Post Exposure Prophylaxis for Occupational and Non-occupational Exposures to HIV: A 14-year Cohort Study in Lagos, Nigeria

Background: Preventing new HIV infections among individuals is a major strategy to fight the HIV/AIDS scourge worldwide. In addition to the availability and use of highly active antiretroviral therapy to treat infections, short term treatment options to curtail the spread of potential infection of the virus in exposed individuals has been instituted. The various modes of exposure to the HIV virus and the risk of infection have been categorized with corresponding treatment options.

Aim: To evaluate the nature of exposure, time of presentation for treatment, adherence to follow up visits, treatment outcome and identify gaps of treatment procedures in a HIV treatment centre.

Study design: A retrospective cohort study.

Place and duration of study: The HIV treatment centre domiciled at the Clinical Sciences Department of the Nigerian Institute of Medical Research, Lagos, Nigeria from January 2006 to September 2019.

Methodology: A database retrospective review was conducted for adult patients who were treated for post exposure prophylaxis during the study period. A total of 422 patients whose records met the inclusion criteria were reviewed. Data were analyzed and presented using descriptive statistics.

Results: The mean age of the patients was 31.5 ± (10.1) years and higher proportions of the age group were <30 years (52.1%). Majority were females (71.6%), single (63%), had tertiary level of education (68.5%), were employed (70.6%) and had high risk exposures (76.3%). The most commonly prescribed regimen was LPV/r +AZT/3TC (56.2%).More than half (65.9%) had non-occupational exposures and overall, 97.2% presented for treatment within 72hours of exposure but only1.6% completed the follow up visits.

Conclusion: Treatment outcome appears good because no sero-conversion was reported or recorded. The younger age group had higher incidence of rape which was mainly among students which calls for urgent attention. There was a high incidence of needle stick injury among health care workers. There is a need to devise strategies to encourage completion of follow up visits.

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