Between delivering chronic care and answering patients' burdens: Understanding HIV specialist nurses' experiences in the age of treatment

Abstract

Aim(s): To understand the experiences of HIV nurses in the context of ambivalence between biomedical treatment advancements and the continuing burden for people living with HIV and negative representations of HIV. Design: An interpretative phenomenological study was conducted using in-depth interviews. Methods: Twenty-one interviews with nurses were conducted between November 2021 and March 2022. A thematic analysis was performed. Results: Six themes related to the nurses' experiences emerged. Despite effective treatment for most people with HIV, nurses identify patient populations that require additional care. Nurses are flexible in making extra appointments to accommodate complex issues in these patients. Nurses develop a unique relationship with their patients based on trust and empathy, linked to patient's experiences with stigma and discrimination for people with HIV. Nurses perceive their tasks as becoming increasingly complex. There is explicit awareness about the changes in HIV care from acute to chronic care and how this affects nurses' tasks. Nurses continue to differentiate HIV from other chronic conditions. Conclusion: Biomedical advancements change the organization of HIV care while public health concerns remain and patient population has particular needs due to negative social representations of HIV. Nurses navigate these issues in their everyday care. Implications for the Profession and/or Patient Care: A potential re-evaluation of the role of nurses in providing chronic HIV care. Impact: Our study addresses the roles of HIV nurses as care is shifting towards chronic care models. The unique relationship between nurses and patients is key in understanding the importance of nurses in the care trajectory. These findings impact the institutional role of nurses in HIV treatment centres and the institutional organization of HIV care. Report Method: The COREQ guideline was used. Patient or Public Contribution: Amsterdam UMC (AMC) staff, the national organization of HIV Nurses and patient organizations contributed to the study design.