Providing HIV care : lessons from the field for nurses and healthcare practitioners

Explores a European HIV perspective on care for the first time Designed with the aim of improving outcomes for people living with HIV Topical and focuses on being a practical guide to improve outcomes for patients This very first book helps nurses and healthcare practitioners working in the field of HIV care across European to have practical examples of how they could improve/ adapt their services to improve outcomes for people living with HIV. It provides the reader with both knowledge on a variety of different HIV related topic areas and also helps them to translate this learning into a clinical setting. The main focus of the book is to share best practice in HIV nursing, with the aim of providing a practical guide from multiple countries to improve outcomes for people living with HIV. The book also acts as a resource to healthcare practitioners who are interested in working in many places in the world or carrying out research in HIV care. Acknowledgements......Page 5 Contents......Page 6 About the Authors......Page 8 Introduction......Page 13 Chapter 1: We Broke the Rules: Building the Foundation of HIV Nursing......Page 14 Chapter 4: HIV Is a Small Word with a Big Impact: Psychosocial Interventions to Support Children, Young People, and Families with HIV......Page 15 Chapter 7: Access to HIV Services for Key Populations: Leaving No One Behind......Page 16 Chapter 9: Care Considerations for Ageing with HIV......Page 17 Chapter 11: Ageing with HIV: Lifestyle Interventions Towards Health......Page 18 Chapter 13: Wounded Healers in a Shared Traumatic Reality: Why and How We Should Engage in Stepped-Care, Self-Care for Ourselves......Page 19 Overall Aim of the Book......Page 20 1.1 Chapter Overview......Page 21 1.1.1 Social Turmoil......Page 22 1.1.2 Why Does Biomedicine Foster Inequalities?......Page 23 1.1.3 Nurses’ Responses: Theory, Models, and Conceptual Frameworks for a New Nursing Care......Page 24 1.2 HIV/AIDS: The Chance to Turn Theory into Practice......Page 25 1.2.1 An Applied Model of Patient-Centred Care......Page 28 1.2.2 The Impact of New Treatments on Nursing and Care Delivery......Page 31 1.3 Conclusion......Page 32 References......Page 34 2.1 Background......Page 37 2.3 Aspects of Care Framework......Page 39 2.4 Building a Network of Care for Newly Diagnosed Patients......Page 40 2.5 Monitoring Supporting and Promoting Self-Management and Retention in Care......Page 41 2.6 Pro-active Support to Facilitate Re-engagement in Care......Page 42 2.7 Health Promotion Including Prophylaxis, Risk Reduction, and Partner Notification......Page 43 2.8 Developments to Improve Healthcare Delivery Models......Page 44 References......Page 46 3.1 History of Nursing Leadership......Page 48 3.2 The History of Nurse Leadership in the UK HIV Sector......Page 49 3.3 Leadership and Governance......Page 50 3.4 Care Models Involving Nurse Leadership for People Living with HIV......Page 52 3.4.1 Leadership Attributes, Qualities, or Outcomes......Page 55 3.5 Adapting Nurse Leadership for the Future......Page 57 3.6 My Life: Personal Reflections on Leadership......Page 60 3.8 Learning Points: Recommendations for Nurse Leadership in HIV......Page 62 References......Page 63 4.1 Introduction......Page 68 4.2 The Presence of HIV Disrupts Normal Family Functioning......Page 69 4.3 The Family is the Point of Intersection of HIV, Coping, and Well-Being......Page 70 4.4 HIV Stigma: What Is It?......Page 72 4.6.1 Intergenerational Interventions......Page 74 4.6.2 Parent/Caregiver Only Interventions......Page 77 4.6.3 Child/Young Person Only Interventions......Page 78 4.7 Can the Most Effective Components of Support Programmes Be Identified?......Page 80 4.8 Conclusion......Page 82 References......Page 83 5.1 Defining Sexual Health......Page 87 5.1.3 Impact of Poor Sexual Health......Page 88 5.1.6 STIs......Page 89 5.2 Chlamydia and Lymphogranuloma Venereum (LGV)......Page 90 5.2.3 Secondary Syphilis......Page 91 5.2.5 Late Latent Syphilis (Tertiary)......Page 92 5.2.7 Herpes Simplex Virus......Page 93 5.2.9 Contraception......Page 94 5.2.10.2 Intrauterine Device......Page 95 5.2.12 Oestrogen......Page 96 5.3.1 Interactions......Page 97 5.3.3 Female Sexual Dysfunction......Page 98 5.3.5 Management......Page 99 5.3.7 Drugs Associated with SDU......Page 100 5.3.8 Service Provision Models......Page 101 5.3.11 Blood Tests and Vaccinations......Page 103 5.3.12 Symptomatic Patients......Page 104 5.3.14 Case Study......Page 105 References......Page 106 6.1 Introduction......Page 111 6.2 Role of Nurses in Public Health in the Region: Historical Outlook......Page 112 6.3 HIV Epidemic in Eastern Europe......Page 113 6.4 Nurses’ Experience in Test&Treat Clinic in Odessa......Page 115 6.4.1.1 Organisation of Work......Page 116 6.4.1.2 Increasing the Role of the Nurse......Page 118 6.4.1.4 Education and Training......Page 119 6.5 Recommendations......Page 120 References......Page 121 7.1 Introduction to the Chapter......Page 123 7.2.1 Why Are Key or Vulnerable Populations More at More Risk?......Page 124 7.2.2 HIV Key and Vulnerable Populations: Focus on Europe......Page 126 7.3 Barriers Affecting Key Populations Accessing Services......Page 129 7.3.1.1 Us and Them......Page 130 7.3.2.1 Some background to Structural Barriers......Page 132 7.3.2.2 The Impact......Page 134 7.3.3 Health Care: Is It a Safe Haven for Key Populations?......Page 136 7.4.1 General Ways to Improve Services......Page 137 7.4.2 Focus: A Rights-Based Approach......Page 138 7.4.3 Focus: Communities......Page 139 7.4.4 Focus: Nurses and Health Care......Page 140 7.4.5.2 The Experience of ‘Mary’......Page 143 7.4.5.4 Pregnancy......Page 144 7.5.1 Nursing......Page 145 7.5.3 Policy and Planning......Page 146 7.6 Concluding Comments......Page 147 References......Page 148 Chapter 8: HIV Care in Rural Areas......Page 155 8.2 What Does It Mean to Provide Care in a Rural Setting?......Page 156 8.3 HIV Care in a Rural Setting......Page 158 8.4 Stigma......Page 159 8.5 Practical Solutions to Address Stigma Within a Rural Setting......Page 160 8.6 Living and Ageing Health and Well-Being in Rural Areas......Page 161 8.7 Access to HIV Services......Page 163 8.8 HIV Testing......Page 164 References......Page 166 Further Readings......Page 167 9.1.1 Pharmacokinetics and Drug Metabolism......Page 168 9.1.2 HIV Antiretroviral Therapy......Page 169 9.1.3 Polypharmacy......Page 170 9.2.2 Cardiovascular Disease......Page 171 9.2.4 Renal Disease......Page 172 9.2.6 HIV-Associated Neurocognitive Disorder......Page 173 9.2.7 Osteopenia, Osteoporosis, and Fractures......Page 174 9.3.3 Mobility, Physical Function, and Frailty......Page 175 9.3.4 Sexual Health......Page 176 9.3.5 Recommendations for Nursing Practice......Page 177 9.4 Chapter Summary and Conclusion......Page 179 References......Page 180 10.1 Introduction......Page 183 10.3 Research Gaps......Page 184 10.3.1 Best Practice Examples......Page 185 10.5 Sexual Health and Rights: The Pleasure Deficit......Page 186 10.5.1 Women of Reproductive Age......Page 188 10.5.3 The Role of Nurses in HIV Services......Page 189 10.6 Conclusion......Page 190 References......Page 192 11.1 Introduction......Page 195 11.2 Comorbidities: The Persistent Challenge......Page 196 11.3 Preventing Risk Factors and Reducing the Morbidity Associated with PLHIV is a Priority......Page 197 11.4 The Role of the Nurse......Page 199 11.6 Conclusion: Points for Learning......Page 201 References......Page 202 12.1 Introduction......Page 204 12.2 Compassion Focussed Therapy......Page 205 12.2.1 Evolutionary Stance – Normalising Difficulties......Page 206 12.2.2 Tricky Brain......Page 207 12.3 Three Systems Model of Emotional Regulation......Page 209 12.3.2 Drive System......Page 210 12.3.3 Soothing System......Page 211 12.3.5 Soothing Threat and Shame......Page 212 12.4 Building Compassion: Engagement and Action......Page 213 12.4.3 Building Compassion for Yourself......Page 215 12.5 Applying the Three Systems: HIV, Mental Health and Trauma......Page 216 12.5.1 Existing Vulnerabilities: The Increased Risk of Contracting HIV......Page 217 12.5.2 Triggering the Threat System: HIV as (Re)traumatising......Page 219 12.5.4 Disengagement from Care......Page 223 12.6 Compassion: How Can it Help in HIV Care?......Page 225 12.6.1 Compassionate Communication......Page 226 12.6.3 Connecting with Others......Page 227 12.7 Compassion Fatigue: The Impact of Caring for Traumatised People and Populations......Page 228 12.7.1 The Potential Cost of Caring......Page 229 12.7.2 Is it Another Term for Burnout?......Page 230 12.7.3 What Factors Contribute to it?......Page 231 12.7.5 Critique and Conceptual Concerns......Page 232 12.8 Importance of Self-Care: Compassion to Self......Page 233 12.8.2 Promoting Self-Compassion: Its Vital Role for Health Professionals......Page 235 12.8.3 Promoting Self-Compassion in HIV Health Settings......Page 236 12.9 Conclusion......Page 237 References......Page 238 13.1.1 The Importance of Staff Wellbeing......Page 243 13.2.1 Occupational Health......Page 244 13.2.2 Nurses’ Mental Health......Page 245 13.2.3 Non-work Stress and Wellbeing......Page 246 13.2.5 HIV Nursing-Specific Challenges......Page 247 13.2.6 Impact of Covid-19......Page 248 13.2.7 Individual and Organisational Accountability......Page 249 13.2.9 Terminology......Page 250 13.3.1 Assessment of Wellbeing......Page 251 13.3.2 Disclosure of Difficulties......Page 252 13.3.3 Wellbeing Interventions......Page 253 13.4 Conclusion......Page 254 References......Page 255