Assessment of knowledge, attitude, and practice regarding HIV post-exposure prophylaxis after occupational exposure among doctors working at Royal Care International Hospital (2021)

Assessment of knowledge, attitude, and practice regarding HIV post-exposure prophylaxis after occupational exposure among doctors working at Royal Care International Hospital (2021) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of knowledge, attitude, and practice regarding HIV post-exposure prophylaxis after occupational exposure among doctors working at Royal Care International Hospital (2021) Rawan Khalid, Raheeg Mohamed, Elmuiz Abdelrahman, Hassan Mohammed, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4539317/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Despite the high rates of needle stick injuries, post-exposure prophylaxis usage is mainly unreported. Healthcare workers are at high risk of contracting HIV due to occupational exposure to blood and bodily fluids. The purpose of this study is to evaluate physicians working at Royal Care International Hospital regarding their knowledge, attitudes, and practices regarding HIV post-exposure prophylaxis (PEP). Methods: From Janury to march 2021, 204 doctors participated in a facility-based cross-sectional study at Royal Care International Hospital. The study used a structured self-administered questionnaire that included questions about demographic information, knowledge, attitudes, and practices regarding HIV PEP. Results: While 74% of participants knew that HIV PEP existed, the majority of participants (79.4%) knew very little about it. Only 69.6% of participants knew when it is best to begin HIV PEP after exposure, and the majority of participants were unable to name the conditions under which it is recommended. All of the participants thought HIV PEP was important, and 82.4% of them thought it was generally a good thing. Of the participants, 63 (30.9%) reported having been exposed to HIV-risky situations at work; however, only 42 (66.6%) of them disclosed this information, and only 27 (42.8%) of them received HIV PEP. Conclusion: While a considerable proportion of the participants had experienced an HIV-risky condition, the study found that there was a low reporting rate and low use of HIV PEP among them. Additionally, the majority of the participants had a positive attitude towards HIV PEP. INTRODUCTION 2.1 Background: Human immunodeficiency virus (HIV) is the primary cause of acquired immunodeficiency syndrome (AIDS), a major global health burden that was first reported in Atlanta, Georgia, in 1981. However, an outbreak in Africa prior to the first case being reported of a disease that weakens the immune system in Africa and causes weight loss diarrhoea was identified, along with evidence of the presence of HIV antibodies in African sera collected in the early 1960s (1). The disease continues to be a major global concern, as 38.0 million people were estimated to be living with the disease at the end of 2019, and over two-thirds of those (25.7 million) are living in the African region (2). The World Health Organisation (WHO) classifies healthcare workers as a high-risk group because they may come into contact with infectious body materials like blood and bodily fluids through needle stick injuries, contact with non-intact exposed skin, reuse of improperly sterilised needles, and improper handling and disposal of hazardous waste products. The WHO estimates that 90% of occupational risk to HIV occurs in healthcare settings of developing countries. Inadequate safety protocols and standards in hospitals, restricted access to PPE and post-exposure assessment and treatment, and high rates of HIV cases going undetected are additional factors that can raise the occupational risk of HIV for healthcare workers in developing nations (3–5). PEP stands for preventive measures against HIV/AIDS. It includes first aid, counselling, risk assessment, laboratory testing, and a short course of antiretroviral medication (ARMP) that is administered within an hour, should not last longer than 72 hours, and is typically continued for 28 days to prevent the disease from developing. This course consists of antiretroviral medications such as Tenofovir with emtricitabine and protease inhibitors, or Zidovudine with lamivudine and protease inhibitors as alternate regimens. These are standard PEPs for occupational HIV exposure since 1990. PEP was regarded as a useful technique for decreasing the likelihood of seroconversion, however, there have been instances where it hasn't worked. Failure has frequently been ascribed to the length of time that treatment was delayed, the degree of exposure, or both (1,3,5). The effectiveness of HIV PEP is considered to be time-dependent, as the treatment works mainly by preventing the reproduction of the virus inside the exposed body, it is very important to start the treatment as early as possible after exposure and maintain the right amount of medication in the bloodstream for maximum effectivity Sudan's HIV prevalence was estimated by the national estimation to be 0.03%. However, according to a recent meta-analysis, the overall pooled HIV prevalence was only 1%, indicating a significant underestimation that may have resulted from underreporting of the illness because social and cultural contexts can make it difficult to conduct behavioural and risk assessments (6). These social and cultural factors lead to stigmatisation of the disease increasing exposure to risk situations and creating barriers to accessing effective HIV prevention, testing and treatment services which in turn increases the HIV vulnerability in the region (2). Nevertheless, evidence has reported the existence of a knowledge gap regarding PEP among healthcare workers, for instance, a study in London was conducted indicating that only 22% of the doctors were able to identify the three drugs used in HIV PEP (4), another study was conducted in Ethiopia, Jimma town showed that 83.9% of the healthcare workers had inadequate knowledge about the HIV PEP (7). In addition to that, a study was conducted in a dental teaching hospital and academy teaching hospital reporting poor knowledge and practice of PEP among dental care practitioners in Khartoum, showing that 63.4% of them were exposed to blood-borne risky conditions, and very few of them utilized PEP due to lack of the institution PEP service and support (8). Given all the above circumstances, doctors should have proper knowledge about the protocols regarding HIV PEP for the prevention of the disease especially in resource-constrained countries like Sudan. However, there is very limited data regarding healthcare-related occupational exposure and PEP usage, although it is crucial to assure the safety of healthcare workers given that inadequate knowledge can lead to devastating consequences. Additionally, to the best of our knowledge, no prior study has been done on this topic in the current study area; as a result, this study aims to close the knowledge, attitude, and practice gap among healthcare workers at Khartoum, Sudan's Royal Care International Hospital. Hence this study aimed to assess the knowledge, attitude, and practice of doctors working at Royal Care International Hospital regarding HIV post-exposure prophylaxis. METHODOLOGY Study design and settings: An observational facility-based descriptive cross-sectional study. The study was conducted at Royal Care International Hospital (RCIH) which is a tertiary care multi-disciplinary private hospital providing different medical services and specialities, composed of 10 departments including surgery, paediatrics, ER, ICU, obstetrics and gynaecology and others. RCIH was established in 2010 and is located in Burri, Khartoum, Sudan. The study included all doctors working in different departments who were at risk of exposure to infectious material at Royal Care International Hospital during the data collection period. Inclusion criteria were all physicians working at Royal Care International Hospital from both genders, and all departments, including medical officers, registrars, and specialists. Exclusion criteria for physicians who have no direct contact with the patients and who refuse to participate in the study. Sampling and data: All physicians working at Royal Care International Hospital were approached for the study and a total of 204 out of 258 were reached with a response rate of 79% Explanation: Couldn’t complete the sample size due to limitations of time, refusal to participate and unreached individuals. Total coverage and census sampling were used to cover all the doctors at RCIH. The data was collected in the period between January to March 2021. Data was collected using an online form structured self-administered questionnaire based on WHO post-exposure prophylaxis guidelines and relevant published article (9), it consists of 30 closed-ended questions: Demographics consisted of four questions about the demographic information of the participants including age, sex, marital status, and work experience. Knowledge of HIV PEP was assessed using eight questions. Attitude towards HIV PEP using eight questions. And Practice of HIV PEP using ten questions. "Adequate knowledge" was defined as having more than or equal to six correct answers (75%) out of eight knowledge questions with equally distributed scores. Similarly, respondents were deemed to have a “positive attitude” if they answered more than or equal to 75% (6 out of 8) on the attitude questions. Respondents who answered more than or equal to six out of eight questions (75%) were deemed to be practising PEP for HIV in order to ascertain their practice. The methods were assessed according to how well they adhered to the then-current guidelines for practices (9). All information obtained through questionnaires was coded into variables after it was gathered and entered into a Microsoft Excel database. The Statistical Package for Social Science (SPSS) version 26.0 was used to analyse the data. Tables, pie charts, and bar charts were used to display the data, and descriptive statistics were used to calculate frequencies, percentages, means, and standard deviations. By computing the total number of correct answers to PEP questions about HIV, the respondents' knowledge and attitudes were assessed and categorised correspondingly. Ethical consideration: The study was conducted according to the declaration of Helsinki. Ethical approval was sought from the ethical committee, the Department of Community Medicine, University of Khartoum. Permission was obtained from the hospital before data collection, and consent was taken from the participants. Participants Consent: Consent was obtained from all the participants before participation, and the participation was voluntary withdrawal was allowed at any moment. Confidentiality of the participants was maintained and no information that can lead to subject identification was taken. RESULTS Sociodemographic characteristics: A total of 204 doctors were involved in this study with their mean age lying between 20-30 years, of which 119 (58.3%) were females making up the majority of the respondents and 85 (41.7%) were males. Most of the respondents, 171 (83.8%), were in the age group of 20 to 30 years old, and 32 were in the age group of 31 to 40 making up (15.7%) of the respondents, Nearly half of the respondents had 1 to 3 years of experience 103 (50.5%) and 33 (16.2%) had more than 5 years of experience as shown in (Table 1) Knowledge of HIV PEP: The study revealed a big knowledge gap among the respondents regarding HIV post-exposure prophylaxis, the vast majority of participants 162 (79.4%) had an inadequate level of knowledge and scored less than 75% of total knowledge score. The participants had a mean score of 3.9 + 1.3 out of 7. Although 151 (74%) were aware of the existence of HIV PEP, and 190 (93.1) knew the meaning of post-exposure prophylaxis, the majority were not aware of the availability of PEP guidelines in the hospital 137 (67.2%). Most of the respondents were not able to identify indications for HIV post-exposure prophylaxis, and only 72 (35.3%) were aware of its indication when the HIV status of the source is unknown making this the question with the lowest score. 142 (69.6%) of our respondents knew about the preferable time to start PEP, but only 75 (36.8%) knew about the maximum delay for starting PEP. (Table 2) Attitude towards HIV PEP: All of the respondents believed that HIV post-exposure prophylaxis is important, and almost all 200 (98%) stated that HIV PEP should be available in the work area, 192 (94.1%) believed that PEP reduces the likelihood of being HIV positive, 182 (89.2%) of our respondents believed in the effectivity of PEP, and 139 (68.1%) believed that it can prevent further infection. However, 82 (40.2%) believed PEP is not important if the exposure is not with the blood of a patient with known HIV positive. Overall, most of the participants 168 (82.4%) showed a positive attitude towards HIV PEP, with a mean score of 6.5 + 0.9 out of 8 (Table 3). Practice of HIV PEP: About one-third of the doctors who participated in this study 63 (30.9%) mentioned that they have experienced an occupational to an HIV risky condition, 42 (66.6%) of those have reported the exposure, and only 27 (42.8%) of those have received PEP. 64 (61.5%) of the participants stated that the unavailability of PEP services was the most common barrier that prevented the doctors from receiving PEP, and 15 (60%) of those who received PEP were exposed to blood from a known HIV-positive patient. Among all the respondents who took PEP, two individuals initiated outside of the ideal time frame (after 72 hours). Only 13 (48.1%) of the 27 who took PEP stated that they completed the course, and 7 of them stated that their reason for discontinuation of the course was fear of the side effects. (Table 4). Association of Demographic Variables with Knowledge and Attitude Scores Regarding HIV PEP: The chi-square test was used to assess the association between demographic characteristics and knowledge and attitude. No significant association was found between age and knowledge (X² = 3.94, p = 0.14) or attitude scores (X² = 5.25, p = 0.07). Most respondents aged 20-30 had adequate knowledge (34 out of 171) and positive attitudes (143 out of 171). Also, there was no significant link between sex and knowledge (X² = 2.50, p = 0.11) or attitude scores (X² = 0.14, p = 0.71). Both males and females predominantly had positive attitudes. Marital status did not significantly affect knowledge scores (X² = 4.78, p = 0.09), with singles having the highest adequate knowledge (33 out of 173). However, it was significantly associated with attitude scores (X² = 6.84, p = 0.03), with singles showing the highest positive attitudes (146 out of 173). Work experience showed no significant relationship with knowledge (X² = 2.00, p = 0.57) or attitude scores (X² = 2.83, p = 0.42). Doctors with 1-3 years of experience had the highest adequate knowledge (22 out of 113) and positive attitudes (89 out of 113) (Table 5). Association of Demographic Variables with Occupational Exposure, Reporting, and HIV PEP Practices: The study assessed occupational exposure to HIV, reporting, and post-exposure prophylaxis (PEP) among doctors at Royal Care International Hospital. No significant associations were found between age and having occupational exposure, reporting it, receiving PEP, or completing ART. Reporting of exposure was not significantly associated with sex (X² = 0.03, p = 0.86), Also with other practices. Marital status significantly impacted receiving PEP (X² = 6.60, p = 0.04). Singles had higher positive practice of receiving PEP. Other associations were not significant. Also, no significant associations were found between work experience and having an exposure, reporting it, receiving PEP, or completing ART. In summary, sex significantly influenced the reporting of exposure, while other variables showed no significant impact on HIV exposure and PEP practices (Table 6). DISCUSSION Due to the high frequency of sharp needle injuries, which put doctors and other healthcare workers at unnecessary risk of contracting a disease that can be prevented with proper management, the risk of HIV transmission is deemed high in a healthcare setting. This study indicated that most of the doctors who participated in this study (79.4%) had inadequate knowledge scores on HIV post-exposure prophylaxis which reveals a higher knowledge gap in comparison to (70%) in UOGCSH in Ethiopia (5), (61.5%) in Tanzanian healthcare facilities (10), (73.7%) in Cameroon (11); this could be explained by the lack of training programs regarding this matter in our study setting, and also indicates that more work needs to be done to increase awareness and knowledge of healthcare professionals on HIV PEP. The effectiveness of post-exposure prophylaxis (PEP) has been shown to be time-dependent, so in order for the treatment to be effective in preventing infection, doctors should have a solid understanding of the start time and length of the course. In our study, 69.6% of participants said that PEP should be taken as soon as possible after exposure, but only 36.8% were aware that the maximum delay in taking PEP is 72 hours. A related study carried out at the University of Gondar Comprehensive Specialised Hospital in Ethiopia revealed that 75.5% of participants were aware of the appropriate time to start PEP (5), this difference in the level of awareness is considered to be worrisome and can be explained by the lack of HIV PEP training programs for our participants. Regarding the duration of the PEP course, less than half of our participants (48.5%) conveyed appropriate duration (28 days) this percentage seems to be significantly higher than the one found in a similar study conducted at Lagos University Hospital in Nigeria where only (15.3%) of the participants knew the correct duration of the PEP course (10) . This could perhaps be an indication that it was included in university curriculums in Sudan. Even though our participants knew not much about HIV, a significant portion of them (82.4%) had a positive attitude towards post-exposure prophylaxis, all of them said they thought it was important, 89.2% of them thought PEP was effective, and 94.1% thought it decreased the risk of HIV infection. Despite having a positive attitude towards the issue, they were unable to gain experience or knowledge about HIV PEP because of a lack of resources. The study conducted at UOGCSH revealed a higher overall attitude score of 93.1% (5), this can be attributed to the different levels of awareness in different settings due to the higher prevalence of HIV in Ethiopia in comparison to Sudan. In this study (30.9%) of the participants mentioned that they had experienced occupational exposure to infective material, this percentage of occupational exposure was found to be higher in Tehran teaching hospitals, in Iran (53.4%)(12), and in Lagos University Hospital in Nigeria (47.3%)(13), and lower in UOGCSH in Ethiopia (16.8%) (5), and Tanzanian healthcare facilities (27.1%) (10). The difference between these studies might be due to the difference in clinical settings and precautionary regulations. Only one-third (66.6%) of the participants in this study who have experienced occupational exposure have reported the incidence, this result is higher when compared to a study conducted in Tehran teaching hospitals in Iran where only (36.8%) (12). of the exposed participants reported the incident, (37%) in Botswana public hospitals, and (41%) in Lagos Hospital in Nigeria (13). Out of the 63 exposed individuals only 27 (42.8%) stated that they have received PEP, 15 (60%) of them were exposed to blood from an HIV-positive source, and only 13 (48.1%) of them were able to complete the 28 days regimen, those who did not complete the course mentioned that the major reason for discontinuation was fear of the adverse effects of the antiretroviral drugs. The case seems to be similar in UOGCSH where 37 of the participants experienced occupational exposure but only 18 (48.6%) have received PEP and only 50% of those were able to complete the ART course (5). This seems to be the case in a similar study conducted in Tygerberg Hospital in South which revealed that the PEP dropout rate was found to be 40%, and the reasons for discontinuation were fear of adverse effects and assuming that it was enough (14). Our study had some important limitations to point out. First, the study included only doctors working in one hospital, which may not be representative of doctors in Khartoum state, Sudan. Some doctors working in the hospital were unwilling to participate and others were absent at the time of data collection. This resulted in decreased power of the study. Second, some of the answers might have not been honest (social desirability bias). Lastly, the online questionnaires were filled by the participants without observation by the data collector; hence, some of the questions might have been differently interpreted. Based on our findings, We recommend that educational intervention should be carried out to enhance the practice of PEP. HIV PEP guidelines should be provided and followed by hospitals. Also, New strategies must be developed to reduce the risk of occupational exposure. ART for PEP should be available in every hospital, and in cases of occupational exposure, treatment should be immediately initiated. In conclusion, the findings of this study revealed that there is a significant knowledge gap regarding HIV PEP among doctors working at Royal Care International Hospital. Although lacking knowledge, most of these doctors showed a positive attitude towards HIV PEP. A significant proportion have had an occupational exposure that would warrant the use of PEP, in addition to low reporting rates, low use of PEP after occupational exposure, and low PEP completion rates. Declarations 6.1 Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. 6.2 Competing Interests The authors have no relevant financial or non-financial interests to disclose. 6.3 Author Contributions: All authors (Rawan Khalid, Raheeg Mohamed, Elmuiz Abdelrahman, Hassan Mohammed, Ahmed Makki, Abdulrahman Abdeldaim, Malaz Idrees, Yumna Magzoub, Nada Gaafar, Eltayeb AbdAlla) contributed to the study conception, design, material preparation and data collection. Data analysis was performed by Eltayeb AbdAlla. The first draft of the manuscript was written by Rawan Khalidand all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. 6.4 Data Availability: The datasets generated and analysed in this study are available from the corresponding author on reasonable request. 6.5 Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Ethical approval was sought from the ethical committee, the Department of Community Medicine, University of Khartoum. Permission was obtained from the hospital before data collection, and consent was taken from the participants. 6.6 Consent to participate: Consent was obtained from all the participants before participation, and the participation was voluntary withdrawal was allowed at any moment. 6.7 Consent to publish All participants provided informed consent for publication of their data References Shenkut M. Assessment of Knowledge, Attitude & Practice of Health Professionals towards Post Exposure Prophylaxis of HIV/AIDS in Woldia General Hospital, Woldia, North-Eastern Ethiopia. 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Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230075 Tables Tables 5 to 6 are available in the Supplementary Files section Table 1: Shows the sociodemographic characteristics of doctors working at RCIH 2020-2021 variable Answers N % Age group (years) 20 - 30 171 83.8 31 - 40 32 15.7 41 - 50 1 .5 >50 0 0.0 Gender Male 85 41.7 Female 119 58.3 Marital status Single 173 84.8 Married 30 14.7 Divorced 1 .5 Years of experience 5 33 16.2 Table 2: Knowledge about PEP for HIV among doctors working at RCIH 2020-2021 Variable answers n % Awareness of PEP No 53 26.0 yes 151 74.0 Know the meaning of PEP no 14 6.9 yes 190 93.1 Aware of the availability of PEP guidelines in this hospital. no 137 67.2 yes 67 32.8 Identify indication for PEP When the source patient is at high risk for HIV* 88 43.1 When the source patient is known to be HIV positive* 156 76.5 When The HIV status of the source is unknown* 72 35.3 For any needle stick injury in the workplace 87 42.6 The maximum delay to take PEP 12 hours 31 15.2 24 hours 49 24.0 48 hours 49 24.0 72 hours* 75 36.8 Preferable time to start PEP within an hour* 142 69.6 After 6 hours 39 19.1 After 12 hours 18 8.8 After 72 hours 5 2.5 Duration of ART intake for PEP for 28 days* 99 48.5 for 40 days 24 11.8 for six months 67 32.8 for life time 14 6.9 Know about the PEP guideline no 145 71.1 Yes 59 28.9 Knowledge score Poor 162 79.4 Adequate 42 20.6 Table 3: Attitude about PEP doctors working in RCIH 2020-2021 Variable Answer N % Think PEP is important Yes 204 100.0 No 0 0.0 PEP training is important for behavioral change No 6 2.9 Yes 198 97.1 PEP guidelines should be available in the work area Agree 200 98.0 Disagree 4 2.0 PEP can reduce the likelihood of becoming HIV positive Agree 192 94.1 Disagree 12 5.9 PEP prevents further infection Agree 139 68.1 Disagree 65 31.9 PEP should be indicated for any type of sharp injuries Agree 108 52.9 Disagree 96 47.1 PEP is not important if the exposure is not with blood of a patient with known HIV positive Agree 82 40.2 Disagree 122 59.8 Post-exposure prophylaxis is effective for HIV prevention. Agree 182 89.2 Disagree 22 10.8 Attitude Score Negative 36 17.6 Positive 168 82.4 Table 4: Practice of PEP for HIV among doctors working in RCIH 2020-2021 Variable Answers n % Occupational exposure to HIV risky conditions. No 141 69.1 Yes 63 30.9 Did you report it? No 162 79.4 Yes 42 20.6 Reaction of HCWs toward HIV exposed individuals Supportive and maintained confidentiality. 100 49.0 Confidentiality was not maintained. 37 18.1 Did not show concern about my accidental exposure 29 14.2 Did you receive PEP after exposure? No 177 86.8 Yes 27 13.2 What was the barrier that prevented you from getting the PEP? Unaware of the existence of PEP and protocol 33 31.7 Lack of understanding the value of reporting exposure 24 23.1 Fear of stigma and discriminations 10 9.6 Lack of support and encouragement to report 21 20.2 PEP service is unavailable 64 61.5 Reason for receiving PEP Exposure to blood from known HIV positive patients 15 60.0 Exposure to blood from patient whose HIV status is unknown 6 24.0 Injury from any sharp object 4 16.0 Time to initiate PEP after exposure Within 1 hour. 7 29.2 After 2 - 6 hours 9 37.5 After 6 - 10 hours 6 25.0 After 72 hours 2 8.3 Duration of PEP For 3 days 9 47.4 For 28 days 7 36.8 For 15 days 3 15.8 Completed the prescribed ART for PEP No 7 35.0 Yes 13 65.0 Reason for discontinuation of the ART for PEP Fear of adverse effects 7 41.2 Assuming that it was enough 5 29.4 Assuming that the drug was not effective 5 29.4 Additional Declarations No competing interests reported. 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Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"","lastName":"Makki","suffix":""},{"id":314420476,"identity":"9a90703a-13b4-4c44-b872-df234a081fc6","order_by":5,"name":"Abdulrahman Abdeldaim","email":"","orcid":"","institution":"University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Abdulrahman","middleName":"","lastName":"Abdeldaim","suffix":""},{"id":314420477,"identity":"91fa5657-756d-4b10-aee3-b30c5395d795","order_by":6,"name":"Malaz Idrees","email":"","orcid":"","institution":"University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Malaz","middleName":"","lastName":"Idrees","suffix":""},{"id":314420478,"identity":"4f0d10e6-cfc7-43cd-9072-1a712c348e87","order_by":7,"name":"Yumna Magzoub","email":"","orcid":"","institution":"University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Yumna","middleName":"","lastName":"Magzoub","suffix":""},{"id":314420479,"identity":"ea25c247-252c-4610-8abd-7b356db4097f","order_by":8,"name":"Nada Gaafar","email":"","orcid":"","institution":"University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Nada","middleName":"","lastName":"Gaafar","suffix":""},{"id":314420480,"identity":"456b457b-e99e-4958-a5d9-94ffdcaeaf5b","order_by":9,"name":"Eltayeb AbdAlla","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+0lEQVRIie2QsUoDMRiAc/6QLv816x3RdwgUDlzuXkUJdLrNRVGwEvBGZ6HPkblHIC73AAftYC10cikiKII0EZ2Ei6NDviF8P+SD/CEkEvmPjL7OhRPVPjrDcTAB+E7QSuET+vckq4vMazBhwNoXPF+Vd2inF691eUgJrJ/6gSRXABy7rbxvlF0eaekeRieTeiARBghPb40UnZ0ucw0uQcqHksoAfKSfRlZ9XZzl+jqcCADK05kphVs/2WkTTjIDxfHcbk+yzkqe6AekENiFNTeb/vlqVbFGtbt3fVmxkVpvhhLPARJyOnMC6EcIXPckb+4bfiQSiUQiv9gDbCZH0J2tS28AAAAASUVORK5CYII=","orcid":"","institution":"University of Khartoum","correspondingAuthor":true,"prefix":"","firstName":"Eltayeb","middleName":"","lastName":"AbdAlla","suffix":""}],"badges":[],"createdAt":"2024-06-06 10:24:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4539317/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4539317/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85462480,"identity":"6cc088d3-752c-4a77-8fb4-5da81445393f","added_by":"auto","created_at":"2025-06-26 07:47:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1640912,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4539317/v1/28df97e3-ec7d-4d37-97c8-4afa096cee07.pdf"},{"id":59097987,"identity":"0f882209-c961-4130-a9f3-33a71e954e40","added_by":"auto","created_at":"2024-06-26 10:20:12","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":23036,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-4539317/v1/5763504a124c3153f4519cfd.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of knowledge, attitude, and practice regarding HIV post-exposure prophylaxis after occupational exposure among doctors working at Royal Care International Hospital (2021)","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003e2.1 \u0026nbsp; Background:\u003c/p\u003e\n\u003cp\u003eHuman immunodeficiency virus (HIV) is the primary cause of acquired immunodeficiency syndrome (AIDS), a major global health burden that was first reported in Atlanta, Georgia, in 1981. However, an outbreak in Africa prior to the first case being reported of a disease that weakens the immune system in Africa and causes weight loss diarrhoea was identified, along with evidence of the presence of HIV antibodies in African sera collected in the early 1960s\u0026nbsp;(1).\u003c/p\u003e\n\u003cp\u003eThe disease continues to be a major global concern, as 38.0 million people were estimated to be living with the disease at the end of 2019, and over two-thirds of those (25.7 million) are living in the African region\u0026nbsp;(2).\u003c/p\u003e\n\u003cp\u003eThe World Health Organisation (WHO) classifies healthcare workers as a high-risk group because they may come into contact with infectious body materials like blood and bodily fluids through needle stick injuries, contact with non-intact exposed skin, reuse of improperly sterilised needles, and improper handling and disposal of hazardous waste products. The WHO estimates that 90% of occupational risk to HIV occurs in healthcare settings of developing countries. Inadequate safety protocols and standards in hospitals, restricted access to PPE and post-exposure assessment and treatment, and high rates of HIV cases going undetected are additional factors that can raise the occupational risk of HIV for healthcare workers in developing nations\u0026nbsp;(3\u0026ndash;5).\u003c/p\u003e\n\u003cp\u003ePEP stands for preventive measures against HIV/AIDS. It includes first aid, counselling, risk assessment, laboratory testing, and a short course of antiretroviral medication (ARMP) that is administered within an hour, should not last longer than 72 hours, and is typically continued for 28 days to prevent the disease from developing. This course consists of antiretroviral medications such as Tenofovir with emtricitabine and protease inhibitors, or Zidovudine with lamivudine and protease inhibitors as alternate regimens. These are standard PEPs for occupational HIV exposure since 1990. PEP was regarded as a useful technique for decreasing the likelihood of seroconversion, however, there have been instances where it hasn\u0026apos;t worked. Failure has frequently been ascribed to the length of time that treatment was delayed, the degree of exposure, or both\u0026nbsp;(1,3,5).\u003c/p\u003e\n\u003cp\u003eThe effectiveness of HIV PEP is considered to be time-dependent, as the treatment works mainly by preventing the reproduction of the virus inside the exposed body, it is very important to start the treatment as early as possible after exposure and maintain the right amount of medication in the bloodstream for maximum effectivity\u003c/p\u003e\n\u003cp\u003eSudan\u0026apos;s HIV prevalence was estimated by the national estimation to be 0.03%. However, according to a recent meta-analysis, the overall pooled HIV prevalence was only 1%, indicating a significant underestimation that may have resulted from underreporting of the illness because social and cultural contexts can make it difficult to conduct behavioural and risk assessments\u0026nbsp;(6). These social and cultural factors lead to stigmatisation of the disease increasing exposure to risk situations and creating barriers to accessing effective HIV prevention, testing and treatment services which in turn increases the HIV vulnerability in the region\u0026nbsp;(2).\u003c/p\u003e\n\u003cp\u003eNevertheless, evidence has reported the existence of a knowledge gap regarding PEP among healthcare workers, for instance, a study in London was conducted indicating that only 22% of the doctors were able to identify the three drugs used in HIV PEP\u0026nbsp;(4), another study was conducted in Ethiopia, Jimma town showed that 83.9% of the healthcare workers had inadequate knowledge about the HIV PEP\u0026nbsp;(7). In addition to that, a study was conducted in a dental teaching hospital and academy teaching hospital reporting poor knowledge and practice of PEP among dental care practitioners in Khartoum, showing that 63.4% of them were exposed to blood-borne risky conditions, and very few of them utilized PEP due to lack of the institution PEP service and support\u0026nbsp;(8).\u003c/p\u003e\n\u003cp\u003eGiven all the above circumstances, doctors should have proper knowledge about the protocols regarding HIV PEP for the prevention of the disease especially in resource-constrained countries like Sudan. However, there is very limited data regarding healthcare-related occupational exposure and PEP usage, although it is crucial to assure the safety of healthcare workers given that inadequate knowledge can lead to devastating consequences.\u003cbr\u003e Additionally, to the best of our knowledge, no prior study has been done on this topic in the current study area; as a result, this study aims to close the knowledge, attitude, and practice gap among healthcare workers at Khartoum, Sudan\u0026apos;s Royal Care International Hospital. Hence this study aimed to assess the knowledge, attitude, and practice of doctors working at Royal Care International Hospital regarding HIV post-exposure prophylaxis.\u003c/p\u003e"},{"header":"METHODOLOGY","content":"\u003cp\u003e\u003cstrong\u003eStudy design and settings:\u003c/strong\u003e\u0026nbsp;\u003cbr\u003e\u0026nbsp;An observational facility-based descriptive cross-sectional study. The study was conducted at Royal Care International Hospital (RCIH) which is a tertiary care multi-disciplinary private hospital providing different medical services and specialities, composed of 10 departments including surgery, paediatrics, ER, ICU, obstetrics and gynaecology and others. RCIH was established in 2010 and is located in Burri, Khartoum, Sudan.\u003c/p\u003e\n\u003cp\u003eThe study included all doctors working in different departments who were at risk of exposure to infectious material at Royal Care International Hospital during the data collection period. Inclusion criteria were all physicians working at Royal Care International Hospital from both genders, and all departments, including medical officers, registrars, and specialists. Exclusion criteria for physicians who have no direct contact with the patients and who refuse to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling and data:\u003cbr\u003e\u0026nbsp;\u003c/strong\u003eAll physicians working at Royal Care International Hospital were approached for the study and a total of 204 out of 258 were reached with a response rate of \u0026nbsp; 79%\u003cbr\u003e\u0026nbsp;Explanation: Couldn’t complete the sample size due to limitations of time, refusal to participate and unreached individuals. Total coverage and census sampling were used to cover all the doctors at RCIH. The data was collected in the period between January to March 2021. Data was collected using an online form structured self-administered questionnaire based on WHO post-exposure prophylaxis guidelines and relevant published article\u0026nbsp;(9), it consists of 30 closed-ended questions:\u003c/p\u003e\n\u003cp\u003eDemographics consisted of four questions about the demographic information of the participants including age, sex, marital status, and work experience. Knowledge of HIV PEP was assessed using eight questions. Attitude towards HIV PEP using eight questions. And Practice of HIV PEP using ten questions.\u003c/p\u003e\n\u003cp\u003e\"Adequate knowledge\" was defined as having more than or equal to six correct answers (75%) out of eight knowledge questions with equally distributed scores. Similarly, respondents were deemed to have a “positive attitude” if they answered more than or equal to 75% (6 out of 8) on the attitude questions. Respondents who answered more than or equal to six out of eight questions (75%) were deemed to be practising PEP for HIV in order to ascertain their practice. The methods were assessed according to how well they adhered to the then-current guidelines for practices\u0026nbsp;(9).\u003c/p\u003e\n\u003cp\u003eAll information obtained through questionnaires was coded into variables after it was gathered and entered into a Microsoft Excel database. The Statistical Package for Social Science (SPSS) version 26.0 was used to analyse the data. Tables, pie charts, and bar charts were used to display the data, and descriptive statistics were used to calculate frequencies, percentages, means, and standard deviations. By computing the total number of correct answers to PEP questions about HIV, the respondents' knowledge and attitudes were assessed and categorised correspondingly.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted according to the declaration of Helsinki. Ethical approval was sought from the ethical committee, the Department of Community Medicine, University of Khartoum. Permission was obtained from the hospital before data collection, and consent was taken from the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants Consent:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConsent was obtained from all the participants before participation, and the participation was voluntary withdrawal was allowed at any moment. Confidentiality of the participants was maintained and no information that can lead to subject identification was taken.\u0026nbsp;\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic characteristics:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;A total of 204 doctors were involved in this study with their mean age lying between 20-30 years, of which 119 (58.3%) were females making up the majority of the respondents and 85 (41.7%) were males. Most of the respondents, 171 (83.8%),\u0026nbsp;were in the age group of 20 to 30 years old, and 32 were in the age group of 31 to 40 making up (15.7%) of the respondents,\u0026nbsp;\u003cbr\u003e\u0026nbsp;Nearly half of the respondents had 1 to 3 years of experience 103 (50.5%) and 33 (16.2%) had more than 5 years of experience as shown in (Table 1)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge of HIV PEP:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study revealed a big knowledge gap among the respondents regarding HIV post-exposure prophylaxis, the vast majority of participants 162 (79.4%) had an inadequate level of knowledge and scored less than 75% of total knowledge score.\u0026nbsp;The participants had a mean score of 3.9 + 1.3 out of 7. Although 151 (74%) were aware of the existence of HIV PEP, and 190 (93.1) knew the meaning of post-exposure prophylaxis, the majority were not aware of the availability of PEP guidelines in the hospital 137 (67.2%). Most of the respondents were not able to identify indications for HIV post-exposure prophylaxis, and only 72 (35.3%) were aware of its indication when the HIV status of the source is unknown making this the question with the lowest score. 142 (69.6%) of our respondents knew about the preferable time to start PEP, but only 75 (36.8%) knew about the maximum delay for starting PEP. (Table 2)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttitude towards HIV PEP:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll of the respondents believed that HIV post-exposure prophylaxis is important, and almost all 200 (98%) stated that HIV PEP should be available in the work area, 192 (94.1%) believed that PEP reduces the likelihood of being HIV positive, 182 (89.2%) of our respondents believed in the effectivity of PEP, and 139 (68.1%) believed that it can prevent further infection. However, 82 (40.2%) believed PEP is not important if the exposure is not with the blood\u0026nbsp;of a patient with known HIV positive. Overall, most of the participants 168 (82.4%) showed a positive attitude towards HIV PEP, with a mean score of 6.5 \u003cu\u003e+\u003c/u\u003e 0.9 out of 8 (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePractice of HIV PEP:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAbout one-third of the doctors who participated in this study 63 (30.9%) mentioned that they have experienced an occupational to an HIV risky condition, 42 (66.6%) of those have reported the exposure, and only 27 (42.8%) of those have received PEP. 64 (61.5%) of the participants stated that the unavailability of PEP services was the most common barrier that prevented the doctors from receiving PEP, and 15 (60%) of those who received PEP were exposed to blood from a known HIV-positive patient. Among all the respondents who took PEP, two individuals initiated outside of the ideal time frame (after 72 hours). Only 13 (48.1%) of the 27 who took PEP stated that they completed the course, and 7 of them stated that their reason for discontinuation of the course was fear of the side effects. (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssociation of Demographic Variables with Knowledge and Attitude Scores Regarding HIV PEP:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe chi-square test was used to assess the association between demographic characteristics and knowledge and attitude. No significant association was found between age and knowledge (X² = 3.94, p = 0.14) or attitude scores (X² = 5.25, p = 0.07). Most respondents aged 20-30 had adequate knowledge (34 out of 171) and positive attitudes (143 out of 171). Also, there was no significant link between sex and knowledge (X² = 2.50, p = 0.11) or attitude scores (X² = 0.14, p = 0.71). Both males and females predominantly had positive attitudes. Marital status did not significantly affect knowledge scores (X² = 4.78, p = 0.09), with singles having the highest adequate knowledge (33 out of 173). However, it was significantly associated with attitude scores (X² = 6.84, p = 0.03), with singles showing the highest positive attitudes (146 out of 173). Work experience showed no significant relationship with knowledge (X² = 2.00, p = 0.57) or attitude scores (X² = 2.83, p = 0.42). Doctors with 1-3 years of experience had the highest adequate knowledge (22 out of 113) and positive attitudes (89 out of 113) (Table 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssociation of Demographic Variables with Occupational Exposure, Reporting, and HIV PEP Practices:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study assessed occupational exposure to HIV, reporting, and post-exposure prophylaxis (PEP) among doctors at Royal Care International Hospital. No significant associations were found between age and having occupational exposure, reporting it, receiving PEP, or completing ART. Reporting of exposure was not significantly associated with sex (X² = 0.03, p = 0.86), Also with other practices. Marital status significantly impacted receiving PEP (X² = 6.60, p = 0.04). Singles had higher positive practice of receiving PEP. Other associations were not significant. Also, no significant associations were found between work experience and having an exposure, reporting it, receiving PEP, or completing ART. In summary, sex significantly influenced the reporting of exposure, while other variables showed no significant impact on HIV exposure and PEP practices (Table 6).\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eDue to the high frequency of sharp needle injuries, which put doctors and other healthcare workers at unnecessary risk of contracting a disease that can be prevented with proper management, the risk of HIV transmission is deemed high in a healthcare setting.\u003c/p\u003e\n\u003cp\u003eThis study indicated that most of the doctors who participated in this study (79.4%) had inadequate knowledge scores on HIV post-exposure prophylaxis which reveals a higher knowledge gap in comparison to (70%) in UOGCSH in Ethiopia\u0026nbsp;(5), (61.5%) in Tanzanian healthcare facilities\u0026nbsp;(10), (73.7%) in Cameroon\u0026nbsp;(11); this could be explained by the lack of training programs regarding this matter in our study setting, and also indicates that more work needs to be done to increase awareness and knowledge of healthcare professionals on HIV PEP.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe effectiveness of post-exposure prophylaxis (PEP) has been shown to be time-dependent, so in order for the treatment to be effective in preventing infection, doctors should have a solid understanding of the start time and length of the course. In our study, 69.6% of participants said that PEP should be taken as soon as possible after exposure, but only 36.8% were aware that the maximum delay in taking PEP is 72 hours. A related study carried out at the University of Gondar Comprehensive Specialised Hospital in Ethiopia revealed that 75.5% of participants were aware of the appropriate time to start PEP\u0026nbsp;(5), this difference in the level of awareness is considered to be worrisome and can be explained by the lack of HIV PEP training programs for our participants.\u003c/p\u003e\n\u003cp\u003eRegarding the duration of the PEP course, less than half of our participants (48.5%) conveyed appropriate duration (28 days) this percentage seems to be significantly higher than the one found in a similar study conducted at Lagos University Hospital in Nigeria where only (15.3%) of the participants knew the correct duration of the PEP course\u0026nbsp;(10)\u003csup\u003e.\u0026nbsp;\u003c/sup\u003eThis could perhaps be an indication that it was included in university curriculums in Sudan.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEven though our participants knew not much about HIV, a significant portion of them (82.4%) had a positive attitude towards post-exposure prophylaxis, all of them said they thought it was important, 89.2% of them thought PEP was effective, and 94.1% thought it decreased the risk of HIV infection. Despite having a positive attitude towards the issue, they were unable to gain experience or knowledge about HIV PEP because of a lack of resources. The study conducted at UOGCSH revealed a higher overall attitude score of 93.1%\u0026nbsp;(5), this can be attributed to the different levels of awareness in different settings due to the higher prevalence of HIV in Ethiopia in comparison to Sudan.\u003c/p\u003e\n\u003cp\u003eIn this study (30.9%) of the participants mentioned that they had experienced occupational exposure to infective material, this percentage of occupational exposure was found to be higher in Tehran teaching hospitals, in Iran (53.4%)(12), and in Lagos University Hospital in Nigeria (47.3%)(13), and lower in UOGCSH in Ethiopia (16.8%)\u0026nbsp;(5), and Tanzanian healthcare facilities (27.1%)\u0026nbsp;(10). The difference between these studies might be due to the difference in clinical settings and precautionary regulations. Only one-third (66.6%) of the participants in this study who have experienced occupational exposure have reported the incidence, this result is higher when compared to a study conducted in Tehran teaching hospitals in Iran where only (36.8%)\u0026nbsp;(12). of the exposed participants reported the incident, (37%) in Botswana public hospitals, and (41%) in Lagos Hospital in Nigeria\u0026nbsp;(13).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOut of the 63 exposed individuals only 27 (42.8%) stated that they have received PEP, 15 (60%) of them were exposed to blood from an HIV-positive source, and only 13 (48.1%) of them were able to complete the 28 days regimen, those who did not complete the course mentioned that the major reason for discontinuation was fear of the adverse effects of the antiretroviral drugs. The case seems to be similar in UOGCSH where 37 of the participants experienced occupational exposure but only 18 (48.6%) have received PEP and only 50% of those were able to complete the ART course\u0026nbsp;(5). This seems to be the case in a similar study conducted in Tygerberg Hospital in South which revealed that the PEP dropout rate was found to be 40%, and the reasons for discontinuation were fear of adverse effects and assuming that it was enough\u0026nbsp;(14).\u003c/p\u003e\n\u003cp\u003eOur study had some important limitations to point out. First, the study included only doctors working in one hospital, which may not be representative of doctors in Khartoum state, Sudan. Some doctors working in the hospital were unwilling to participate and others were absent at the time of data collection. This resulted in decreased power of the study. Second, some of the answers might have not been honest (social desirability bias). Lastly,\u0026nbsp;the online questionnaires were filled by the participants without observation by the data collector; hence, some of the questions might have been differently interpreted.\u003c/p\u003e\n\u003cp\u003eBased on our findings, We recommend that educational intervention should be carried out to enhance the practice of PEP.\u0026nbsp;HIV PEP guidelines should be provided and followed by hospitals. Also,\u0026nbsp;New strategies must be developed to reduce the risk of occupational exposure.\u0026nbsp;ART for PEP should be available in every hospital, and in cases of occupational exposure, treatment should be immediately initiated.\u003c/p\u003e\n\u003cp\u003eIn conclusion, the findings of this study revealed that there is a significant knowledge gap regarding HIV PEP among doctors working at Royal Care International Hospital.\u0026nbsp;Although lacking knowledge,\u0026nbsp;most of these doctors showed a positive attitude towards HIV PEP.\u0026nbsp;\u0026nbsp;A significant proportion have had an occupational exposure that would warrant the use of PEP, in addition to low reporting rates, low use of PEP after occupational exposure, and low PEP completion rates.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e6.1 \u0026nbsp; Funding\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e6.2\u0026nbsp; \u0026nbsp;Competing Interests\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e6.3\u0026nbsp; \u0026nbsp;Author Contributions:\u003c/p\u003e\n\u003cp\u003eAll authors (Rawan Khalid, Raheeg Mohamed, Elmuiz Abdelrahman, Hassan Mohammed, Ahmed Makki, Abdulrahman Abdeldaim, Malaz Idrees, Yumna Magzoub, Nada Gaafar, Eltayeb AbdAlla)\u0026nbsp;contributed to the study conception, design, material preparation and data collection. Data analysis was performed by Eltayeb AbdAlla. The first draft of the manuscript was written by\u0026nbsp;Rawan Khalidand all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e6.4\u0026nbsp; \u0026nbsp;Data Availability:\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analysed in this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e6.5\u0026nbsp; \u0026nbsp;Ethics approval:\u003c/p\u003e\n\u003cp\u003eThis study was performed in line with the principles of the Declaration of Helsinki. Ethical approval was sought from the ethical committee, the Department of Community Medicine, University of Khartoum. Permission was obtained from the hospital before data collection, and consent was taken from the participants.\u003c/p\u003e\n\u003cp\u003e6.6\u0026nbsp; \u0026nbsp;Consent to participate:\u003c/p\u003e\n\u003cp\u003eConsent was obtained from all the participants before participation, and the participation was voluntary withdrawal was allowed at any moment.\u003c/p\u003e\n\u003cp\u003e6.7\u0026nbsp; \u0026nbsp;Consent to publish\u003c/p\u003e\n\u003cp\u003eAll participants provided informed consent for publication of their data\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eShenkut M. Assessment of Knowledge, Attitude \u0026amp; Practice of Health Professionals towards Post Exposure Prophylaxis of HIV/AIDS in Woldia General Hospital, Woldia, North-Eastern Ethiopia. International Journal of Healthcare Technology and Management. 2018 Jan 23;8. \u003c/li\u003e\n\u003cli\u003e_aids-data-book_en.pdf [Internet]. [cited 2024 Jun 1]. Available from: https://www.unaids.org/sites/default/files/media_asset/2020_aids-data-book_en.pdf\u003c/li\u003e\n\u003cli\u003eMashoto KO, Mubyazi GM, Mushi AK. Knowledge of occupational exposure to HIV: a cross sectional study of healthcare workers in Tumbi and Dodoma hospitals, Tanzania. BMC Health Serv Res [Internet]. 2015 Jan 22 [cited 2024 Jun 1];15(1):29. Available from: https://doi.org/10.1186/s12913-015-0700-z\u003c/li\u003e\n\u003cli\u003eMathewos B, Birhan W, Kinfe S, Boru M, Tiruneh G, Addis Z, et al. Assessment of knowledge, attitude and practice towards post exposure prophylaxis for HIV among health care workers in Gondar, North West Ethiopia. BMC Public Health [Internet]. 2013 May 25 [cited 2024 Jun 1];13(1):508. Available from: https://doi.org/10.1186/1471-2458-13-508\u003c/li\u003e\n\u003cli\u003eAnteneh B, Belachew SA, Endeshaw A, Wubneh ZB, Sarkar BR. Knowledge, attitude and practices of medical and health science students on the antiretroviral based HIV post-exposure prophylaxis in an Ethiopian hospital: an institutional based cross-sectional study. BMC Health Serv Res [Internet]. 2019 Oct 21 [cited 2024 Jun 1];19(1):713. Available from: https://doi.org/10.1186/s12913-019-4611-2\u003c/li\u003e\n\u003cli\u003eBashir F, Ba Wazir M, Schumann B, Lindvall K. The realities of HIV prevention. A closer look at facilitators and challenges faced by HIV prevention programmes in Sudan and Yemen. Global Health Action [Internet]. 2019 Jan 1 [cited 2024 Jun 1];12(1):1659098. Available from: https://doi.org/10.1080/16549716.2019.1659098\u003c/li\u003e\n\u003cli\u003eTebeje B, Hailu C. Assessment of HIV post-exposure prophylaxis use among health workers of governmental health institutions in Jimma Zone, Oromiya Region, Southwest Ethiopia. Ethiopian Journal of Health Sciences [Internet]. 2010 [cited 2024 Jun 1];20(1). Available from: https://www.ajol.info/index.php/ejhs/article/view/69429\u003c/li\u003e\n\u003cli\u003eElsadig TA, Awooda EM. Level of Knowledge, Attitude and Practice of Sudanese Dentists toward Post Exposure Prophylaxis in Khartoum City. \u003c/li\u003e\n\u003cli\u003eEticha EM, Gemeda AB. Knowledge, Attitude, and Practice of Postexposure Prophylaxis against HIV Infection among Healthcare Workers in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. AIDS Research and Treatment [Internet]. 2019 Feb 21 [cited 2024 Jun 1];2019:e7947086. Available from: https://www.hindawi.com/journals/art/2019/7947086/\u003c/li\u003e\n\u003cli\u003eMabwe P, Kessy AT, Semali I. Understanding the magnitude of occupational exposure to human immunodeficiency virus (HIV) and uptake of HIV post-exposure prophylaxis among healthcare workers in a rural district in Tanzania. Journal of Hospital Infection [Internet]. 2017 Jul 1 [cited 2024 Jun 1];96(3):276\u0026ndash;80. Available from: https://www.sciencedirect.com/science/article/pii/S0195670117300191\u003c/li\u003e\n\u003cli\u003eAminde LN, Takah NF, Dzudie A, Bonko NM, Awungafac G, Teno D, et al. Occupational Post-Exposure Prophylaxis (PEP) against Human Immunodeficiency Virus (HIV) Infection in a Health District in Cameroon: Assessment of the Knowledge and Practices of Nurses. PLOS ONE [Internet]. 2015 Apr 16 [cited 2024 Jun 1];10(4):e0124416. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124416\u003c/li\u003e\n\u003cli\u003eShokuhi S, Gachkar L, Alavi-Darazam I, Yuhanaee P, Sajadi MM. Occupational Exposure to Blood and Body Fluids among Health Care Workers in Teaching Hospitals in Tehran, Iran. Iranian Red Crescent Medical Journal [Internet]. 2012 Jul 1 [cited 2024 Jun 1]; Available from: https://www.semanticscholar.org/paper/613a3dcc8d65d4e849b9244850b6c813ed73e26c\u003c/li\u003e\n\u003cli\u003eAjibola S, Akinbami A, Elikwu C, Odesanya M, Uche E. Knowledge, attitude and practices of HIV post exposure prophylaxis amongst health workers in Lagos University Teaching Hospital. Pan African Medical Journal [Internet]. 2014 [cited 2024 Jun 1];19(1). Available from: https://www.ajol.info/index.php/pamj/article/view/134249\u003c/li\u003e\n\u003cli\u003eKabotho KT, Chivese T. Occupational exposure to HIV among nurses at a major tertiary hospital: Reporting and utilization of post-exposure prophylaxis; A cross-sectional study in the Western Cape, South Africa. PLOS ONE [Internet]. 2020 Apr 14 [cited 2024 Jun 1];15(4):e0230075. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230075\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 5 to 6 are available in the Supplementary Files section\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Shows the sociodemographic characteristics of doctors working at RCIH 2020-2021\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003evariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnswers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.510204081632654%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eAge group (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e20 - 30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e83.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e31 - 40\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e41 - 50\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;50\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.510204081632654%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e41.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.510204081632654%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e84.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarried\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDivorced\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.510204081632654%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eYears of experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 1\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e23.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1 - 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e50.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e4 - 5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.24657534246575%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt; 5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.87671232876713%\" valign=\"top\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Knowledge about PEP for HIV among doctors working at RCIH 2020-2021\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eanswers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eAwareness of PEP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e26.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e74.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eKnow the meaning of PEP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eno\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e93.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eAware of the availability of PEP guidelines in this hospital.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eno\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e67.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e32.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eIdentify indication for PEP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhen the source patient is at high risk for HIV*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e43.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhen the source patient is known to be HIV positive*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhen The HIV status of the source is unknown*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e35.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFor any needle stick injury in the workplace\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e42.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eThe maximum delay to take PEP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e12 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e15.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e24 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e48 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e72 hours*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e36.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003ePreferable time to start PEP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ewithin an hour*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e69.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 6 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 12 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 72 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eDuration of ART intake for PEP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003efor 28 days*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e48.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003efor 40 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003efor six months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e32.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003efor life time\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.166666666666668%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eKnow about the PEP guideline\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eno\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.833333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e71.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.630289532293986%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.18485523385301%\" valign=\"top\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eKnowledge score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e79.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdequate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Attitude about PEP doctors working in RCIH 2020-2021\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnswer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eThink PEP is important\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEP training is important for\u0026nbsp;\u003c/strong\u003ebehavioral\u003cstrong\u003e\u0026nbsp;change\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e97.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEP guidelines should be available in the work area\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEP can reduce the likelihood of becoming HIV positive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e94.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEP prevents further infection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e68.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e31.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEP should be indicated for any type of sharp injuries\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e52.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e47.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEP is not important if the exposure is not with blood of a patient with known HIV positive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e40.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e59.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.249169435215947%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-exposure prophylaxis is effective for HIV prevention.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.083056478405314%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.750830564784053%\" valign=\"top\"\u003e\n \u003cp\u003e182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.916943521594686%\" valign=\"top\"\u003e\n \u003cp\u003e89.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.55555555555556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.111111111111114%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Practice of PEP for HIV among doctors working in RCIH 2020-2021\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnswers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupational exposure to HIV risky conditions. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e69.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e30.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDid you report it?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e79.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReaction of HCWs toward HIV exposed individuals\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSupportive and maintained confidentiality.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e49.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eConfidentiality was not maintained.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e18.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDid not show concern about my accidental exposure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDid you receive PEP after exposure?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e86.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat was the barrier that prevented you from getting the PEP?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnaware of the existence of PEP and protocol\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e33\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e31.7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLack of understanding the value of reporting exposure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e24\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e23.1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFear of stigma and discriminations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e9.6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLack of support and encouragement to report\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e21\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e20.2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEP service is unavailable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e64\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e61.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReason for receiving PEP \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExposure to blood from known HIV positive patients\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExposure to blood from patient whose HIV status is unknown\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInjury from any sharp object\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime to initiate PEP after exposure \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWithin 1 hour.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e29.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 2 - 6 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 6 - 10 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 72 hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of PEP\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFor 3 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e47.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFor 28 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e36.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFor 15 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCompleted the prescribed ART for PEP \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e35.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e65.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReason for discontinuation of the ART for PEP \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFear of adverse effects\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssuming that it was enough\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e29.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssuming that the drug was not effective\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e29.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4539317/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4539317/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eDespite the high rates of needle stick injuries, post-exposure prophylaxis usage is mainly unreported. Healthcare workers are at high risk of contracting HIV due to occupational exposure to blood and bodily fluids. The purpose of this study is to evaluate physicians working at Royal Care International Hospital regarding their knowledge, attitudes, and practices regarding HIV post-exposure prophylaxis (PEP).\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFrom Janury to march 2021, 204 doctors participated in a facility-based cross-sectional study at Royal Care International Hospital. The study used a structured self-administered questionnaire that included questions about demographic information, knowledge, attitudes, and practices regarding HIV PEP.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eWhile 74% of participants knew that HIV PEP existed, the majority of participants (79.4%) knew very little about it. Only 69.6% of participants knew when it is best to begin HIV PEP after exposure, and the majority of participants were unable to name the conditions under which it is recommended. All of the participants thought HIV PEP was important, and 82.4% of them thought it was generally a good thing. Of the participants, 63 (30.9%) reported having been exposed to HIV-risky situations at work; however, only 42 (66.6%) of them disclosed this information, and only 27 (42.8%) of them received HIV PEP.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eWhile a considerable proportion of the participants had experienced an HIV-risky condition, the study found that there was a low reporting rate and low use of HIV PEP among them. Additionally, the majority of the participants had a positive attitude towards HIV PEP.\u003c/p\u003e","manuscriptTitle":"Assessment of knowledge, attitude, and practice regarding HIV post-exposure prophylaxis after occupational exposure among doctors working at Royal Care International Hospital (2021)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-26 10:20:08","doi":"10.21203/rs.3.rs-4539317/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aaeb5d15-4bc3-4206-9966-3093b1cd0afa","owner":[],"postedDate":"June 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-26T07:38:50+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-26 10:20:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4539317","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4539317","identity":"rs-4539317","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}