Association of HIV post-exposure prophylaxis knowledge and utilisation among healthcare workers in Ghana: parallel mediation effect of perceived HIV risk and perceived availability of PEP
Promise Kwame Salu, Jacob Owusu Sarfo, Mustapha Amoadu, Thomas HormenuIntroduction
Post-exposure prophylaxis (PEP) for HIV is an effective intervention for preventing HIV transmission after occupational exposures among healthcare workers (HCWs). This study examined the association between PEP knowledge and its utilisation among HCWs in District Hospitals in Ghana and the mediating roles of perceived risk of HIV and availability of PEP in the PEP knowledge–utilisation relationship.
Methods
An analytic cross-sectional study was conducted among medical doctors, nurses, midwives and laboratory technicians at district hospitals in the Greater Accra Region of Ghana between January and May 2025. An adapted questionnaire was used to collect data from 786 HCWs who needed PEP services out of 2006 who were sampled using the census sampling approach. The hierarchical binary logistic regression method and the parallel mediation model were used to analyse the data.
Results and conclusion
Among HCWs who were exposed and potentially at risk of HIV infection, 52% reported having utilised PEP. Most participants demonstrated good knowledge of PEP (64.2%) with the majority also reporting moderate perceived risk of HIV (69.8%). Moderate social support for PEP was 49.9% and poor social support was 32.2%. Two-thirds of participants reported high availability of PEP (59.8%). Controlling for sociodemographic and social support covariates, HCWs with poor knowledge of PEP, respectively, had 37% (adjusted OR (AOR)=0.63, p=0.030) and 39% (AOR=0.61, p=0.020) lower odds of utilising PEP compared with those with good knowledge. Perceived availability of PEP services partially mediated the relationship between PEP knowledge and utilisation (β=0.16, CI (0.03 to 0.07). It is concluded that perceived availability of PEP services strengthens the relationship between PEP knowledge and utilisation. Providing education and training on PEP coupled with the visible provision of resources for the delivery of PEP services could improve utilisation of PEP among HCWs.