B4. Post Exposure Prophylaxis (pep) for HIV in Queen Elizabeth Central Hospital (QECH), Blantyre
J.J.G. van Oosterhout, MD; Department of Medicine, College of Medicine, Blantyre
Objectives and scope: To describe the organization and evaluation of the PEP programme of the College of Medicine and QECH during the first year of operation.
Methodology: Review of the files of clients who sought advice after occupational injuries; interviews to assess the incidence of occupational injuries among nurses.
Results: The PEP programme was started in 2003, initially with donated drugs. 29 (7 nurses, 10 doctors, 2 clinical officers, 10 others) clients sought advice after occupational injuries in the first year, of whom 19 started PEP, all with Duovir®. In one case PEP was stopped due to side effects. Few nurses and clinical officers attended as clients. In interviews, 76% of the nurses reported occupational injuries in 2004, (by extrapolation 66% of those should have used PEP, but did not) but few sought advice, most because they were unaware about the PEP programme and some because they refused an HIV test.
Conclusions: Although the reported incidence of occupational injuries was high, uptake in the PEP programme was unacceptably low, in particular among nurses, mainly due to poor awareness.
Recommendations: In a PEP programme an ongoing publicity campaign among all potential beneficiaries is essential. Representation of all cadres of the staff in the management of the programme is recommended. Risk prevention strategies and hepatitis B vaccination policy need to be reviewed. Triple ARV – PEP needs to become available for special circumstances.