Nurses, alongside doctors and allied health professionals, working at the forefront of HIV care in Australia in the early years of the epidemic, faced a highly politicised and stigmatising landscape given the nature of the illness and the already marginalised affected population. With no precedents, the HIV nursing models that emerged were shaped by the response the crisis demanded, creating a diverse range of nursing roles and a strong, flexible professional specialty. This challenging working environment has been attributed to the strong alliances formed between health professionals, creating the cohesive and resilient sector that still exists today.
In this largely collegial working environment, nurses across all areas work collaboratively with HIV specialist general practitioners, infectious disease specialists, HIV specialist pharmacists, social workers and other allied health professionals to provide holistic, equitable HIV care. HIV specialist nurses work across a range of areas including:
- Community and domiciliary nursing services such as Bolton Clarke, Silver Chain, Sydney District Nursing Service
- General practice and community health
- Acute and subacute hospital in-patient and out-patient care; Hospital Admission Risk Programs
- Youth, maternal and child health
- Refugee health
- Sexual health services
- Clinical trial research.
Given the differing levels of complexity among patients, nursing roles vary considerably between settings. Nurses across the sector can experience differing levels of acuity for the same patient based on the setting from which they are providing care, whether it be seeing that patient at a routine GP follow-up appointment or undertaking a home visit through a community nursing program. A strength in the collegial working environment of the HIV sector is the ability for nurses across the spectrum of roles to support one another to ensure the best patient outcomes. This collegial approach can be conferred to other sectors not traditionally involved in HIV care who may now be involved in HIV prevention or diagnosis, given the expansion of HIV treatment and prophylaxis initiatives.