NURSETRI, Nursing role in HIV care: an overview
Jane BrutonClinical Research Nurse
NURSETRI
Aim:• To share experiences and learning• To assist in the development of nursing and
midwifery skills in caring for individuals with HIV• To develop sustainable links with other nurses
through exchanges and continued contact.
Estimated Global HIV statistics
35.6 million people living with HIV globally 201317.7 million women 2.1 million newly infected 20131.5 million deaths globally 2013= reduction in new infections and deaths globally
However..50% of people living with HIV don’t know their status
HIV and AIDS 2013 RomaniaCumulative number people diagnosed with HIV since 1985
19,261 (of which 9,946 diagnosed as children)
Adults aged 15 to 49 prevalence rate 2013 0.1% (% - 0.2%)
Adults 15 and up living with HIV 12,223
Adults 20 – 29 years old 7,012
Children <14 years old 202
New born 7
Romania New diagnoses 2013
• Majority heterosexual transmission 54.5% of all new cases
• IVDU’s 29.23% of all new cases (up from 3% in 2010)
• MSM maintained at 11.4% as previous 2 years• Most new cases 35% registered between 20 –
24 years old and are late presenters
Treatment today
Treatment to prevent transmissionWHO treatment start at 500EACS treatment start at 350 (consider at 500
in certain circumstances)
Treatment to prevent HIV acquisitionPREPPEP
Global treatment access
• 85% PLWHA eligible (WHO guidelines 2013)• Almost 12 million have access to ARV’s• 18 million no access
The challenge of universal access on nurses role
•Task shifting – resource poor countries•Advanced practice – resource rich
The treatment continuum -ideal versus poor engagement in care
Aware of diagnosisAware of diagnosis
Linked to HIV CareLinked to HIV Care
Retained in HIV Care
Retained in HIV Care
Fully engaged
in HIV care
Fully engaged
in HIV care
Aware of HIV
Not linked to care
Aware of HIV
Not linked to care
Having other
medical care not HIV care
Having other
medical care not HIV care
Linked to HIV careLost to
follow up
Linked to HIV careLost to
follow up
In and out of HIV care
In and out of HIV care
Unaware of
diagnosis
Unaware of
diagnosis
ART adherentUndetect-
able VL
ART adherentUndetect-
able VL
Impact of psycho-social issues
• Stigma internal external• Racism/Homophobia• Poverty• Housing instability• Employment instability• Substance use – drugs alcohol• Coexisting conditions – mental health
Nurses role in……..
• Testing• Engagement in care• Retention in care• Maintaining an undetectable viral load
Testing
•Non-judgemental approach•Indicator diseases•Taking opportunities
Engagement in care
• Confidentiality• Non-judgemental• Assessment and review• Support • Nurse contact and follow up• Education• Advocacy• Navigation
Retention in care
Treatment support (including readiness to start assessment)
Assessment and review CoordinationFollow-upSign posting
Undetectable viral load
•Adherence and treatment support
Aim of nurse meeting
• Cover all the key issues for nurses role in the continuum of HIV care
• Discuss the challenges and ask questions• Share experiences and learn from each other• Network And enjoy!