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On May 18, 1981, the New York Native published a report on “an exotic new disease” that became the first ever news story on human immunodeficiency virus (HIV) and the spread of acquired immunodeficiency syndrome (AIDS). A few weeks later, the Centers for Disease Control and Prevention published a report in the Mortality and Morbidity Weekly Report describing the same deadly disease affecting otherwise healthy young men in Los Angeles. This is commonly known as the outset of the HIV Epidemic. In the 42 years since the start of this epidemic, community leaders, health care professionals and organizations have banded together to dispel the stigma around HIV, advocate for testing and improve the quality of life of those afflicted.
Now, on HIV Vaccine Awareness Day, it’s the perfect time for nurse practitioners (NPs) to reflect on their role in ending this epidemic. As stated by NPs Karen S. Moore, DNP, ANPBC, FNP-C, FAANP, FAAN, and Courtney J. Pitts, DNP, MPH, FNP-BC, FAANP, for the Journal for Nurse Practitioners (JNP), “NPs across all practice settings must be well versed in the medication regimens for prevention of the transmission of HIV, as well as treatment of existing HIV infection and common opportunistic infections experienced by people living with HIV.”
Since 1981, more than 700,000 people have died from HIV in the United States. Though HIV incidence has declined in recent years, approximately 30,635 people received an HIV diagnosis in 2020. What's more, about 13% of the 1.2 million Americans with HIV are unaware they have the disease and need to be tested. Though these statistics paint a grim picture of this epidemic’s reach, advancements in antiretroviral therapy and proven models of effective HIV care have enabled those currently living with HIV to live long and healthy lives without fear of transmitting the virus to others.
“During these past four decades, HIV has gone from a quickly debilitating and lethal disease to a chronic manageable condition,” write Moore and Pitts. Scientists across the globe have made great strides in research, developing new prevention modalities and effective treatments while continuing work towards a safe and effective HIV vaccine. It is with these advances in treatment and prevention in mind that the U.S Department of Health and Human Services launched the Ending the HIV Epidemic in the U.S. (EHE) initiative.
Announced in 2019, the EHE initiative aims to utilize the advances in HIV prevention, diagnosis and treatment to reduce the number of new HIV infections in the U.S by 75% in 2025, and by at least 90% by 2030. While this may seem like a tall order, Julee B. Waldrop, DNP, FNP-BC, FAANP, FAAN, believes the time is right. In an editorial for JNP, Waldrop states: “It is the right time to make this push, because we have the tools to make it happen. We have antiretroviral therapy that can prevent transmission. We have demonstrated models of HIV care and prevention that work. We have pre-exposure prophylaxis that can decrease the risk of acquiring HIV up to 97% in high-risk individuals. We have syringe services programs that can prevent harm (e.g., overdose deaths and infectious disease) and serve as entry points to treatment. We have the surveillance capabilities to identify outbreaks and respond promptly to mitigate new transmissions.”
Waldrop adds that, “NPs can contribute towards EHE by incorporating screening, prevention and treatment consistently in their practices, collaborating to provide data and evaluation of programs and models of care that work and lobbying regulators to remove barriers to full scope of practice for NPs.” This aligns with the four key strategies of the EHE: Diagnose, Treat, Prevent and Respond. Consider the following resources and tools from the American Association of Nurse Practitioners® (AANP) on your journey to help bring an end to this epidemic:
Prevention and treatment methods for HIV and other infectious diseases are continually evolving as new diseases emerge and innovations are made to reduce disease transmission. If you’re interested in effective strategies for disease containment; pandemic risk, impact and mitigation; or innovations in treatment-resistant coinfections, the Infectious Disease and HIV AANP Community is a great fit for you!
Designed to support discussion, document sharing, collaboration and networking, each of the 28 AANP Communities maintains a dedicated online forum where you can instantly connect with like-minded NP colleagues and share information.