RNs can play larger role in HIV/AIDS prevention

HIV, (the virus) and AIDS, (the subsequent syndrome of infections) appeared in the early `80s, and has since then affected the practice of registered nurses. There is a group of nurses working in various clinical care areas who have very little day-to-day involvement with HIV/AIDS. These nurses, perhaps unaware of the golden opportunities they have to advance HIV/AIDS education and screening efforts, are the focus of this article. They may believe themselves to be under-qualified, or question whether it is part of their role. This article is intended to challenge that perspective.

All registered nurses come into contact with people, at risk of contracting HIV because the virus does not respect a persons' age, class, gender; race, or sexual orientation. In Alberta, the incidence of new HIV cases between May 1998 and April 2000 is fairly equally divided between homosexual, heterosexual, and intravenous drug users. In the same time period, two babies have been born HIV positive, there have been six new cases of HIV infection in youth between the age of 15 and 19, and 106 women have been newly diagnosed with the virus (1). Nurses' close contact with everyone provides a privileged position to give spur-of-themoment HIV/AIDS education and screening. This need not be time consuming, but can take the form of an astute comment or gently asked question during other care-giving activities.

in order to do this, nurses need to know the basics about HIV transmission, be able to talk about these basics in a non-judgmental way with patients/clients, and be able to encourage HIV testing to those who admit to high-risk behavior. However, a recent survey of health care professionals' indicated that many nurses are hesitant to incorporate HIV/AIDS prevention into their practice (2).

There may be some very understandable barriers to providing this information. Many people, nurses included, are still unsure about current knowledge and HIV/AIDS, transmission, and occupational risk and are hesitant to explore the facts for themselves. In addition, different health care agencies apply the concept of Universal Precautions to different situations. These two factors alone "muddy the waters" for nurses about HIV/AIDS. In addition, many nurses are overwhelmingly aware of the complexity of HIV/AIDS medication therapies. It may be possible that nurses, rather than give inaccurate or convoluted information to their patients, stay silent about HIV/AIDS prevention and screening.

Some initial strategies to break through the knowledge barrier could be to learn about HIV/AIDS from a primary source. This might include finding a pamphlet at a local AIDS service organization, or doing some Internet research. Some basic, yet interesting, sites are listed below.

Another barrier may be that talking about HIV/AIDS involves talking about sexuality, one of the most difficult and intimate subjects of conversation for our culture. Although nurses are comfortable providing care involving genitals, talking about their sexual functions is completely different! Experienced sexuality educators suggest that the best way to break the sound barrier around this topic is to find a private place and practice by talking out loud, first to oneself, then to a significant other or adolescent. Once the sound barrier is broken it is easier to say the words to patients.

As an example of informal education and screening in a day-today setting, consider the following scenario. A 15-year old male is admitted to an orthopedic unit because of complex fractures, and the nurse notices his tattoos and multiple piercings. The nurse can easily ask if it hurt to get the tattoos or piercings, where he got them, and reinforce that any needle inserted into the skin must be sterile to avoid the risk of HIV. The nurse might then ask if he has his tongue pierced. The nurse can explain that tongue piercings can result in a perpetual open wound that is vulnerable to HIV transmission during oral sex. if the young man seems surprised by this, and admits to engaging in this activity she might encourage him to visit the local STD clinic for HIV testing, "just to be sure."

This type of short exchange can have a profound effect in advancing HIV, awareness and screening among nurses, patients. Registered nurses are extremely skillful in talking to patients; their education and practice in non-judgmental listening, comforting, and counseling stands them in good stead to broach the topic of MAIDS. Knowledge and familiarity with the avenues of HfV transmission may mobilize nurses who question their ability or role in thwarting the virus and disease. All nurses can, in fact, take advantage of their trusted place in society, and help people be aware and safe from HIV and AIDS.

Recommended Internet Sites

An excellent beginner's site is: AIDS Calgary at www.aidscalgary.org

More in-depth information about HIV/AIDS issues cart be discovered at www.poz.com.

Health Canada's site is excellent regarding HIV/AIDS transmission in healthcare settings http:/Aww.hc-sc.gc.ca/main/ledc/web/publicat/ ccdr/97vol23/bbp_sup/index.html