What Nurses Should Know About Advancements in HIV Prevention and Treatment

Human Immunodeficiency Virus (HIV) is a transmissible disease that was once very poorly understood. In many communities around the world, it remains a huge problem. Fortunately, scientists and caregivers have made considerable progress in HIV prevention and treatment in recent years.   

Recommended course: HIV/AIDS Update: Prevention, Transmission, and Treatment, 2nd Edition  

What is the Human Immunodeficiency Virus?  

The Human Immunodeficiency Virus is a virus that impacts the disease-fighting cells in the human body. This blood-borne virus is typically transmitted through sexual contact and shared needles used for IV drug use. The human body cannot fight the virus alone, and treatment is required to stop HIV from causing severe health problems.   

An HIV infection can lead to Acquired Immunodeficiency Syndrome (AIDS), which is a late stage of HIV infection. A person with AIDS has almost no ability to fight off infection. They are likely to develop opportunistic infections like Candidiasis, Cryptococcosis, Cytomegalovirus (CMV), Herpes simplex, cervical cancer, and more.   

If a person with HIV does not seek treatment, their life expectancy decreases dramatically. Without medical management, most people who develop AIDS will pass away within one year. However, effective treatment options have become much more readily available in recent years.   

History of HIV prevention and treatment  

HIV and AIDS appeared in the United States in the early 1980’s. First emerging as a problem among the gay male community, cases quickly spread to others, including women and children. Those affected by the disease passed away at alarming rates, which made it difficult for scientists to understand the disease and its transmission.   

Throughout the next several decades, people with HIV and AIDS faced extreme bias at work and in healthcare. Lawmakers banned people with HIV from entering the country, and some schools banned children with HIV from attending.    

Fortunately, AZT, a drug that had failed as a cancer treatment in the 1960s was available and ready to be trialed as a treatment for HIV. AZT, also known as zidovudine, belongs to a class of drugs known as nucleoside reverse transcriptase inhibitors, or NRTIs. Studies showed this drug to be effective in people infected with HIV, as it delayed the progression of HIV to AIDS.   

Since 1987, there have been more than 25 drugs developed for the treatment of HIV and AIDS. These medications have progressed from frequent drug dosing and severe side effects to medications that patients only need to take once or twice a day, with minimal side effects.   

New therapies for HIV prevention and treatment 

Antiretroviral medication, which is the most common therapy for the treatment of HIV, remains largely the same as it did years ago, though research has resulted in improved dosing schedules and decreased side effects. Patients who receive early treatment for their HIV can enjoy normal life expectancies and have a near-zero risk of transmitting the disease to their sexual partners.   

In fact, with medication, many patients diagnosed with HIV can decrease the viral load in their blood levels to nearly undetectable. While this is not a cure, it does mean that the disease is well-controlled.  

Types of medications used in HIV treatment include:   

  • Antiretroviral therapy  
  • Entry/attachment inhibitors  
  • Integrase inhibitors  
  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs)  
  • Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)  
  • Protease inhibitors  
  • Pharmacokinetic enhancers  
  • Capsid inhibitors  

Many fixed-dose combination (FDC) drugs are also available for patients. These combine several drugs that patients can take in a single dose, simplifying the medication plan for those infected with HIV.   

While HIV prevention and treatment has improved significantly over the years, there is still no complete cure for HIV. Current treatment strategies focus on lowering the viral load of the infection, improving the immune function of people infected with the disease, and preventing transmission from one person to another.   

Researchers continue to work hard in search of a cure for HIV. Several trials have been successful in eliminating the HIV virus in previously infected patients. While these curative treatments are still experimental and rare, they offer hope to HIV patients and their families.   

Nursing care of patients with HIV  

While treatment of HIV has improved, there are still many social barriers that people diagnosed with HIV must overcome. Patients diagnosed with HIV have faced discrimination and poor treatment for decades, usually rooted in bias, misunderstanding, and fear.   

A diagnosis of HIV can still be terrifying and life-changing for a patient. Because of the lingering stigma associated with an HIV infection, the patient may feel embarrassed or hesitant to talk about how to manage the disease. Nurses must be kind, compassionate, patient, and understanding when helping patients work through their feelings after an HIV diagnosis.   

Nurses who care for HIV-positive patients can help their patients by doing the following:   

  • Recommending support groups, online and in-person  
  • Participating in implicit bias training  
  • Remaining non-judgmental   
  • Offering reassurance  
  • Educating the patient on the effectiveness of HIV treatment  
  • Educating the patient on safe sex practices  
  • Offering information about needle exchange programs  
  • Encouraging medication adherence  
  • Using universal precautions  

Nursing care of patients with AIDS 

Patients who do not receive early treatment for their HIV may develop AIDS. AIDS causes many more problems than early HIV infection and requires a different treatment approach. Patients with AIDS have severely weakened immune systems. They may struggle to maintain a healthy weight and may develop painful sores on their skin.   

Nurses caring for these patients should practice strict infection control, provide excellent oral and skin care, and offer emotional support for their patients. In addition, nurses practice universal precautions including handwashing, wearing gloves, and handling sharp instruments with caution. Often, these are enough to prevent the spread of HIV in the hospital. Nurses who practice these standard precautions have no reason to fear caring for a patient diagnosed with HIV.