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HIV prone occupational exposures: epidemiology and factors associated with initiation of post-exposure prophylaxis.
J Epidemiol Community Health. 2009 May; 63(5):373-8.JE

Abstract

BACKGROUND

Occupational exposures to bloodborne viruses are very common. Whilst occupational HIV transmissions are rare, the serious physical, psychological and cost implications of potential transmission make this an important public health topic. European and UK guidelines recommend HIV post-exposure prophylaxis (PEP) as a valuable tool of preventing occupational HIV infection. Yet one in five UK healthcare workers did not initiate PEP despite having been exposed to an HIV-positive source patient. The aim of the study is to examine factors associated with PEP uptake behaviour.

METHODS

The study is based on an analysis of the UK Health Protection Agency surveillance database of 'Significant Occupational Exposures to Bloodborne Viruses in Healthcare Workers'. Associations between possible predicting factors and PEP-uptake have been examined with univariate analysis and logistic regression modelling.

RESULTS

Univariate analysis and logistic regression found significant associations between PEP-uptake and visible blood on the device (p<0.0001) and a linear relationship with increasing injury depth (p<0.0001). Doctors were significantly more likely to start PEP than nurses (OR 1.88, 1.16; 3.02). Multiple imputation of missing values did not significantly alter these results.

CONCLUSIONS

PEP-uptake was associated with known transmission risk factors, suggesting awareness of current guidelines. The significant differences in PEP-uptake across occupation categories may be due to differential risk perceptions or other underlying factors. This is the first national study to examine PEP-uptake following occupational exposures to HIV. Further research and exploration of these findings are warranted, to understand the role of PEP-uptake behaviour in preventing occupational HIV transmission.

Authors+Show Affiliations

Health Protection Agency, Centre for Infections, London, UK. dominik.zenner@lshtm.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19188197

Citation

Zenner, D, et al. "HIV Prone Occupational Exposures: Epidemiology and Factors Associated With Initiation of Post-exposure Prophylaxis." Journal of Epidemiology and Community Health, vol. 63, no. 5, 2009, pp. 373-8.
Zenner D, Tomkins S, Charlett A, et al. HIV prone occupational exposures: epidemiology and factors associated with initiation of post-exposure prophylaxis. J Epidemiol Community Health. 2009;63(5):373-8.
Zenner, D., Tomkins, S., Charlett, A., Wellings, K., & Ncube, F. (2009). HIV prone occupational exposures: epidemiology and factors associated with initiation of post-exposure prophylaxis. Journal of Epidemiology and Community Health, 63(5), 373-8. https://doi.org/10.1136/jech.2008.081463
Zenner D, et al. HIV Prone Occupational Exposures: Epidemiology and Factors Associated With Initiation of Post-exposure Prophylaxis. J Epidemiol Community Health. 2009;63(5):373-8. PubMed PMID: 19188197.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HIV prone occupational exposures: epidemiology and factors associated with initiation of post-exposure prophylaxis. AU - Zenner,D, AU - Tomkins,S, AU - Charlett,A, AU - Wellings,K, AU - Ncube,F, Y1 - 2009/02/02/ PY - 2009/2/4/entrez PY - 2009/2/4/pubmed PY - 2010/3/17/medline SP - 373 EP - 8 JF - Journal of epidemiology and community health JO - J Epidemiol Community Health VL - 63 IS - 5 N2 - BACKGROUND: Occupational exposures to bloodborne viruses are very common. Whilst occupational HIV transmissions are rare, the serious physical, psychological and cost implications of potential transmission make this an important public health topic. European and UK guidelines recommend HIV post-exposure prophylaxis (PEP) as a valuable tool of preventing occupational HIV infection. Yet one in five UK healthcare workers did not initiate PEP despite having been exposed to an HIV-positive source patient. The aim of the study is to examine factors associated with PEP uptake behaviour. METHODS: The study is based on an analysis of the UK Health Protection Agency surveillance database of 'Significant Occupational Exposures to Bloodborne Viruses in Healthcare Workers'. Associations between possible predicting factors and PEP-uptake have been examined with univariate analysis and logistic regression modelling. RESULTS: Univariate analysis and logistic regression found significant associations between PEP-uptake and visible blood on the device (p<0.0001) and a linear relationship with increasing injury depth (p<0.0001). Doctors were significantly more likely to start PEP than nurses (OR 1.88, 1.16; 3.02). Multiple imputation of missing values did not significantly alter these results. CONCLUSIONS: PEP-uptake was associated with known transmission risk factors, suggesting awareness of current guidelines. The significant differences in PEP-uptake across occupation categories may be due to differential risk perceptions or other underlying factors. This is the first national study to examine PEP-uptake following occupational exposures to HIV. Further research and exploration of these findings are warranted, to understand the role of PEP-uptake behaviour in preventing occupational HIV transmission. SN - 1470-2738 UR - https://www.unboundmedicine.com/medline/citation/19188197/HIV_prone_occupational_exposures:_epidemiology_and_factors_associated_with_initiation_of_post_exposure_prophylaxis_ L2 - https://jech.bmj.com/lookup/pmidlookup?view=long&amp;pmid=19188197 DB - PRIME DP - Unbound Medicine ER -