Clinical-year Medical Students

Background: Human Immunodeficiency Virus (HIV) remains a critical public health burden, particularly in high-prevalence settings like Nigeria. Within this environment, clinical-year medical students represent a highly vulnerable demographic; their transition into hands-on patient care and the accompanying steep clinical learning curve frequently expose them to occupational hazards such as needle-stick injuries and mucosal splashes. Although Post- Exposure Prophylaxis (PEP) can reduce the transmission risk by over 80% if initiated within the critical 72-hour window, its clinical effectiveness is heavily contingent upon the trainees' underlying awareness, positive attitudes, and prompt health-seeking behaviours. Assessing the Knowledge, Attitude, and Practice (KAP) of these students is therefore vital for identifying hidden educational deficits and designing targeted, student-centred institutional safety interventions. Objective: The objective of this study was to explore the experiences of clinical-year medical students at the University of Benin regarding HIV post-exposure prophylaxis, specifically by evaluating their knowledge, attitude, practice, and the barriers limiting its utilisation. Methodology: A quantitative descriptive cross-sectional study design was employed. The study was conducted among clinical-year (400, 500, and 600-level) medical students at the University of Benin, Edo State, Nigeria. A multistage sampling technique was used to select 313 respondents. Data were collected via a pretested, self-administered online questionnaire xii (Google Forms). Responses were scored to formally categorize participants' knowledge, attitude, and practice into specific tiers (e.g., poor, fair, good). Data were analysed using IBM SPSS version 27.0, with statistical significance determined through Chi-square tests, Fisher’s exact tests, and binary logistic regression. Result: A total of 313 students participated (100% response rate), with a mean age of 23.03±2.40 years and a male majority (62.9%). While a high proportion (89.1%) were aware of PEP, detailed knowledge was grossly inadequate: 41.2% had poor knowledge, 43.8% had fair knowledge, and only 15.0% possessed good knowledge. Prior HIV testing emerged as the sole independent predictor of good knowledge (p < 0.001). Conversely, an overwhelming majority (90.4%) demonstrated a positive attitude toward PEP, which was significantly predicted by having a higher knowledge score (p = 0.007). Regarding practice, 8.3% reported a history of occupational exposure, but only 23.1% of those exposed actually initiated PEP, resulting in an overall poor practice rate of 88.5%. Major barriers to utilisation included a lack of knowledge regarding reporting protocols (86.6%), uncertainty about exposure risk (74.4%), and fear of stigma (74.1%). Conclusion: The study reveals a critical gap between high theoretical awareness and positive attitudes versus severely deficient practical knowledge and poor utilisation of HIV PEP among clinical-year medical students. Individual demographic factors did not significantly improve practice, indicating that the low utilisation is heavily driven by structural and informational barriers. To mitigate these occupational hazards, institutions must integrate formal PEP protocol training into the clinical curriculum, guarantee confidential reporting pathways, and ensure unrestricted 24-hour access to prophylaxis services. xiii Keywords: HIV, Post-Exposure Prophylaxis, Clinical-year Medical Students, Occupational Exposure, Knowledge Attitude and Practice, University of Benin, Nigeria