Healthcare Workers' Experiences With Hepatitis B Virus Post-Exposure Prophylaxis Management at a Military Hospital in Ghana: A Qualitative Study

Background: Hepatitis B virus (HBV) infection poses a significant occupational risk to healthcare workers (HCWs), particularly in high-endemic settings like Ghana. Despite the availability of post-exposure prophylaxis (PEP), adherence remains suboptimal due to systemic and individual-level barriers. Aim: This study explored the experiences of HCWs in managing HBV PEP following occupational exposures. Methods: An exploratory qualitative design was employed at a Military Hospital in Accra. Data were collected through 5 focus group discussions and 13 in-depth interviews with a diverse sample of HCWs, including doctors, nurses, EMTs, and laboratory staff. Participants were purposively selected based on their exposure risk and/or involvement in PEP coordination. Thematic analysis was conducted using Braun and Clarke's framework. Results: Four themes emerged. (1) Resource availability was a critical factor in PEP adherence. Inconsistent access to HBV test kits, protocols, and the high cost of vaccines and HBIG hindered response. (2) Psychological factors, including fear of infection and stigma, shaped reporting and follow-up behaviors. Peer and supervisor support improved adherence, while past negative experiences with HIV PEP deterred reporting. (3) Hospital policies and guidelines were inadequately implemented, often favoring HIV over HBV. Risk assessments were inconsistently conducted, and HBV was rarely included in training sessions. (4) Challenges with adherence, such as forgetfulness and poor knowledge of HBV PEP protocols, undermined completion of the vaccine series and appropriate post-vaccination testing. Conclusion: HCWs' experiences with HBV PEP management reveal a complex interplay of structural, institutional, and psychological factors. Strengthening HBV-specific training, subsidizing vaccines, improving access to diagnostic tools, and reducing stigma are critical for enhancing PEP adherence. Findings inform policy and intervention strategies to protect HCWs in HBV-endemic settings.