The American Nurses Association (ANA) released a Position Statement with 13 updated policies on prevention and care for HIV and related conditions. The position statement was released on December 2, the day after World AIDS Day for which the theme for 2019 was “Communities make the difference”.
HIV/AIDS is still a public health problem
There has been great progress in the diagnosis and treatment of HIV/AIDS since the first cases were reported in the 1980s. However, there are more than 1 million people in the US living with HIV and the Centres of Disease Control estimate that around 15% of these people are not aware of their HIV status. This has implications not only for their own health but also for transmitting the disease to others.
Current prevention and treatment services are still not effectively reaching a large number of people, particularly in certain communities and geographical regions. Reasons for this include unequal access to health services and also the persistent stigma and discrimination associated with HIV. The current direction in the national HIV/AIDS policy is to target these groups directly in planning for interventions and allocating resources.
The policy statements released by the ANA align with current national policy and that of the Association of Nurses in AIDS Care. These policies serve as a nursing practice guide for HIV prevention and care. They also spell out the nurse’s role in advocacy for preventing HIV and improving the health outcomes for those living with the condition.
Nurses’ role in HIV prevention and care
The National HIV/AIDS Strategy calls for more HIV service providers and improved access to prevention services in order to reduce new infections. The ANA’s position is that advanced practice nurses (ARPN’s) should be allowed to practice and prescribe to the full extent of their education and training and be used to lead interprofessional teams.
Nurses are also central to the services providing voluntary counseling and testing, prevention education, and referral where necessary. Nursing care plans for HIV/AIDS should make provision for this wherever appropriate. Furthermore, nurses should be educated about the issues around access to HIV care and prevention. They should take a leadership role in improving access to services and providing culturally sensitive, quality care.
Furthermore, nurses are central to coordinating the care for persons living with HIV who often have co-morbidities and also social support needs. Nurses need to assist individuals in maintaining long-term antiretroviral therapy. This is not only to improve the patient’s health outcomes but is also significant in preventing transmission.
Barriers to HIV prevention and care
Nurses need to be aware that HIV still has a disproportionately large impact on specific communities such as African-Americans, Hispanic/Latino communities, gay and bisexual men, persons with substance use disorders, as well as the youth.
Nurses need to contribute towards breaking down the existing barriers which prevent people from accessing care. These barriers include not only inadequate service delivery but also sexism, racism, homo- and transphobia.
Nurses should also support the review of laws that perpetuate the stigma attached to HIV and interfere with effective care delivery.
“Our nation cannot solve this epidemic without nurses. These policy statements demonstrate nurses’ pivotal role in both prevention and treatment and support national strategies and goals around HIV and AIDS care,” Ernest Grant, President of the ANA, emphasized in a press statement.