[P5] IN EASTERN UGANDA TRAINING IN POST-EXPOSURE PROPHYLAXIS (PEP) AFTER OCCUPATIONAL EXPOSURE TO HIV PRODUCED SIGNIFICANT IMPROVEMENTS IN PRACTICE AND IMPROVED LINKS BETWEEN HIV UNITS TO ALLOW BETTER PRACTICE TO EXTEND THROUGHOUT THE REGION

14th Annual Conference of the British HIV Association

23-25 April 2008, Belfast

IN EASTERN UGANDA TRAINING IN POST-EXPOSURE PROPHYLAXIS (PEP) AFTER OCCUPATIONAL EXPOSURE TO HIV PRODUCED SIGNIFICANT IMPROVEMENTS IN PRACTICE AND IMPROVED LINKS BETWEEN HIV UNITS TO ALLOW BETTER PRACTICE TO EXTEND THROUGHOUT THE REGION

HIV Med 2008; 9(Suppl. 1):11 (abstract no. P5)

JSO Obbo¹, P Olupot-Olupot¹, J Balyejjusa¹ and J Meadway²
¹ Mbale Regional Referral Hospital, Mbale, Uganda, ² MforM-Africa, London, UK

DISCUSSION: In Uganda there is a high risk that any sharps injury to hospital staff will be from an HIV- infected patient. We assessed PEP practice in hospitals and clinics in Eastern Uganda before and one year after training led by UK clinicians.

METHODS: In 2006, 28 clinicians from the Regional Referral Hospital (RRH) and other hospitals and health care units throughout the region attended a 4 day HIV Update Course funded by a UK charity. An interactive session on PEP was used to establish current practice and to give information; other sessions were on antiretrovirals (ARVs) and on confidentiality. In 2007 at a second course participants completed a questionnaire about PEP before a further interactive session.

RESULTS:In 2006 no hospital or unit had a written procedure for PEP, a confidential testing system for staff or ready availability of PEP. All in-patient units and most out-patient units had access only to first-line ARVs in a fixed-dose combination containing nevirapine. Clinicians were unaware of the risks of nevirapine for a patient with a normal CD4. In 2007 the RRH had established a team to work on a PEP protocol, and linked with a nearby HIV unit to provide confidentiality and appropriate ARVs for its staff. Most course participants remained unaware of PEP recommendations in Ugandan National Guidelines. Only two identified three classes of ARVs mentioned for PEP; four could not identify any ARV used. The RRH were developing a written protocol, PEP pack and staff training. Course participants planned that the RRH protocol would become a model for units in the region.

CONCLUSIONS: National Guidelines for PEP are not being followed in regions of Uganda. Training sessions for clinicians resulted in significant changes in practice at the main hospital and links which could extend improvements throughout the region.

2008-04-23
P5

Copyright © 2008 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD