Ian Hodgson
Independent Consultant in Global Health

Welcome to the fourth and final issue of HIV Nursing for 2019! This issue includes five articles covering a range of topics, such as engaging with hard-to-reach patients, communication skills in practice, palliative care and HIV, and conference reports from Italy and Australia.
Our first article, by two Indonesia-based nurses, Aulia Latif and Andi Irwan, is a systematic review of palliative care in HIV. The core practices of palliative care offer a mechanism to enhance the person-centred nature of HIV care [1] , and, with the significant improvement in life expectancy of people living with HIV it is now more important than ever to ensure there is effective support for people in balancing their lives with HIV and dealing with the other consequences of living longer, such as ageing. This article suggests there is no generalised ‘model’ for palliative care and HIV, and limited instruments available to evaluate the quality of life for people living with HIV receiving palliative care. Suggestions for further research are provided.
A key challenge for any health system that provides HIV care is ensuring people who require interventions are able to access the services they need. There can be many barriers, for example, in one study from the Russian Federation the most commonly reported barriers involved difficulties accessing care providers, dissatisfaction with the quality of services, and negative attitudes of provider staff [2] . Our second article, by Pauline Jelliman, is part of our series of Best Practice Guidelines, and considers ways to improve service access for people affected by HIV and who may fi nd it diffi cult to engage, for example, because of language, social complexity, being homeless, or with mental health issues. As this article states, ‘Nurses are well placed to engage with the hard-to-reach to facilitate treatment, care and support allowing people with HIV to live well,’ and the article’s recommendations provide a helpful framework for all carers working in the HIV sector.
The third article, by Robert Downes and Elizabeth Foote, is part of HIV Nursing’s Continuing Professional Development (CPD) series. This article provides insights into effective communication between healthcare workers and patients with HIV. Poor patient–provider communication continues to be reported by people living with HIV, and it can lead to poor health outcomes and less willingness to seek or remain in care [3] . In this CPD article, the many ways that nurses improve their listening, verbal, non-verbal and written skills are discussed. There is also consideration of other topics, such as emotional intelligence and motivational interviewing. Maximising communication skills in nurse–patient interactions will encourage patients to ‘interact with us and encourage them to identify and articulate their needs, fears, anxieties and a desire for advice, guidance and support.’ There are also useful activities and recommendations for personal reflection to improve practice. You have no excuse!
Our final two articles of this issue are conference reports from two continents. In October 2019 over 100 HIV nurses from across the European region met in Rome for the third European HIV Nursing Conference , and this report describes some of the key content. It also highlights the significant need for HIV nursing skills to be shared as widely as possible, especially to areas where nurses are in the early phases of establishing effective nurse-led services and taking the lead in HIV care planning and delivery. This is especially the case between Western and Eastern Europe where there is a significant gap in progress towards the 90-90-90 targets [4] .
The second conference report is from Australia and provides details of the Australasian HIV & AIDS and Sexual Health Conferences (ASHM), held in Perth, September 2019. The article includes details of the core presentations, with useful commentary on the relevance and potential impact on nursing practice in a number of sexual health fields, such as sexual and reproductive health and rights, mHealth, initiating HIV treatment, PrEP, and HIV services in primary care.
We hope you enjoy this issue of HIV Nursing and, as always, we invite feedback on these articles. If you would like to comment, please send a message to: info@hivnursing.net
1. Harding R. Palliative care as an essential component of the HIV care continuum . Lancet HIV 2018 ; 5 ( 9 ) : e524 – e530.
2. Kuznetsova A , Meylakhs AY , Amirkhanian YA et al. Barriers and facilitators of HIV care engagement: results of a qualitative study in St. Petersburg, Russia . AIDS Behav 2016 ; 20 ( 10 ): 2433 – 2443 . Available at : www.ncbi.nlm.nih.gov/pmc/articles/ PMC4945482/ (accessed November 2019)
3. Norberg A , Nelson J , Holly C et al. Experiences of HIV-infected adults and healthcare providers with healthcare delivery practices that infl uence engagement in US primary healthcare settings . JBI Database of System Rev Implement Rep 2019 ; 17 ( 6 ) : 1154 – 1228.
4. Alcorn K. Progress on 90-90-90 HIV targets shows stark gap between eastern and western Europe. AIDSMAP , 7 November 2019 . Available at : www.aidsmap.com/news/ nov-2019/progress-90-90-90-hiv-targets-shows-stark-gapbetween- eastern-and-western-europe\ (accessed November 2019)
Correspondence : Ian Hodgson