HIV post-exposure prophylaxis adherence following occupational exposure due to needle stick and sharp injuries among healthcare workers in peri-urban tertiary hospital, Kenya

Background: Needle stick and sharp injuries (NSSIs) amongst healthcare workers (HCWs) are among the most common occupational accidents in hospitals. Approximately half of the responsible instruments are contaminated with blood, putting users at risk infection from blood-borne pathogens such as HIV. Although post-exposure prophylaxis has been shown to reduce the risk of HIV transmission, adherence to therapy is a well-documented challenge. Aim: To assess healthcare workers adherence to HIV post-exposure prophylaxis following Needle stick and sharp injuries. Method: A retrospective chart review was conducted on HCWs who were started on HIV PEP following a reported occupational exposure due to NSSIs between February 2017 and June 2022 to assess adherence. Result: A total of 136 HCWs had occupational exposure to NSSIs. The majority of the exposures (82.3%) were high risk for HIV transmission. Overall adherence to the 28-day HIV PEP course was 26%. HCWs were more likely to complete HIV PEP when the source's HIV status was positive compared to when it was negative [ 42.4% vs 11.8%; p = 0.001]. The drug regimen (TDF/3TC/DTG) was significantly associated with defaulting treatment (aOR; 5.5 (95% CI 2.16 - 14.02) (p= 0.001), compared with patients using the TDF/3TC/ATVr regimen. Conclusion: 74% of HCWs who started PEP defaulted the recommended 28-day course. Possible strategies for improving adherence and occupational health are required. Contributions: Few studies in Kenya have assessed the completion rate for PEP among HCWs; these findings will contribute to the body of knowledge in this area. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of Kijabe Institutional Ethical Review Committee gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors