Post-exposure prophylaxis for HIV: A 10-year review of data from a tertiary health facility in northcentral Nigeria

*[1]Audu, E. S., [2]Bello, S. O., [3]Ablaku, A., [4]Audu, A. A., 5Bako, I. A., 5Mathew, M., and 6Anazodo, M. C.

1Department of Medical Microbiology, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria

2Department of Paediatrics, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria

3Pharmacy Unit, Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria

4Department of Human Anatomy, Federal University, Lafia, Nasarawa State, Nigeria

5Department of Community Medicine, Federal University, Lafia, Nasarawa State, Nigeria

6Department of Community Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria *Correspondence to: estanamo@gmail.com; +2347083599740 ORCID: 0000-0002-3129-7754

Abstract:  

Background: Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is the use of short-term antiretroviral therapy (ART) following a single risk exposure to a potential source of HIV infection. If commenced within 72 hours following exposure, PEP has been reported to be very effective in preventing replication and spread of the virus and therefore prevent acquisition of infection. PEP is recommended for exposures occurring in both occupational and non-occupational settings. The objectives of this study are to review the profile of patients and determine the reasons for accessing PEP services in our facility with a view to recommending evidence-based solutions and ultimately contributing to achieving zero transmission of HIV.  

Methodology: A retrospective review of records of patients who received PEP for HIV in our facility over a 10year period was carried out. Demographic and clinical variables of interest were extracted from the medical records and the PEP register of 252 eligible patients. Data were presented as frequencies, means, percentages and range. Bivariate analysis to determine association of clinical and demographic variables was carried out using the Statistical Package for the Social Sciences (SPSS) with p<0.05 considered as statistical significance.

Results: The mean age of the 252 patients studied was 26.25±11.81 years, and females accounted for 52.7%.  The commonest reason for seeking HIV PEP was occupational exposure from sharps or needle sticks or splashes in 43.3% (109/252), while rape/sexual assault was the most common non-occupational reason for PEP in 29.0% (73/252) cases. Most (72.6% and 95.2%) of the patients presented within 24 hours and 72 hours respectively following exposure. While females accounted for 98.6% of cases of rape and sexual assault, children aged 10 years and below made up 28.8%.

Conclusion: Although most patients sought PEP for HIV due to occupational exposure, majority of those who came for non-occupational exposure were due to rape or sexual assault, most of which occurred in children and adolescents. There is need to institute measures aimed at reducing the menace of rape and sexual assault especially of minors in our society and for health facilities to have psychosocial support mechanisms for these patients.

Keywords: post-exposure, prophylaxis, HIV, retrospective, record

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Post-exposure prophylaxis for HIV: A 10-year review of data from a tertiary health facility in northcentral Nigeria