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

Healthcare workers (HCWs) are at risk of HIV infection due to occupational exposure, making adherence to post-exposure prophylaxis (PEP) crucial in preventing HIV transmission. This study explored the barriers and benefits to PEP adherence among HCWs at AIC-Kijabe Hospital and identified mechanisms to improve adherence. It was a phenomenological qualitative research design that used semi-structured interviews to collect data from a purposive sample of 35 HCWs. The study was conducted in AIC-Kijabe Hospital. Data were collected through face-to-face interviews with HCWs who reported exposure to HIV and were initiated on PEP. Key informant interviews were also conducted, those of whom were Chronic Care Clinic (CCC) team members. The guide was pilot-tested at AIC-Kijabe Naivasha Medical Centre to enhance its reliability and validity. The interviews were audio-recorded, with the consent of the participants. Deductive thematic analysis was employed to analyze the interview data. The transcribed interview was coded and categorized into themes and sub-themes. NVivo data analysis software was used to facilitate the organization and analysis process. Several barriers to PEP adherence were identified and they were based on Personal/ Individual drug-related, organizational, and interpersonal factors. Personal factors included forgetfulness, acceptance of stigma, and low-risk perception. Drug/Medicine-related were fear of side effects, and logistical challenges e.g. pill too big to swallow. Organizational/institutional factors included process inefficiencies and institutional stigma, as well as interpersonal factors like lack of social support. The perceived benefits noted by the participants included a reduction of the risk of HIV transmission to HCWs, their spouses, and patients. It also gave them peace of mind. Adherence to PEP was also viewed as an ethical duty and obligation. The findings underscore the importance of addressing multi-level barriers to PEP adherence among HCWs. Interventions should include educational programs to reduce stigma and improve risk perception, organizational reforms to streamline PEP access, and provision of psychological and social support for HCWs.