NHIVNA Best Practice Rules of engagement for ‘hard-to-reach’ patients living with HIV: a guide for nurses

Pauline Jelliman MSc, BA, RGN
Former Clinical Lead HIV and TB Community Services , Liverpool , UK

In this best practice guidance we will examine the importance of meaningful engagement between people living with HIV and health care, clarify the terms ‘hard to reach’, ‘meaningful engagement’ and examine why some individuals struggle to engage in care. The guidance section will suggest ways to overcome highlighted issues.
Guidelines provide the backdrop to guide us in our practice to deliver safe, effective, patient-centred care. However, access to such rich evidence-based resources could be futile if services cannot engage with patients in the first instance. This can be frustrating for nurses and inequitable for patients in an era of such monumental advances in HIV treatment and care.
A diagnosis of HIV can hinder engagement with services as a stand-alone issue, or as a component of other health and social problems rendering a minority hard to reach. This situation can lead to poorer health outcomes for people with HIV and potential onward transmission for sexual partners. The purpose of this document is, therefore, to enhance already excellent
HIV services in the UK by providing additional guidance on how nurses can engage with those deemed hard-to-reach. This will not only contribute
to further exceeding UNAIDS targets [1] but help to address unmet needs for those who require maximum support.
Keywords
HIV, patient engagement, hard to reach, met need