In 2017, 963 Australians received a diagnosis of human immunodeficiency virus (HIV) infection. For all of these people, this was a life-changing event. Pretest discussion may have been limited or may not have occurred at all. Newly diagnosed people with HIV (even those well prepared during pretest discussion) may respond with a wide range of feelings and questions (Table 1).
Nurses are often involved at (or shortly after) the time of diagnosis. The initial (and subsequent) encounters present a unique opportunity to enable a healthy adjustment from being a person without HIV infection to being an HIV-positive person. All but a few newly diagnosed people make this adjustment, usually over a period of 6 months or less. Those who don’t are often identifiable by one or more of the characteristics discussed under service engagement (Table 2). Commonly these may be:
- Alcohol and other drug use
- Significant mental health issues
- Younger age
- Belonging to a religious or ethnic group or culture where pre- or extramarital sex, injection drug use and homosexuality are taboo
The single most important nursing function at the initial encounter with a newly diagnosed patient is to foster engagement.