Rural nursing students' knowledge, attitudes, and beliefs about HIV/AIDS: a research brief.

The purpose of this study was to explore rural student nurses' knowledge, attitudes, and beliefs about caring for people with HIV/AIDS. The results from this study were consistent with other past studies where judgmental attitudes toward patients with HIV/AIDS were demonstrated. Data indicate that nursing students' attitudes, beliefs, and knowledge about HIV/AIDS have not changed over the past decade. Based on these findings, many implications for nurse educators exist. Nurse educators need to examine approaches to teaching about HIV/AIDS that can increase knowledge and influence the actual treatment of individuals who have this disease. In addition, the focus for rural nursing programs should be on increasing the understanding of the impact of HIV/AIDS on rural communities and to help project future needs for HIV/AIDS-related services.     

HIV disease in primary care

During the past decade, a large number of new drugs for treating HIV and its complications have been developed. The increasingly sophisticated use of these drugs in combination has led to a marked reduction in HIV-related morbidity and mortality in countries where they are available. HIV/AIDS patients receiving treatment are now expected to live into old age. The beneficial effect of HIV treatment has resulted in an expanding population of persons living with HIV/AIDS who will need the care of an HIV specialist because of the complexity of the treatment regimens and the rapidly changing HIV/AIDS knowledge base. However, this growing and aging population will also benefit from the care of a primary care physician. The primary care generalist is in the best position to recognize and diagnose HIV infection, evaluate HIV risk in his or her patient population, and help prevent HIV infection in persons at risk. In patients known to be infected, the primary care generalist will be best able to manage hyperlipidemia, diabetes, cardiovascular disease, and other disorders of an aging population with an increased risk of these and other conditions. Patients with HIV infection frequently accumulate a large number of specialist physicians, and the unique ability of the primary care physician to monitor their care and act as a knowledgeable patient advocate is a great benefit to the patient.     

Palliative care for AIDS: challenges and opportunities in the era of highly active anti-retroviral therapy

In contrast to the first decade of the AIDS epidemic, the past decade has seen an increasing separation between AIDS care and palliative care services. While this may be due in part to the perception that AIDS is no longer a uniformly fatal illness, AIDS in fact remains an important cause of morbidity and mortality for young adult populations in the United States, particularly among certain racial-ethnic minorities. Death rates have remained steady since the dramatic decreases noted in the mid-1990s, and causes of death now increasingly include co-morbidities such as hepatitis B, C, end-organ failure, and various malignancies. Moreover, as AIDS has been transformed into a more manageable, chronic disease in the era of 'highly active antiretroviral therapy' (HAART), the opportunities for palliative care interventions have only increased. Patients with AIDS continue to experience a high burden of pain and other chronic symptoms, over a longer period of time, with a disease course marked by more cumulative exacerbations and remissions than when AIDS was a stereotypic, rapidly fatal illness. Advance care planning and discussions of goals of care are more complex and involve more uncertainty than was the case when prognosis was clear-cut and treatment options were more limited. For all of these reasons, it is important for the distance which has developed between HIV and palliative care providers to be bridged. Contrary to popular perceptions, palliative medicine continues to have much to offer in the HAART era for the care of patients and families with HIV/AIDS, for whom treatment outcomes will only benefit from greater integration of disease-specific and palliative interventions. The challenge for care providers is now to implement successful strategies for integrating AIDS and palliative care services in all relevant clinical environments.     

宁德市HIV/AIDS流行病学调查及哨点监测结果分析

目的分析宁德市HIV/AIDS病例流行病学调查及哨点监测结果,提出针对性防治措施,以降低艾滋病的发病率。方法利用行为学、血清学监测资料,采用SPSS11.5统计软件,分析宁德市艾滋病流行趋势。结果宁德市至2005年底共检出HIV/AIDS51例,男女性别比为1.55∶1,死亡10例。感染途径以性传播为主,同时存在母婴传播及经血传播。2000年起设立血清学哨点监测相继从性病门诊就诊者、暗娼、吸毒者中检出HIV感染者;娱乐场所服务小姐提供商业性行为比例较高,每次都使用安全套比例偏低。结论影响艾滋病流行的危险因素在宁德市持续存在,艾滋病在高危人群中快速传播或流行的潜在危险不断加大,流行强度有快速增长的趋势,今后需建立健全艾滋病监测体系,加大干预力度,遏制艾滋病从高危人群向一般人群蔓延。     

Risk of AIDS-related virus (human immunodeficiency virus) transmission through apheresis procedures

Since exposure to blood products occurs on a daily basis during hemapheresis, the acquired immunodeficiency syndrome (AIDS) epidemic has a serious impact both for patients undergoing apheresis procedures as well as for health professionals working in the field. We studied serum samples from 110 patients who underwent therapeutic plasmapheresis for a variety of diseases not related to AIDS for the presence of antibodies to human immunodeficiency virus (HIV). Exchange fluids used in the majority of the patients were plasma protein fraction and 5% human albumin. Four patients received only fresh-frozen plasma. Fifty-five patients also received IV gammaglobulin. The follow-up period exceeded 24 months. All patients who did not belong to any known high-risk group for AIDS were negative for HIV antibodies prior to treatment and remained negative at last follow-up. Seven patients were homosexual men. All seven were seropositive prior to plasmapheresis and remained so throughout the treatment period. Seven health professional working in a busy haemapheresis unit were followed for 2 1/2 years. All remain HIV seronegative with normal immune function. These data indicate that transmission of HIV is unlikely through haemapheresis procedures.     

Black populations, human immunodeficiency virus/acquired immune deficiency syndrome, and research: implications for nurses.

Knowledge that is generated from research is critical toward understanding the prevention, impact, and treatment of human immunodeficiency virus (HIV) disease and acquired immune deficiency syndrome (AIDS). During the past several decades, the Black community has been disproportionately affected by the HIV/AIDS epidemic. Therefore, engaging their participation in HIV/AIDS research is necessary to understand the disease further and to develop strategies for nursing interventions. Many factors hinder Blacks from participating in HIV/AIDS research. This review provides information for nurses about problems related to recruitment and recommendations for recruiting Black participants for HIV/AIDS research.     

African American caregivers and HIV/AIDS formal resources.

The African American community continues to be disproportionately affected by the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in many ways. In addition to the prevalence rates of the disease in the community, caregivers of people living with HIV/AIDS continue to be challenged as they strive to provide care and support to love ones. The purpose of this pilot study is to explore how African American caregivers of adults living with HIV/AIDS engage available formal resources within their community. African American caregivers (N = 10) were recruited from Long Island, New York and interviewed using unstructured and semi-structured questions. The caregivers' use of community resources were associated with circulating communication within the community about the resource. For example, formal (health & social) resources were recommended and/or accessed if the resource had a positive, historical past of rendering culturally sensitive and medically competent care to the African American community. Recommendations for further study and community- level implications for health care professionals are suggested.     

Reducing the rate of mother-to-child HIV transmission in Africa.

Currently there are about twenty four million HIV/AIDS (human immunodeficiency virus and acquired immunodeficiency syndrome) cases on the continent of Africa. Over the past two years, many health care professionals have been in a stage of denial concerning this problem. According to researchers attending the XIII International AIDS Conference held in Durban, South Africa, the world became aware that cost-effective strategies are needed desperately to stop the rapid spread of HIV/AIDS in Africa. Recent studies suggest that modest antiretroviral drug therapies for HIV-positive pregnant women can reduce one-half of the risk of HIV transmission to the unborn child. Challenges to the governments of Africa such as the high cost of drugs, lack of health care infrastructure and cultural barriers, priority to treat only pregnant women has been a difficult decision, while other infected persons with HIV are not treated.     

Temporal trends in the prevalence of HIV and other transfusion-transmissible infections among blood donors in northern Thailand, 1990 through 2001

BACKGROUND: Thailand's epidemic of HIV infection, which began in 1988, has primarily involved heterosexual transmission of the virus. This study describes changes in prevalence of HIV and other infectious diseases among blood donors in northern Thailand from 1990 through 2001. STUDY DESIGN AND METHODS: Serologic screening results and demographic data were analyzed from 276,066 donors screened at two blood collection facilities in Chiang Mai, Thailand, from 1990 through 2001. RESULTS: The HIV prevalence peaked in 1991 to 1993 at 4.04 percent and then declined to 0.38 percent in 2001. The overall prevalence of HIV infection was 2.16 percent; HIV prevalence was higher among male (2.24%) than among female (0.64%) donors, in first-time donors, and in replacement volunteer donors. The majority of the donors were men and first-time donors throughout this study. The prevalence of antibodies to syphilis decreased significantly in both men and women. However, the prevalence of antibodies to HCV and HBsAg were stable. CONCLUSIONS: The declining HIV prevalence from 1990 through 2001 among blood donors in two large blood banks in northern Thailand indicates significant progress toward recruitment of a safer donor population in a developing country despite a major HIV and AIDS epidemic involving the general population.     

Vietnam: integrating palliative care into HIV/AIDS and cancer care

Vietnam is struggling to meet the growing need for both disease-modifying and palliative care for people with life-threatening chronic diseases such as HIV/AIDS and cancer. Recently, Vietnam initiated rapid development of a national palliative care program for HIV/AIDS and cancer patients that builds on existing palliative care programs and experience and integrates palliative care into standard HIV/AIDS and cancer care. National palliative care guidelines have been issued by the Ministry of Health based on a rapid situation analysis. Plans now call for review and revision of opioid laws and regulations to increase availability of opioids for medical use, training in palliative care for clinicians throughout the country, and development of palliative care programs both in the community and in inpatient referral centers.     

Topical microbicides for the prevention of genital herpes infection

Genital herpes is one of the most prevalent sexually transmitted infections worldwide and is the most common cause of genital ulcers. Despite increased public awareness and the initiation of efforts to prevent transmission, the prevalence of herpes simplex virus (HSV) type 2 continues to increase. What makes HSV so difficult to control is that most sexual and perinatal transmission occurs during unrecognized or asymptomatic shedding. The impact of genital herpes as a public health threat is amplified because of its epidemiological synergy with HIV/AIDS. Thus, there is an urgent need for novel prophylactic methods, such as topical microbicides designed for genital application, to prevent both HSV and HIV transmission. Several candidate microbicides are being advanced to clinical trials based on in vitro activity and animal studies. These include compounds that inactivate virus directly, those that enhance innate immunity, and drugs that block viral binding and entry. A more vigorous evaluation of the safety of these and other candidate topical microbicides in development should include assessment of the impact of repeated application on innate host defences in the genital tract.     

低发病率地区20例HIV/AIDS个案流行病学调查分析

目的了解低发病率地区HIV/AIDS在人群中的发病特征。方法采用河南省性病艾滋病防治研究所制订的《HIV/AIDS个案调查表》,对HIV/AIDS本人或家属进行逐项调查,并采血送省进行CD+4T淋巴细胞检测。结果(1)濮阳市HIV/AIDS流行率为0.56/10万(河南省人群估计HIV感染率约为35/10万),处于低发病率水平。(2)以性接触传播为主(50%),5例为配偶间性传播,5例有婚外性行为史。(3)HIV感染者CD+4T淋巴细胞大于300者只有3例,已陆续开始发病与死亡。结论濮阳市HIV/AIDS处于低发病率水平;以性接触传播为主;性行为传播是由高危人群向一般人群扩散的桥梁。     

The work of clinical nurse specialists (HIV/AIDS) in areas with a low prevalence of HIV infection

The role of the clinical nurse specialists (HIV/AIDS) who work in areas with a low known prevalence of HIV is considered and their contribution to patient care, either directly or indirectly through the education and support of other health care workers, is discussed. Attention is given to the implications for nursing practice and the role of the clinical nurse specialist associated with the relative infrequency of contact with patients who have HIV disease; and some of the issues for people living with HIV/AIDS in rural areas are alluded to. Finally, some of the limitations of the clinical nurse specialist role are delineated and some consideration is given to the future role of clinical nurse specialists for HIV and AIDS.     

Sharing the challenge: mobilizing nurses against HIV/AIDS in Africa.

For two years ICN implemented a WHO/GPA-funded project in Africa to increase the capability and effectiveness of selected national nurses' associations (NNAs) to participate in their countries' campaigns to prevent HIV transmission; reduce the impact of HIV/AIDS on individuals, families and communities; and decrease morbidity and mortality associated with HIV/AIDS. The results have been gratifying. Not only have the nurses from the participating NNAs become a force to be reckoned with in their countries' HIV/AIDS efforts but they have activated major changes in nursing practice and in the delivery of care. Serving as role models, these nurses (numbering over 800) are mobilizing not only their colleagues but all others involved in caring for persons with AIDS.     

浙江省湖州市410例男男性行为者艾滋病知识和高危行为调查分析

目的 了解浙江省湖州市男男性行为者(MSM)的艾滋病知识知晓率、相关高危行为、预防服务及艾滋病既往检测情况,为制定艾滋病防治对策提供参考依据。 方法 采用统一的调查问卷,利用湖州地区网络同志QQ群在线收集相关的资料,对2011年6-9月MSM进行问卷调查,进行统计分析。 结果 共收集有效调查问卷410份,调查对象艾滋病知识知晓率为67.1%。不同年龄、职业、文化程度、现住地及居住时间、经济收入、自我鉴别性取向的调查对象之间艾滋病知晓率差异有统计学意义(P0.01)。调查对象最近6个月同性性伴数在2人及以上的达34.4%,最近1个月同性肛交性行为次数超过3次的达44.4%,最近一次同性肛交性行为使用安全套占39.2%,最近6个月同性肛交性行为每次使用安全套占19.9%。调查对象对安全套预防同性传播艾滋病效果的认同度达85.6%,对坚持使用安全套信心的占77.1%。影响个人使用安全套的主要因素为降低性快感(41.2%)、身边没有(26.3%)和性伴不愿使用(21.5%)。调查对象最近1年接受过艾滋病预防服务(接受过宣传资料和安全套发放、咨询服务等)的占46.1%。 结论 湖州市MSM艾滋病知识知晓率较低,无保护的肛交性行为、多性伴等相关高危行为发生率较高。需加强对MSM健康教育和行为干预,以有效控制艾滋病经性途径传播。     

2014年成都市性病门诊男性就诊者艾滋病哨点监测结果分析

目的 了解2014年成都市性病门诊男性就诊者艾滋病的流行特征以及艾滋病与丙型病毒性肝炎(丙肝)、梅毒的感染情况,为制订相关的防控措施提供科学依据。 方法 对400例性病门诊男性就诊者进行问卷调查,同时采集静脉血进行艾滋病、梅毒和丙肝的血清学检测。 结果 400例男性就诊者中,艾滋病病毒、梅毒、丙肝抗体检出率分别为5.50%、16.00%、0.25%,其中艾滋病知识总知晓率为86.00%,而近1年内接受艾滋病相关干预服务仅11.18%。近3个月23.36%的调查对象与暗娼发生过性行为,35.08%的人与临时性伴发生过性行为,5.00%的人承认与同性发生过肛交性行为。 结论 性病门诊是艾滋病/性病患者的集中场所,性病门诊就诊者又存在着知识和高危行为的分离现象,因此需加强对性病门诊就诊者的监测及针对性的行为干预,减少艾滋病/性病的传播。     

Gay men and HIV/AIDS: understanding the double stigma.

Many men with HIV/AIDS are and will continue to be homosexual or bisexual. Effective care requires understanding the impact of the double stigma of being gay and having HIV/AIDS. While providers have traditionally focused on gay men with HIV disease as individuals, this article directs providers' attention to the importance of social dimensions in creating a plan of care.     

HIV and older adults: clinical outcomes in the era of HAART

As the human immunodeficiency virus (HIV) epidemic enters its third decade, nurses are caring for increasing numbers of older adults with HIV who are on complicated medication regimens or highly active antiretroviral therapy (HAART). Although HAART has revolutionized HIV and acquired immunodeficiency syndrome (AIDS) care, little is known about how older adults respond to the new therapies. A review of the medical records of 19 older (> or = 50 years) and 18 younger (< 40 years) adults initiated on their first HAART regimen revealed both older and younger adults had similar positive clinical outcomes. Nurses need to individualize their care to patients of all ages rather than develop specific clinical guidelines for older adults with HIV.