Perceived Factors Influencing Adherence to HIV Post-Exposure Prophylaxis among Healthcare Workers at AIC Kijabe Hospital

Abstract

Abstract Healthcare workers (HCWs) are at risk of HIV infection due to occupational exposure, this makes adherence to post-exposure prophylaxis (PEP) crucial in preventing HIV transmission. This study explores the perceived barriers and benefits to PEP adherence among HCWs at AIC-Kijabe Hospital and identifies mechanisms to improve adherence. It was a phenomenological qualitative research design that used semi-structured interviews to collect data from a purposive sample of 35 HCWs. The study was conducted in AIC-Kijabe Hospital. Data were collected through face-to-face interviews with HCWs who reported exposure to HIV and were initiated on PEP. Key informant interviews were also conducted, those of whom were Chronic Care Clinic (CCC) team members. The guide was pilot-tested at AIC-Kijabe Naivasha Medical Centre to enhance reliability and validity. The interviews were audio-recorded, with the consent of the participants. Were audio-recorded with the consent of participants to ensure accurate data was captured. The interview data was analyzed using deductive thematic analysis. The transcribed interview was coded and categorized into themes and sub-themes. NVivo data analysis software was used to facilitate the institutional and analysis process. The researcher adhered to ethical guidelines, protecting participants’ privacy and confidentiality. Before conducting interviews, informed consent was obtained from all the participants. To ensure the ethical conduct of the study, ethical approval was sought from the Kijabe Institute Review Board (KIRB) and the National Commission for Science, Technology, and Innovation (NACOSTI). Several barriers to PEP adherence were identified, and they were based on Personal/ Individual drug-related, institutional, and interpersonal factors. Personal factors included forgetfulness, acceptance of stigma, and low-risk perception. Drug/Medicine-related were fear of side effects and logistical Challenges, e.g. pill too big to swallow. Institutional Factors included process inefficiencies and institutional Stigma. Interpersonal factors like lack of social support. The Perceived Benefits noted by the participants included a reduction of the risk of HIV transmission to HCWs, their spouses, and patients. It also gave them peace of mind. Adherence to PEP was also viewed as an ethical duty and obligation. Mechanisms to Improve Adherence proposed included enhanced accessibility of PEP 24/7, Staff sensitization and education, psychosocial support, Process improvement, and Follow-up support and Reminders. This study highlights significant barriers to PEP adherence among HCWs at AIC-Kijabe Hospital, including personal, drug-related, and institutional challenges. However, the perceived benefits, such as reducing HIV transmission risk and promoting occupational safety, provide strong motivation for adherence. Addressing the identified barriers through targeted interventions can enhance PEP adherence and improve healthcare delivery. For HCWs, engagement in continuous medical education, seeking support and encouraging the use of reminders to counter forgetfulness. Organizational recommendations: streamline processes at follow-up clinics, enhance confidentiality, and reduce stigma associated with PEP. Policy recommendations: develop clear guidelines on PEP management and Enforce workplace safety protocols.