ASSESSMENT OF KNOWLEDGE, ATTITUDE, PRACTICE (KAP) AND ASSOCIATED FACTOR TOWARDS HIV POST EXPOSURE PROPHYLAXIS (PEP) AMONG SPHMMC CLEANING STAFF,2018 EC

Abstract

ABSTRACT Introduction: Occupational exposure to blood borne pathogens remains a major concern in healthcare settings, with cleaners facing heightened risk due to frequent contact with contaminated waste and body fluids. Although Ethiopia has national guidelines on HIV post-exposure prophylaxis (PEP), little was known about how these guidelines were understood and applied by cleaning staff. This study assessed the knowledge, attitudes, and practices of cleaners toward PEP at St. Paul’s Hospital Millennium Medical College (SPHMMC) and examined factors associated with these outcomes. Methods: A cross-sectional study was conducted among cleaning staff using a structured questionnaire that captured sociodemographic characteristics, knowledge of PEP, attitudes toward its use, and practices following occupational exposure. Descriptive statistics summarized key variables, while correlation and multiple regression analyses identified factors associated with knowledge, attitude, and practice. Results: The demographic findings show that the cleaning workforce is predominantly young, with the highest proportions in the 26–35 years (37.1%) and 36–45 years (31.0%) age groups, while 24.8% were aged 18–25 years and only 6.2% were 46–55 years. Females constituted an overwhelming majority (99.0%) of the participants. In terms of educational status, 38.1% had completed primary education, 29.0% secondary education, and 19.0% had no formal education, whereas only 12.8% had attained diploma or degree-level qualifications. Regarding work experience, 31.0% had worked for 3–4 years, 28.1% for 1–2 years, 21.0% for less than one year, and 19.0% for five or more years. Most participants were married (60.0%), and the dominant religious affiliation was Orthodox Christianity (57.6%), followed by Protestant (32.9%) and Muslim (8.6%). Departmental distribution showed that 29.0% of respondents worked in Surgery, 27.6% in Obstetrics and Gynecology, 27.1% in Pediatrics, and 15.2% in Internal Medicine. Overall, these prevalences indicate that the study population is largely composed of young, female cleaning staff with moderate work experience and primarily basic educational backgrounds, working predominantly in high-risk clinical departments. This profile highlights their increased vulnerability to occupational exposure and underscores the importance of strengthening PEP-related awareness, training, and protective practices within this group. Conclusion: The study concluded that knowledge among cleaning staff was moderate, attitudes were acceptable but influenced by workplace context, and practices were poor. Demographic factors showed minimal influence on knowledge or practice, while department assignment shaped attitudes. These findings highlight the need for improved training, strengthened adherence support, and better enforcement of universal precautions to enhance outcomes. Recommendations: The study recommended strengthening role-specific and repeated training for all cleaning staff, implementing department-focused sensitization to improve attitudes, reinforcing universal precautions through consistent supply and supervision, and enhancing adherence support for PEP initiation and completion. System-level improvements rather than demographic targeting were emphasized to address the identified gaps. Key words: HIV, Post-Exposure Prophylaxis, Cleaning Staff, Knowledge, Attitude, Practice, Occupational Exposure, SPHMMC