Page 261 - Encyclopedia of Nursing Research

228 n HIV/AIDS cAre AND TreATMeNT

Hiv/aiDs Care anD comorbidities. Nurse researchers have exam-
ined individual symptoms such as fatigue
H treatMent (pence et al., 2009) and peripheral neuropathy
(Nicholas et al., 2010). The UcSF International
HIV/AIDS Nursing research Network con-
Throughout the world, HIV/AIDS is emerg- tinues to conduct research and publish work
ing as a chronic illness that has a particular on self-care symptom management strategies
impact on marginalized and/or economi- for six commonly reported symptoms (anxi-
cally constrained populations. In developed ety, depression, diarrhea, fatigue, nausea, and
countries, HIV/AIDS is disproportionally neuropathy), including an intervention study
impacting communities of color, specifi- that examined the effectiveness of a paper-
cally African Americans, and persons who based symptom management manual com-
engage in behaviors such as injection drug pared with a nutrition manual in controlling
use and/or sexual behaviors that result in a multiple symptoms (Wantland et al., 2008).
high risk for infection. Many people living Treatment guidelines for HIV and
with HIV/AIDS in the developed world are related comorbidities, such as tuberculosis,
triply diagnosed with substance abuse and are examined using the most current evi-
mental illness, which impacts on treatment dence from clinical trials every 6 months
adherence (chander et al., 2009), engagement by a panel of HIV specialists (http://aid-
with the health care system, and participa- sinfo.nih.gov/Guidelines/GuidelineDetail.
tion in research. Because of the complex cul- aspx?MenuItem=Guidelines&Search=Off&
tural and political factors along with poverty, GuidelineID=7&classID=1). To suppress the
the incidence of HIV/AIDS in some devel- HIV viral load, adherence with prescribed
oping countries has impacted on projected medications is essential. Nursing research
life expectancies for persons born in those has examined different approaches to pro-
countries. Many nursing researchers have moting adherence (Holzemer et al., 2006) and
established international partnerships to (erlen & Sereika, 2006), but as treatment reg-
address specific issues of living with HIV/ imens evolved from 20 plus pills three times
AIDS in resource constrained countries par- a day with food and activity restrictions to
ticularly those located in sub-Saharan Africa. one pill one time a day with a longer half-
Articles are coauthored by nursing investiga- life, adherence challenges have decreased
tors living in diverse settings, which greatly for motivated clients.
contribute to the research and dissemination Multiple theoretical perspectives have
capacity of nurses in both settings. Through been used in nursing research with HIV/AIDS
programs such as the United Nations Global samples, including the common sense model
Fund (http://www.theglobalfund.org/en/) of illness representation (reynolds et al.,
and the pepFAr (http://www.pepfar.gov/), 2009) and the chronic care Model (http://
more HIV-infected persons throughout the www.improvingchroniccare.org/index.
world are accessing treatment for their infec- php?p=The_chronic_care_Model&s=2). The
tion. Although treatment has greatly impacted centers for Disease control and prevention
on controlling the incredible mortality rates, advocates routine screening of all patients in
it also raises issues related to adherence and health care settings (http://www.cdc.gov/
management of side effects because the avail- hiv/testing/HIVStandardcare/). As these
ability of specific antiretroviral therapy medi- guidelines become implemented in high
cations options is limited in many parts of the incidence settings such as New york State,
world because of the ongoing cost issues. research will be needed to determine organi-
Symptoms can emerge from the dis- zational structures that promote case finding
ease pathology, treatment strategies, and along with access to high-quality HIV care