Post Exposure Prophylaxis for Occupational and Non-occupational Exposures to HIV: A 14-year Cohort Study in Lagos, Nigeria

Background: Preventing new HIV infections among individuals is a major strategy to fight the
HIV/AIDS scourge worldwide. In addition to the availability and use of highly active antiretroviral
therapy to treat infections, short term treatment options to curtail the spread of potential infection of
the virus in exposed individuals has been instituted. The various modes of exposure to the HIV virus
and the risk of infection have been categorized with corresponding treatment options.
Aim: To evaluate the nature of exposure, time of presentation for treatment, adherence to follow up
visits, treatment outcome and identify gaps of treatment procedures in a HIV treatment centre.
Study design: A retrospective cohort study.
Place and duration of study: The HIV treatment centre domiciled at the Clinical Sciences
Department of the Nigerian Institute of Medical Research, Lagos, Nigeria from January 2006 to
September 2019.
Methodology: A database retrospective review was conducted for adult patients who were treated
for post exposure prophylaxis during the study period. A total of 422 patients whose records met the
inclusion criteria were reviewed. Data were analyzed and presented using descriptive statistics.
Results: The mean age of the patients was 31.5 ± (10.1) years and higher proportions of the age
group were <30 years (52.1%). Majority were females (71.6%), single (63%), had tertiary level of
education (68.5%), were employed (70.6%) and had high risk exposures (76.3%). The most
commonly prescribed regimen was LPV/r +AZT/3TC (56.2%).More than half (65.9%) had nonoccupational
exposures and overall, 97.2% presented for treatment within 72hours of exposure but
only1.6% completed the follow up visits.
Conclusion: Treatment outcome appears good because no sero-conversion was reported or
recorded. The younger age group had higher incidence of rape which was mainly among students
which calls for urgent attention. There was a high incidence of needle stick injury among health care
workers. There is a need to devise strategies to encourage completion of follow up visits.