Caring for Patients with HIV/AIDS [Part 1]

Last semester, I cared for a patient with a diagnosis of cryptococcal meningitis, an opportunistic infection secondary to the patient's HIV. At first it was an odd experience for me because it was the first HIV patient I had cared for since my experience in Uganda, and the only HIV patient I had cared for, or encountered, in clinicals. In this particular situation, I felt there was an unspoken uncertainty among the nurses on how to address or go about this positive HIV status. The family of the patient clearly felt it too. I overheard one of the family members say to others in the room, "I just feel as if they aren't telling me something." The family was aware of their loved one's HIV status, so that was not the perceived "secret" being kept by the staff. Somehow the knowledge that this was an HIV positive case changed the manner the nurses approached the patient, the patient's family, and their care overall.

The nurses in Uganda approached each patient who was HIV positive with an acute awareness of the impact of HIV and AIDS. The case was handled in a delicate manner in order to respect the privacy of the patient. The nurses used the term “ISS” [Immune Suppressive Syndrome] to avoid the stigmatization that came along with the dreaded “HIV.” Their understanding of the complex effects of HIV/AIDS on their patients allowed the nurses to also speak frankly and openly. The open dialogue between nurse and patient seemed to maintain their dignity as a person, and not a diagnosis.

The most enriching experience I have had learning about HIV/AIDS was in the city of Arua in northern Uganda. My other nursing friend and I traveled to visit Indiana natives and friends at Radio Pacis. We were scheduled to appear on one of their English health segments. The other guest was a man named Wadri. Together we all discussed the importance of communicating as a couple about your HIV status and going to get tested together. He was well spoken and very knowledgeable about HIV/AIDS, a result of sponsored training and education. Wadri has been HIV positive for about 20 years, which is remarkable since he was diagnosed during the beginning stages in the discovery of HIV/AIDS. Another remarkable thing about Wadri is that he is open about his HIV status, and speaks on the radio every week as an openly HIV positive person. We spent part of our short time at Radio Pacis with Wadri, walking through the city, and talking about his life. He took us to the local AIDS Information Center, and taught us more about what he wants to do for the community as an HIV positive person. Wadri is the paradigm for what mutual openness about HIV/AIDS can do for the community and health care.

Nurses need to openly and respectfully engage the HIV/AIDS community, and fulfill their obligation to the community by being their sound voice in health care. Nurses have to ensure they are aware and comfortable in their care for patients with HIV and AIDS. Otherwise--like anything-the perceptions, ignorance, and uncomfortable issues surrounding HIV and AIDS will impede nurses from optimally caring for their patients. Nurses and nursing students can seek out resources to help develop their knowledge and awareness. The Association of Nurses in AIDS Care [ANAC] is a leader in research, information, and career development for nurses. On their website, ANAC states, "All nurses need to think of themselves as HIV nurses." HealthHIV provides a plethora of educational resources, and can lead you to other organizations dedicated to the same purpose. The Act Against AIDS campaign is yet another great resource for both health care providers and the community. The University of California at San Francisco [UCSF] has a Nursing HIV/AIDS Center that has links to nursing research they h

ave completed. It's important to realize that HIV/AIDS does not just affect Africa and developing countries. In recent years, it seems as if HIV/AIDS has been driven out of the focus of many Western health care providers and consumers. The United States Healthy People 2010 and 2020 include HIV in its objectives. HIV remains a major health concern in Western health that should not be avoided. Nurses worldwide can continue to lead the way in fostering openness, awareness, and respect for people affected by HIV and AIDS.