Abstract

Christina Hara, MadalitsoKalima and Patrick Kamalo

The prevalence of the Human Immunodeficiency Virus (HIV) remains high in sub Saharan Africa and there is a small but significant risk for surgical staff, to contract HIV over time from infected surgical patients. We conducted this study to investigate the attitudes and practices of surgical staff towards the prevention of occupational HIV infection (OHI) at a tertiary hospital in Malawi. This was a cross sectional qualitative study using a semi-structured questionnaire, administered to surgical staff (surgeons, nurses, clinical officers) to assess their attitudes and practices towards self-protection from OHI. We collected data on self-protection measures to reduce risk of HIV exposure, and practices following accidental exposure. We also conducted blinded observations of staff working in the operating theatres. Data were analyzed manually, drawing themes, and observed practices were correlated with reported behaviors. We interviewed 23 study participants and observed 3 theatre sessions which involved 15 theatre staff. Responses were mixed, participants expressed both positive and negative views. Some viewed the infectiousness of HIV from occupational exposure as too low and negligible. The effect of post-exposure prophylaxis was also underrated. Lack of resources for personal protection resulted in most staff not using self-protection materials. There were no written institutional protocols, nor guidelines to train staff on OHI. Within the field of OHI prevention, the beliefs and practice patterns of healthcare staff in this hospital in Malawi are often, but not always, in agreement with the scientific literature. The level of dissemination of information and material support that they receive from the hospital is inadequate.