Nurse have the training, but need more authority, to lead HIV care teams

Nurses are at the heart of achieving HIV treatment and prevention goals, according to the American Nurses Association’s 13 updated policies on preventing and caring for HIV and related conditions, which were released in December 2019.

Tracy Hicks, DNP

But advanced practice registered nurses and other nurses don’t have the necessary authority to do all they can to improve access and reach more patients with preventive education and pre-exposure prophylaxis (PrEP). Nor can they provide the holistic care for which nurses are known, according to Tracy Hicks, DNP, FNP-BC, PMHNP-BC, FIAAN, CARN-AP, a practice owner and program director of the Health AIDS Recovery Program-Special Health Resource, a Ryan White founded clinic in Longview, Texas.

Hicks, who reviewed the ANA HIV policy statement, said its recommendation for full practice authority for APRNs is crucial. Hicks previously provided primary care for those living with HIV. She now focuses on patients’ mental health needs and treating those who need buprenorphine treatment for opioid abuse.

One of the challenges Hicks faces without full practice authority is not being able to prescribe buprenorphine for opioid addiction unless she works with a physician who is Suboxone waivered.

Physicians who are waivered are few and far between, said Hicks said, who is on the board of directors for the American Academy of HIV Medicine. “It is crucial we get that full range of care,” she said. “For me in my private practice, if I don’t have a physician, I can’t help combat the crisis.”

Leading HIV care teams

Nurses stand poised to lead HIV care teams because they’re trained in providing holistic care, take the time to provide that care and are seen by many as trusted providers, according to Hicks.

Caring for HIV patients means looking far beyond the diagnosis.

“The cornerstones of nursing are providing safe care, effective care, shared decision-making and letting the patient have a say in their care,” she said. “We also need to recognize that we can recommend and educate but we really have to delve in and find out if what we’re suggesting is feasible for that client.”

Hicks shared a specific example from her career that highlights how nurses can connect with patients.

“I had a young lady that came in, and she was seen as somebody that was noncompliant,” Hicks said. “She wasn’t taking her medicine. Sitting down and talking with her I said, ‘You haven’t taken your medicine. Your CD4 is 40. You have a viral load of over 50,000. You have two kids at home and you’re 22 (with) no job. What is the deal?’ She told me she was depressed. She was suicidal. And no one had asked her what the reason was. Once I was able to get her treated for depression and into the therapist, she became adherent.”

HIV care comes in many forms

HIV is treatable, yet people are still dying at an alarming rate. The Centers for Disease Control and Prevention reports that about 1.1 million people in the U.S. are living with HIV. About …read more

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