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!