{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:01:08Z","timestamp":1790182868466,"version":"4.1.0"},"reference-count":25,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"unspecified","delay-in-days":84,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,9,7]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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\u2013utilisation relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and conclusion<\/jats:title>\n                    <jats:p>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 (\u03b2=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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004047","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:05:14Z","timestamp":1790179514000},"page":"e004047","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2287-0102","authenticated-orcid":false,"given":"Promise Kwame","family":"Salu","sequence":"first","affiliation":[{"name":"Department of Global Health and Sustainability Studies, Ghana Institute of Management and Public Administration, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob Owusu","family":"Sarfo","sequence":"additional","affiliation":[{"name":"Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Central, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustapha","family":"Amoadu","sequence":"additional","affiliation":[{"name":"Cardiometabolic Epidemiology Research Laboratory, University of Cape Coast, Cape Coast, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hormenu","sequence":"additional","affiliation":[{"name":"Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Central, Ghana"},{"name":"Cardiometabolic Epidemiology Research Laboratory, University of Cape Coast, Cape Coast, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"2026092309050622000_4.3.e004047.1","unstructured":"UNAIDS . Global HIV & AIDS statistics \u2014 2025 fact sheet. 2025. Available: https:\/\/www.unaids.org\/en\/resources\/fact-sheet"},{"key":"2026092309050622000_4.3.e004047.2","unstructured":"World Health Organization . HIV data and statistics. Geneva: WHO; 2025. Available: https:\/\/www.who.int\/teams\/global-hiv-hepatitis-and-stis-programmes\/hiv\/strategic-information\/hiv-data-and-statistics"},{"key":"2026092309050622000_4.3.e004047.3","unstructured":"Population Reference Bureau . The status of the HIV\/AIDS epidemic in sub-Saharan Africa. 2025. Available: https:\/\/www.prb.org\/resources\/the-status-of-the-hiv-aids-epidemic-in-sub-saharan-africa\/"},{"key":"2026092309050622000_4.3.e004047.4","unstructured":"Ghana AIDS Commission . Understanding HIV transmission for an improved AIDS response in West Africa. Accra Ghana AIDS Commission; 2024."},{"key":"2026092309050622000_4.3.e004047.5","unstructured":"World Health Organization . Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021: Accountability for the global health sector strategies 2016\u20132021: actions for impact. Geneva WHO; 2021. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240027077"},{"key":"2026092309050622000_4.3.e004047.6","unstructured":"International Association of Providers of AIDS Care (IAPAC) . Post-exposure prophylaxis (PEP) [Fact sheet]. 2025. Available: https:\/\/www.iapac.org\/fact-sheet\/post-exposure-prophylaxis-pep\/"},{"key":"2026092309050622000_4.3.e004047.7","unstructured":"Babanawo GF . Assessment of knowledge and use of HIV post exposure prophylaxis and healthcare workers\u2019 risk to occupational exposure in New Juabeng Municipality [MPH thesis]. University of Ghana; 2016. Available: https:\/\/ugspace.ug.edu.gh\/handle\/123456789\/21266"},{"key":"2026092309050622000_4.3.e004047.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0124416","article-title":"Occupational post-exposure prophylaxis (PEP) against human immunodeficiency virus (HIV) infection in a health district in Cameroon: assessment of the knowledge and practices of nurses","volume":"10","author":"Aminde","year":"2015","journal-title":"PLoS One"},{"key":"2026092309050622000_4.3.e004047.9","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-13-508","article-title":"Assessment of knowledge, attitude and practice towards post exposure prophylaxis for HIV among health care workers in Gondar, North West Ethiopia","volume":"13","author":"Mathewos","year":"2013","journal-title":"BMC Public Health"},{"key":"2026092309050622000_4.3.e004047.10","article-title":"Knowledge, Attitude, and Practice of Postexposure Prophylaxis against HIV Infection among Healthcare Workers in Hiwot Fana Specialized University Hospital, Eastern Ethiopia","volume":"2019","author":"Eticha","year":"2019","journal-title":"AIDS Res Treat"},{"key":"2026092309050622000_4.3.e004047.11","unstructured":"Maina JW . Utilization of HIV post exposure prophylaxis among healthcare workers in selected health institutions in Nairobi, Kenya [Master\u2019s thesis]. Nairobi: Kenyatta University; 2012. Available: https:\/\/ir-library.ku.ac.ke\/handle\/123456789\/3024"},{"key":"2026092309050622000_4.3.e004047.12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.9734\/ajmah\/2019\/v14i130093","article-title":"Knowledge, Attitude and Utilization of HIV Post-Exposure Prophylaxis among Health Care Workers at HIV Treatment Centers in Port-Harcourt Metropolis","volume":"14","author":"Onuoha","year":"2019","journal-title":"AJMAH"},{"key":"2026092309050622000_4.3.e004047.13","doi-asserted-by":"crossref","first-page":"96","DOI":"10.24248\/eahrj.v3i2.606","article-title":"A Qualitative Study of Perceived Risk of Occupational Exposure to HIV and Use of Post Exposure Prophylaxis Services Among Health-Care Workers in Tanzania","volume":"3","author":"Tarimo","year":"2019","journal-title":"East Afr Health Res J"},{"key":"2026092309050622000_4.3.e004047.14","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.ijid.2021.03.079","article-title":"Predictors of adherence to HIV Post-Exposure Prophylaxis protocol among frontline healthcare workers at the Ho Teaching Hospital, Ghana","volume":"106","author":"Suglo","year":"2021","journal-title":"Int J Infect Dis"},{"key":"2026092309050622000_4.3.e004047.15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0201695","article-title":"Occupational exposure, availability and utilisation of HIV PEP among healthcare workers in Singida, Tanzania","volume":"13","author":"Kimaro","year":"2018","journal-title":"PLoS ONE"},{"key":"2026092309050622000_4.3.e004047.16","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-023-34250-4","article-title":"Occupational exposure to HIV and utilization of post-exposure prophylaxis among healthcare workers at St. Peter\u2019s specialized hospital in Addis Ababa, Ethiopia","volume":"13","author":"Tsega","year":"2023","journal-title":"Sci 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