HIV Pre-Exposure Prophylaxis (PrEP) in Clinical Settings in Western Nigeria: Are Healthcare Providers Prepared?

Abstract

Background: HIV pre-exposure prophylaxis (PrEP) can decrease HIV incidence among several high-risk populations. In order to successfully implement PrEP, healthcare providers will need to have knowledge about counselling, monitoring and drug adherence which are keys to the success of the intervention. This study was carried out to determine the awareness, practice and preparedness of healthcare professionals to prescribe PrEP in clinical settings and identify the factors associated with or encouraging its prescription. This cross-sectional study was carried out in randomly selected primary, secondary and tertiary level hospitals across four states in Western Nigeria (Ondo, Ekiti, Osun and Lagos). The target population were physicians and nurses largely involved in the antiretroviral clinics in the hospitals. Data was collected by trained volunteers and supervised by appointed supervisors by a face-to-face interview. All data were statistically analysed, using Statistical Package for the Social Sciences (SPSS) and statistical test of significance was performed with Chi-Square test. A total of 256 consenting respondents participated in the study with a mean age ± SD of 38.52 ± 9.29 years. Gender distribution of the subjects indicated that 130 (51.6%) of them were males while 124 (48.4%) are females. A total of 89.8% of the respondents have heard about PrEP, with 54.3% of them aware of both oral and topical PrEP while only 4.3% have ever prescribed PrEP. The main factor associated with PrEP prescription was work experience (χ² = 20.815, df = 1, p = 0.001). Work experience has lower association with PrEP prescription (OR: 0.88, 95% CI: 0.82 – 0.95). Healthcare professionals in public hospitals in Nigeria are PrEP aware and willing to prescribe, but few have actually ever done the prescription. Regular supply of drugs for pre-exposure prophylaxis purpose and addressing the potential safety issues and medication-related adverse effects will help aid the PrEP implementation effort nationwide.