We can’t get to 90:90:90, without the 80.

The Nursing Satellite Session

The nursing satellite session at AIDS2014 was themed “Nurses Stepping Up, Stepping Forward and Stepping Beyond!” to link to the conference theme of “Stepping up the Pace” and to provide an opportunity for celebration of the how the work of HIV nurses globally has a significant impact.

Kim Carbaugh, Executive Director of the US-based Association for Nurses in AIDS Care (ANAC) opened the session with a reflection on the UNAIDS 90:90:90 goal – 90% diagnosed, 90% on treatment and 90% on treatment with an undetectable viral load. However, there has been a lack of discussion in the main plenaries, or in any sessions, about the role of nurses in reaching these goals – and with 80% of the global health workforce being nurses, as Kim said, “We can’t get to 90:90:90, without the 80.”

Denise Cummins, a community HIV nurse from Sydney, then discussed her work over the past decade volunteering in Nepal, providing harm minimisation education, clean syringes, workshops and mentoring to people living with, or at risk of, HIV.

Her key message was that all nurses have skills that they can share with those in need and encouraged participants to contact local agencies when they travel and offer to help, even if just for a few hours. Why? to challenge yourself, for cultural exchange, to share your skills, to make a difference, to make friends and to have an adventure.

A/Prof Jason Farley, from Johns Hopkins University (JHU) School of Nursing, Adjunct Associate Professor at the University of KwaZulu Natal in South Africa and UTS in Sydney, and Adult Nurse Practitioner (NP) at JHU spoke about his work in upskilling nurses to manage multi-drug resistant TB (MDR-TB) in South Africa. As the majority of TB in South Africa is diagnosed by nurses, and nurses initiate treatment for non-MDR-TB, the next step in scaling up the response to the TB epidemic was to train and support nurses to initiate MDR-TB treatment.

Jason and colleagues explored whether primary health care nurses were able to safely and effectively initiate treatment for MDR-TB in South Africa, with the support of decision-making tools. Following appropriate training, mentoring and support, the study demonstrated that negative outcomes were not increased and final treatment outcomes were not worsened.

The successes demonstrated in Jason’s program, are so well recognised they have been incorporated into the National Strategic Plan of South Africa on HIV, STIs and TB 2012-2016, “…all primary care, antenatal, TB and mobile outreach health facilities must become fully functional nurse-initiated ART and MDR-TB initiation sites for adults, children and pregnant women.”

A/Prof Jane Tomnay from the Centre for Excellence in Rural Sexual Health (CERSH), University of Melbourne, outlined the model for a comprehensive and coordinated rural sexual health service, incorporating a nurse practitioner (NP), a workforce development network, expanding access to condoms and building GLBTI friendly rural services. Jane explored the benefits and challenges with working in a rural setting and discussed the path to establishing a self-sufficient sexual health NP model.

Sandra Gregson, from the Victorian Aboriginal Health Service, then talked about the model of HIV care and management available to Aboriginal people at the 2nd oldest Aboriginal Health Service in Australia. Conducting about 200 HIV tests/month, the recent new diagnoses have mainly been in Aboriginal people who are injecting drugs. The health service provides holistic care, with allied health and others services available or linked, to aim to engage clients in the improvement of their health and wellbeing in the long term.

Carole Treston, Chief Nursing Officer at ANAC, closed the session with a discussion about the role of nurses in advocacy and policy. Her message was a clear one: nurses, as one of the most respected voices in the community, can have an influential and powerful voice as public policy advocates and should step up and step forward to have their voices heard.

The session was very well attended and the participants were so grateful to have a session focused on the work of nurses.