Assessing adherence to recommended HIV Post Exposure Prophylaxis regimens prescribed to doctors working at the Free State Academic Complex in Bloemfontein, South Africa

Background: The prevalence of HIV infection in South Africa is one of the highest in the world and healthcare workers in this setting are particularly at risk of being infected through occupational exposures. All high-risk exposures to infective bodily fluids are considered as important, warranting the use of post exposure prophylaxis (PEP). This study determined adherence to PEP in doctors, regardless of specialty and rank. Methods: A cross sectional study was conducted by distributing a structured anonymous questionnaire to doctors working in 3 teaching hospitals in central South Africa. Results: A total of 233 of 400 distributed questionnaires were completed (response rate 58,2%) from 543 employed doctors across 3 different hospitals and over 16 specialties (coverage 42.9%). Almost all the respondents (84,7%) had at least one high risk exposure, with an average of 2,3 exposures per respondent. Most (49%) of the respondents were exposed when performing venesection. Majority (58%) thought that the exposure could have been avoided. Of those exposed, 83% used PEP at least once. Of those who took PEP, 56% stopped prematurely with 71% of them citing adverse side effects as the main reason. Workload impacted adherence negatively in at least 50% of respondents. Conclusion: Majority of doctors had more than two occupational exposures. Adherence to PEP is generally poor. This is mainly due to the side effect profile of PEP regimens used at the time of the study. The recent widespread availability of better tolerated ART drugs and more tolerable regimens for PEP, may improve adherence.