38 (74.5)	13 (25.5)	0.049*	2.32 (1.03 −5.38)

Note: *Significant association.

Figure 2 Overall attitude score toward PEP against HIV among health professionals in health centers in the Harari region, Eastern Ethiopia, March–April 2019.

Table 7 Exposure and Measures Taken by the Health Professionals After Exposure in Health Centers in the Harari Region, Eastern Ethiopia, March–April 2019

Questions	Response	Frequency	Percent
Ever exposed while at work	Yes	128	59.0
	No	89	41.0
Frequency of encountered exposure	Once	71	55.5
	Twice	30	23.4
	Three and more times	27	21.1
Type encountered exposures*	Needlestick	111	86.7
	Sharp cut	52	40.6
	Mucosal contact	44	34.4
	Others(splash of body fluid)	12	9.4
Immediate measures after exposures*	Washed with soap and water	72	56.2
	Washed with alcohol and iodine	32	25.0
	Check patient and self HIV status	98	76.5
	Applied pressure to stop bleeding	18	14.0
	Reported the occurrence of injury	15	11.7

Note: *More than one answer is possible and percentage totals are based on respondents.

Table 8 Distribution of Serostatus of Source Patient and Practice of HCWs Towards PEP, Among Health Centers in Harari Region, Eastern Ethiopia, March 2019

Variables	Category	Frequency	Percent
Sero-status of the source patient	Positive	37	28.9
	Negative	49	38.3
	Unknown	42	32.8
Tried to get PEP service	YES	54	68.4
	NO	25	31.6
Started to use PEP	YES	49	90.7
	NO	5	9.3
Duration of starting PEP after exposure	=<One hour	5	10.2
	6–24 hours	26	53.1
	24–72 hours	18	36.7
	After 72 hours	0	0
Completed treatment according to prescription	Yes	44	89.8
	No	5	10.2
Check their status after treatment	Yes	32	65.3
	No	17	34.7
Frequency of taking PEP	Once	42	85.7
	Twice	5	10.2
	Three times	2	4.1
	More than three times	0	0
The reason not to start PEP	Because of adverse effects	13	52
	Lack of information on the existence of service	9	36
	Because of social stigma	2	8
	Others	1	4

Table 9 Distribution of Previous Training on PEP and Perceived Reason for Occupational Exposure, Among Health Professionals in Health Centers in the Harari Region, Eastern Ethiopia, March–April 2019

Variables	Category	Frequency	Percent
Any on/off service training on PEP of HIV	Yes	143	65.9
	No	74	34.1
What do you think is the reason for the occupational exposure*	Negligence of health professionals	135	62.2
	Multiple procedures at the same time/heavy workloads	121	55.7
	Lack of knowledge on the risk	83	38.2
	Recapping of needle	97	44.7
	Uncooperative patient	105	48.4
	Not enough training on the issue	75	34.6
	Unfamiliar procedure	39	18.0

Note: *More than one answer is possible and percentage totals are based on respondents.