Nurses are prone to occupational hazards while carrying out their professional duties. The HIV-related post exposure prophylaxis is recommended for health workers who prick themselves accidentally with needles that have been used on clients. The taking of antiretroviral drugs after encountering needle stick injury has been documented by medical scientists as relatively successful in preventing sero-conversion and decreasing the likelihood of contracting HIV infection. However, some of the nurses are reluctant to implement this programme and yet they have been exposed to needle stick prick. The purpose of this study was to investigate factors contributing to nurses’ poor utilization of HIV-related post exposure prophylaxis (PEP) at a selected region in Swaziland. The study was conducted in one hospital setting and one public health unit. A quantitative research design using an exploratory, descriptive cross sectional survey was used for this study. A census sample size of 200 participants was obtained from a group of nurses working in the government hospital and public health units. Using self-administered questionnaires, quantitative data was obtained and analysed using the Statistical package for social sciences (SPSS) version 23 software computer program. The study findings revealed that though majority of nurses (65%) are knowledgeable about PEP, its importance and operational policies and guidelines, this knowledge level was not transferred to influence the utilization of PEP as only 38% (n=75) reported utilizing PEP. Factors identified as causes of lower levels of PEP service utilization among respondents included fear of undergoing pre-prophylaxis procedures like HIV testing and counselling, and consequences thereof which include stigma, challenges of adherence and dealing with medication side effects. Based on these findings the researcher recommends strengthening of staff development programs offered to nurses with focus on preventive measures against occupational exposure to HIV and AIDS through use of PEP. Institutional responsibility to ensure that PEP policies and guidelines are available and known by all new health personnel during induction and practicing nurses throughout their employment. / Health Studies / M.A. (Nursing Science)