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

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 10- year 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.