Abstract
<title>Abstract</title> <p> <bold>Background</bold> Health professionals (HP) are at heightened occupational risk of exposure to blood-borne pathogens, particularly Human Immunodeficiency Virus, through needle-stick and sharps injuries. This study aimed to determine and report the prevalence of HIV PEP uptake among healthcare workers who reported lifetime exposure to HIV seropositive material from needle-stick injury in South Eastern Nigeria and to identify independent determinants of uptake. Secondary objectives included assessing knowledge of HIV PEP, timing of initiation following exposure, and completion of the prescribed 28-day regimen. <bold>Methods</bold> This was a cross-sectional, web-based survey conducted among health professionals across the South-Eastern region in Nigeria. Data were collected using a semi-structured, self-administered questionnaire distributed through the regional professional associations. Reliability was assessed using Cronbach’s alpha (α = 0.88). Associations between categorical variables and outcomes were assessed using Fisher’s exact tests, while logistic regression was performed to identify independent predictors of PEP uptake. <bold>Results</bold> Fifty respondents (23.9%) had been exposed to seropositive material from needle stick injury at least once in their careers. Among these individuals, only 40.0% initiated HIV post-exposure prophylaxis. Of those who commenced PEP, almost all did so within the acceptable window period of less than 72 hours, while completion of the PEP regimen was high (90.0%). A seroconversion rate of 2.0% was observed; notably, this did not occur among those who received PEP. Physicians were more likely to use PEP following exposure compared to non-physicians (Adjusted OR = 6.27; 95% CI: 1.36–46.41; p = 0.033). <bold>Conclusion</bold> Approximately one in four HPs reported occupational exposure through NSI, yet uptake of HIV PEP remained suboptimal despite universal awareness. Profession was the sole independent predictor of uptake. Improvement in intra-institutional communication of post-exposure policies, timely drug access, and reinforcement of occupational safety protocols may improve uptake and adherence rates. </p>