HIV/AIDS Resources for Nurses

Welcome to the Nursing site, which we hope you will find informative and interesting.

As nurses, we all strive to educate people in efforts to assist in the prevention and treatment of a variety of diseases and conditions. Our role in the field of blood-borne pathogens, including HIV and HCV, is not only to assist in prevention and treatment, but also to help reduce the discrimination and stigma associated with these diseases. A first step to the reduction of stigma is to educate ourselves on the diseases in order to educate others. We hope this site can assist you with your needs as well as linking you to other resources.

In 2011, the majority of people who tested positive for HIV were diagnosed at the University Hospital of Northern BC after first presenting with an AIDS-defining illness; these individuals were unaware of their HIV-positive status. This suggests that HIV tests are being used as a differential diagnosis when people are presenting ill and speaks to the need for increased testing! We cannot stop the spread or treat the disease if we do not have a diagnosis. Advocacy is important in linking patients with testing.

Creating an environment for care

Providing screening, testing, and HIV care encompasses nursing knowledge, nursing arts, science and technology, and best evidence-based practice to name just a few essentials. According to the Canadian Association of Nurses in AIDS Care (CANAC), stigma is a major contributor as to why people are not accessing testing for HIV. We have the medication to increase quality and quantity of life, and excellent support systems; however, we cannot link people to these essential services without testing.

The face of HIV/AIDS has changed. HIV screening recommendations have changed to include offering testing to all age groups and all genders. Screening based on what was previously identified as “high risk populations” or “high risk activities” is no longer effective. If a person is sexually active — they are at risk. If a person engages in blood-to-blood activities — they are at risk.

It is up to all of us to offer a non-biased, non-judgmental, caring approach that has the potential to stop the spread of HIV/AIDS and link someone to quality care.

It is well documented that health care providers can only benefit when they educate themselves on issues related to cultural, gender and sexual diversity. We are all uniquely, beautifully different from one another. Lesbian, gay, bi-sexual, transsexual, transgendered, two-spirited, queer and intersexed [LGBTTTQI] persons can be subject to criticism, social stigma and bias and, as a result, may not seek support and health care services. (CANAC 2012) As health care professionals, it is our duty to provide exemplary, compassionate, ethical, non-judgmental care to all persons. For more information, visit  http://www.genderandhealth.ca/en/modules/sexandsexuality/gss-relevance-01.jsp

HIV has been in the public eye since the 1980s and, despite community effort from the LGBTTTQ community at the start of the epidemic, male-to-male sexual transmission continues to account for over half of all new infections. Support is necessary in all communities regardless of gender, sexuality, race, or religion. Together we can open the doors to quality health care, education, screening, testing and prevention. It is up to us to stop the stigma and the discrimination!

Some of the reasons linked to increased sexual risk-taking are:

  • Belief that it won't happen to me;
  • Low self-esteem, depression, and lack of peer support;
  • Limited access to, or discomfort in accessing prevention services;
  • HIV/AIDS burnout (tired of worrying about it);
  • Outdated or overly simplistic safer sex messages not specific to them; and
  • Media portrayal that HIV is a chronic condition, not a health emergency. (Harrison 2011)

An article written by Scott Harrison, RN© BScN MA CCHNC (2011), asks us as health care professionals to examine the fact that men who have sex with men [MSM] and who are open about it, still feel discomfort in disclosing their sexuality to health care professionals. He asks us to imagine how a man that may not be open about his sexuality may feel in assessments around disclosure.

Harrison throws it on the table when he states that we (health care providers) “bemoan the rising HIV infection rates in this population and the late identification of HIV when [MSM] do get tested.” It is a goal of the STOP HIV/AIDS project to increase screening and testing to prevent not only the spread of HIV infection, but also to diagnose it earlier to link with treatment for best possible outcomes for the person. We do not want to be diagnosing in advanced HIV or AIDS stages of illness.

Aboriginal Two-Spirit people and LGBTQ

In 2010, there was a report done by a team based in Winnipeg entitled, Aboriginal Two-Spirit and LGBTQ Migration, Mobility and Health Research Project. The authors of the community-based research project said they “explored the trajectories of migration of Aboriginal people who identify as Two-Spirit, lesbian, gay, bisexual, transgender and/or queer (LGBTQ) and the impact of mobility on health and wellness.”

Although this study was done in Winnipeg, the findings and focus are quite parallel to our First Nations communities in BC’s north due to the geographical locations of reserves, and the similar disparities suffered by our First Nations communities related to issues of migration.

The authors state that, “Our focus on migration included movement from First Nation reserve communities to urban centers or rural communities (and back and forth) as well as staying or moving within one place. We were interested in the intersection between sexual and gender identities with cultural/Nation and other identities within the historical and present context of colonization in Canada.”

To view the complete research study, visit  www.2spirits.com/MMHReport.pdf

We have the tools necessary to make a substantial difference in reducing HIV transmission and in providing excellence in care for those with HIV, but only if we stop the stigma surrounding this disease and routinely offer HIV testing. There are new ways of testing, and new recommendations to include all people who are sexually active or have a blood-to-blood risk, regardless of any other determinants or circumstance. Be pro-active, urge your clients to request the test!

Public Health and Outreach Nursing

Public health nurses play an important role in testing and supporting people affected by HIV. They offer:

  • Confidential contact tracing;
  • Treatment support;
  • Advocacy; and
  • Liaising with other service providers both within and outside of their respective communities.

The outreach nurse for Northern Health's Blood-Borne Pathogens (BBP) team is focused on providing harm reduction and HIV education, HIV testing, and referral services to the people we test. In addition, we provide education, training, and capacity building with other service providers such as health care workers, outreach and/or support workers, community groups, and agencies to support testing and improve care to those with blood-borne pathogens such as HIV and HCV.

Outreach nursing provides an opportunity to connect with people in their own environment and is part of a best practice approach to engaging difficult-to-reach populations in health care services. Engagement is two-fold: it provides an opportunity to bring information and provide services to patients but, most importantly, it is a stepping stone to building trusting relationships between patients and health care providers. Technology has provided many tools to aid in providing nursing services in outreach settings such as screening tools, equipment, testing supplies and access to information.

A referral is not necessary to access the following nursing services:

  • Insti-HIV testing — also known as rapid testing/point of care testing - visit Insti test demo from Biolytical
  • Traditional HIV testing — blood draw which is sent to a lab;
  • Education for community groups, health care providers and other service providers;
  • Education and training for HIV insti-tests to other health care providers;
  • Support for providers with positive HIV results; and
  • Office appointments or outreach services.

For more information, please contact Lynda Anderson, RN (C) BScN, Public Health, at (250) 565-7350 or cell (250) 617-7942, from Monday to Friday, 8 a.m. to 4:30 p.m.

HIV101.ca is sponsored by the STOP HIV/AIDS pilot project which is funded by the Government of British Columbia supporting Northern Health, Vancouver Coastal Health, the Provincial Health Services Authority, Providence Health Care, and the BC Centre for Excellence in HIV/AIDS. The STOP HIV/AIDS project aims to expand HIV testing, treatment, and support in British Columbia.
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