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Impact of Post-Exposure Prophylaxis Awareness on HIV Post-Exposure Preventive Practices among University Students in Nigeria

Abstract

Human immunodeficiency virus (HIV) infection remains an important public health concern in Nigeria, and timely intervention following potential exposure to HIV is essential for reducing the risk of infection. Post-exposure prophylaxis (PEP) is an emergency HIV prevention intervention involving the use of antiretroviral medicines after a potential exposure to HIV. PEP is most effective when initiated as soon as possible following a potential exposure and requires appropriate clinical assessment, adherence to the prescribed regimen, HIV testing, and follow-up. University students may encounter situations that could result in potential HIV exposure, including unprotected sexual contact, sexual violence, occupational or accidental exposure in relevant settings, and other circumstances requiring urgent professional assessment. PEP awareness provides students with information about HIV exposure, the purpose of PEP, situations in which PEP may be indicated, the urgency of seeking professional care, where PEP services can be obtained, the importance of adherence, HIV testing, follow-up, and other HIV prevention measures. HIV post-exposure preventive practices refer to appropriate actions taken following a potential HIV exposure, including promptly seeking professional medical assessment, obtaining PEP when clinically indicated, adhering to prescribed PEP, completing recommended HIV testing and follow-up, and utilizing appropriate preventive services. In Nigeria, inadequate awareness, misconceptions about PEP, stigma, concerns about confidentiality, uncertainty about where to obtain PEP, and delays in seeking healthcare may limit appropriate post-exposure preventive practices among university students. Effective PEP awareness may improve students' knowledge and encourage timely and appropriate responses following potential HIV exposure. Against this background, this study investigates the impact of post-exposure prophylaxis awareness on HIV post-exposure preventive practices among university students in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding students' responses following potential HIV exposure. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping HIV prevention and healthcare-seeking behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from PEP awareness may influence post-exposure preventive practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how PEP awareness may influence appropriate HIV post-exposure preventive practices among university students in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from undergraduate students in selected universities in Nigeria using a structured anonymous self-administered questionnaire. A multistage sampling technique will be employed to select states, universities, faculties or departments, academic levels, and eligible students. Where feasible, selected student groups will be assigned to intervention and comparison groups. Students in the intervention group will receive structured PEP awareness education covering HIV transmission and prevention, situations involving potential HIV exposure, the purpose and appropriate use of PEP, the importance of seeking professional assessment urgently after potential exposure, where PEP services can be obtained, adherence to prescribed PEP, HIV testing, follow-up care, confidentiality, and other appropriate HIV prevention measures. HIV post-exposure preventive practices will be assessed using indicators such as knowledge of appropriate actions following potential exposure, prompt healthcare-seeking, awareness and utilization of PEP services when clinically indicated, adherence to prescribed PEP, completion of recommended HIV testing and follow-up, and utilization of appropriate HIV prevention services. Descriptive statistics will be used to summarize students' sociodemographic characteristics, baseline HIV and PEP knowledge, exposure to awareness education, and post-exposure preventive practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the impact of PEP awareness on HIV post-exposure preventive practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that PEP awareness has a significant positive impact on HIV post-exposure preventive practices among university students in Nigeria. Students exposed to structured PEP awareness education are expected to demonstrate improved knowledge of appropriate responses following potential HIV exposure and greater readiness to seek timely professional medical assessment. Education may improve understanding of the urgent nature of PEP, reduce misconceptions, increase awareness of where PEP services can be obtained, strengthen knowledge of adherence and follow-up requirements, and encourage appropriate utilization of HIV prevention services. However, awareness alone may not guarantee timely post-exposure action because students may continue to face barriers such as stigma, fear of disclosure, concerns about confidentiality, uncertainty about service availability, financial or transportation difficulties, and delays in recognizing the need for urgent medical assessment. Consequently, PEP awareness is expected to be most effective when supported by accessible and confidential PEP services, trained healthcare providers, clear university referral pathways, 24-hour or emergency access where appropriate, effective HIV counselling, and supportive institutional policies. The study is expected to contribute to the literature on HIV prevention, post-exposure prophylaxis, health education, sexual and reproductive health, university student health, healthcare-seeking behaviour, and public health in Nigeria by providing empirical evidence on the impact of PEP awareness on HIV post-exposure preventive practices among university students. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Agency for the Control of AIDS (NACA), National Primary Health Care Development Agency (NPHCDA), National Universities Commission, university health centres, HIV prevention programmes, healthcare professionals, counselling units, community health workers, development partners, and policymakers regarding strategies for improving timely responses to potential HIV exposure. The study will also provide evidence-based recommendations for strengthening PEP awareness programmes, improving access to confidential PEP services, establishing clear university-based referral pathways, addressing misconceptions and stigma, strengthening HIV counselling and follow-up systems, and promoting timely and appropriate post-exposure preventive practices among university students across Nigeria.

Keywords: Post-exposure prophylaxis awareness, HIV post-exposure preventive practices, university students, PEP, HIV prevention, HIV post-exposure prophylaxis, health education, HIV testing, healthcare-seeking, sexual and reproductive health, public health, Nigeria.