Out of the seven informants one was female. All were directly involved in handling patients with HIV infection. One of them was a general practitioner engaged in delivering women at the maternity ward of the hospital and doing gynecologic and obstetric procedures. Three others were intern doctors who cared for medical, surgical, gynecologic, obstetric and pediatric patients. Other 2 were nurses: a clinical nurse and a midwife. And there was one laboratory worker.
Five major themes emerged:
1. Work Related Transmission of HIV Infection
All the professionals included in the study had adequate awareness about the transmission of HIV infection at workplace. They had mentioned several means of transmission. Some of them were: injury with sharp materials and needles; exposure to body fluids; and contact with wounds during dressing. The participants believed that the major reasons for a healthcare worker acquiring HIV infection at a work place are all related to one or more of the mentioned means.
2. Experience of Injuries at Workplace
Four of the seven subjects had experienced accidents: needle stick injuries, exposure to blood or other body fluid. Their explanations of the incidents indicated the accidents were frequent. They also witnessed a number of other workers experiencing the accidents, and hence indicating the commonness of the problem in healthcare settings.
"“At workplace, I have experienced needle prick injury and splash of amniotic fluid into my mouth and eyes.” (A 24 year old midwife)"
While describing the emotional reactions of the victims during the accidents they generally expressed their sorrow by citing the observed reactions. The following were the direct quotes from the participants:
"“In my experience I know a person who sustained needle stick injury while drawing blood and was really worried and the reaction he took was to stop his work for about 1 month.” (A 24 year old intern doctor)"
"“I know three laboratory technicians who sustained needle stick injuries and took post exposure prophylaxis. During the incident, one of them, a friend of mine, shouted and immediately burst into tears and he even tried to cut his finger.” (A 26 year old medical laboratory technologist)"
Many of the witnessed injuries/accidents were in fact followed by commencement of post exposure prophylaxis which, however, was mentioned by some to be less practiced. In line with this, professionals were well aware of post exposure prophylaxis despite some problems in getting the service at the hospital.
3. The Need for Protective Materials
All the study participants were worried about the inadequacy of protective materials essential in the prevention of HIV transmission in healthcare settings. This was reflected by the respondents mentioning it as the main reason for why the risk of work related HIV transmission was perceived to be high among healthcare workers. Among the materials mentioned to be inadequate were gloves, gowns, goggles and aprons. Additional interventions were also suggested. For example one of the study participants stated the following:
"“Our hospital has to do the following activities in order to handle work related risk of HIV transmission: giving service to HIV patients in a separate place and taking extra care; training healthcare workers on infection prevention; and organizing a committee that can follow the use of universal precautions in the hospital.” (A 26 year old medical laboratory technologist)"
4. Reasons Why HIV Transmission is a Common Risk among Health Professionals
Many reasons were mentioned by the informants. One of them was that medical interventions were related with blood and other body fluids and the use of sharp materials. The other was many patients were not screened and health professionals were generally less careful while caring for those patients which potentially predisposes them for infection. The presence of poor team work among healthcare workers was also raised as a reason enhancing the transmission of HIV infection. With all the mentioned reasons health workers believed that they had a great risk of acquiring HIV at workplace.
5. Care to HIV Patients
Despite all the risks associated with care for HIV patients all professionals strongly reported that they were in good relation with patients with HIV and they treated them just like the other patients.