title: 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.
abstract: BACKGROUND
  Occupational exposure to blood or other body fluids in healthcare settings puts healthcare workers (HCWs) at risk of acquiring human immunodeficiency virus (HIV) infection. It is estimated that between 200 and 5000 HIV infections are transmitted annually to HCWs worldwide. Use of post-exposure prophylaxis (PEP) has been documented to reduce the rate of HIV infection from workplace exposures by 81%.
  
  
  OBJECTIVE
  To investigate the extent of occupational exposure to HIV infection during the period of 12 months before the survey and to identify factors associated with uptake of PEP services among HCWs.
  
  
  METHODS
  We interviewed 221 HCWs from selected healthcare facilities in Kongwa, Tanzania. Data included occupational exposures to body fluids, knowledge and use of PEP.
  
  
  RESULTS
  Sixty (27.1%) of the HCWs had experienced exposures to blood and body fluids, of whom 71.7% (43/60) had needlestick injuries. Medical attendants were more frequently exposed, followed by nurses (31.7% and 28.6% respectively). Of the exposed HCWs, seven (11.7%) reported use of HIV PEP. Reporting of exposure [odds ratio (OR): 8.44; P = 0.016], knowledge of the HIV status of the source patient (OR: 42.19; P = 0.007) and awareness of PEP (OR: 12.72; P = 0.010) were significant predictors of PEP use.
  
  
  CONCLUSIONS
  Uptake of PEP services among HCWs remains low despite high rate of occupational exposures. Wider dissemination of HIV PEP guidelines and training of HCWs is required in Tanzania to ensure that HCWs have knowledge of, and prompt access to, PEP services.
authors.affiliation: Ministry of Health and Social Welfare, Dar es Salaam, Tanzania. Electronic address: pmabwe@hotmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Mabwe
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: A T
authors.initials: AT
authors.lastname: Kessy
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: I
authors.initials: I
authors.lastname: Semali
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008297:Male; D016273:Occupational Exposure; D056990:Post-Exposure Prophylaxis / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012424:Rural Population; D013636:Tanzania
keywords: HIV; Healthcare workers; Post-exposure prophylaxis; Tanzania