I cannot express how privileged and thrilled I am at being part of this first edition of the National HIV Nursing Journal Supplement in British Journal of Nursing. As the current chair of the National HIV Nursing Association, I speak on behalf of the organisation when I say how excited we are at this launch and what it means for HIV nursing.
In 1993, I had my first personal experience of caring for someone with end-stage HIV. I had started my nurse training with the sole purpose of looking after people with HIV, a disease that predominantly affected stigmatised groups in society. I had joined a small HIV organisation called ‘Begin’ and was an HIV buddy while studying to be a nurse. I was on placement on a traditional medical Nightingale ward. At the end of the ward was one single room with big glass windows. In this room lay a beautiful young man who was emaciated and very weak. His eyes were full of fear and there was a sign on his door that read ‘Highly Infectious’. During handover, I'd learnt that he had end-stage HIV. I noticed that very rarely did anyone venture into his room and when they did, they wore gowns and gloves.
I knocked on his door and entered. I didn't put a gown on and I didn't wear gloves. I had nothing to fear as I was well informed about HIV and transmission. I sat on his bed and held his hand and asked him how he was. I had spent approximately 5 minutes with this patient when the matron on the ward opened the door and shouted at me to leave the room immediately. I was a young student nurse at the time and petrified of those in authority; however, I still managed to quietly question what her issue was and state that there was absolutely no risk. I will never forget that dear man and his face will forever be ingrained in my memory Everyone deserves respect, dignity and high-quality care and I have personally fought for this throughout my career. HIV work has taken me on a professional journey to Cambridge, London, Cambodia, Liverpool and Sussex. I have met the most inspiring patients and colleagues over the last 28 years.
The recent TV series It's a Sin featured a group of friends living in the shadow of AIDS in the 1980s. It brought back many memories for those of us who have worked in this field. It is important to remember what it was like, but it is also vital to acknowledge how far we have come. Treatment for HIV has changed dramatically from debilitating, highly toxic regimens with multiple tablets to regimens of one or two tablets a day. The U=U campaign has been instrumental in changing the way society views HIV. U=U stands for Undetectable=Untransmittable and means that when a person is living with HIV and is on effective treatment, this lowers their viral load to undetectable levels so the virus cannot be passed on sexually (Kasadha, 2021).
In 2014, UNAIDS launched the 90-90-90 global plan, with the aim that, by 2020, 90% of all people with HIV would know their status, 90% of all people diagnosed would receive antiretroviral therapy and 90% of all people receiving antiretroviral therapy would have viral suppression (UNAIDS, 2017).
In 2019 there were an estimated 105 200 people living with HIV in the UK. Of these people, 94% are diagnosed. Some 98% of people diagnosed with HIV are on treatment, and 97% of those on treatment are virally suppressed, which means they can't pass the virus on. Of all the people living with HIV in the UK, 89% are virally suppressed (National AIDS Trust, 2021). These figures are encouraging but we still have a long way to go in diagnosing all those with HIV and managing the small but significant number of patients struggling to adhere to treatment.
As our patients with HIV live longer and grow older, we will increasingly rely on other health professionals to be involved in their care. I have been so encouraged over the last few years to see a genuine interest from health professionals working outside of HIV, with a desire to become more knowledgeable so that they can deliver high-quality care. This is why these two National HIV Nursing Journal Supplements a year in BJN are so important in raising the profile of the high-quality care being delivered in the HIV field and, in so doing, increasing education and awareness around HIV.
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