HIV nursing – changing times

Ian Hodgson
Independent Consultant, HIV Education and Research

Welcome to the second issue of HIV Nursing for 2019! This issue includes five articles covering a range of topics such as the U=U campaign, best practice guidance for communication in the HIV-care context, and HIV self-stigma in Chinese populations. We close with abstracts to be presented at this year’s NHIVNA conference.
Shaun Watson discusses a core topic in the HIV sector of late, that people living with HIV, when on treatment and with sufficient viral suppression, cannot pass HIV on to another person. Since the last issue of HIV Nursing there has been much publicity around final results from a large-scale study, released in May 2019, confirming that effective treatment prevents onward HIV transmission in serodifferent couples [1]. This article offers a summary of the science to date, and provides details of the U=U campaign (undetectable = untransmittable). Launched in 2016, the campaign has had significant impact on the understanding of HIV transmission in the context of effective treatment. A number of ‘What ifs’ are addressed and, as Shaun suggests, ‘At the heart of it, U=U should eventually lead to the normalisation of HIV as a virus that can be controlled and stopped, reducing anxiety, fear, and stigma.’
A research article, from Ashley Duncan and Nicola Ashby, is a literature review that explores the possibility of offering critically ill patients an opt-out HIV test. Based on the hypothesis that there are a number of critically ill patients who may be unaware of their HIV status, offering an HIV test may enable better clinical decision making in the treatment of severe life-threatening conditions, in particular sepsis. After reviewing available literature and data, the article concludes with the recommendation that offering an HIV test addresses a key public health need for early diagnosis of sepsis, a condition sadly becoming increasingly prevalent. Clear guidance is required, for as the authors state: ‘There is much room for debate and the healthcare sector can benefit from an up-to-date, clear standardised guideline for the testing of HIV in critically ill patients. Read more…