Stating the obvious – nurses: critical link to women and children affected by HIV/AIDS: a response to the revised WHO HIV treatment guidelines

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The WHO recently revised its global guidance on HIV prevention, care, and treatment. These guidelines form an integral part of a comprehensive approach to treatment and the prevention of vertical (i.e. mother-to-child) transmission of HIV.
As nurses who work in President's Emergency Plan for AIDS Relief (PEPFAR) supported countries, we are advocates for the nurses who will be doing this work. A well informed, highly skilled nursing workforce should be a top priority for all national health systems. Although this is an accepted fact, unfortunately we are not seeing this in practice. Nurses are the largest cadre of healthcare workers, therefore critical that they are actively supported to translate these revised guidelines into practice as well as the most frequently cadre of workers who interact with women and children.
The nursing community has made great strides in adjusting standards and practices to meet the ever-changing needs of our patients. In the USA, HIV programs are successfully utilizing a team approach to care, including nurses as key to the treatment team. In areas of health worker shortages, coupled with a high demand for services, national health systems have shifted some of the responsibilities of treatment to nurses.
However, implementation of the new WHO guidelines will require that nurses once again incorporate a number of changes into their daily practice. Nurses have proven their ability to be leaders in HIV care and treatment in even the most challenging conditions; the authors offer some recommendations to aid proper engagement of nurses in the provision of client-centered HIV prevention, care, and treatment services in light of the WHO guidelines.
Understanding the training and support needs of those who touch the lives of women and children affected by HIV/AIDS daily – nurses, as well as clinical officers, midwives, physicians, and the community – will be critical to the successful implementation of the revised WHO guidelines. It is hoped that application of the recommendations offered here in regions of the world most deeply affected by HIV and AIDS will take us a step closer to securing optimum health for all those living with HIV, and will enhance global efforts to decrease mother-to-child HIV transmission and protect the health of mothers and children living with HIV. Nurses will continue to be on the front lines of care, and for the successful adoption of these guidelines, the voice of nursing needs to be sought out. Consider this quote from Bunesh and Gordon (2000) [2] (‘Envision how things would be if the voice and visibility of nursing were commensurate with the size and importance of nursing in healthcare; p. 11’) Affecting change needs this voice. Nurses are here to support the change.

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