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Making HIV nursing care work for patients

About this project

Explore the people and organisations behind this research, and find related publications by the research team.

Research team

Hilary Piercy

Research partners

Sheffield HIV Services

Funding partners

ViiV healthcare

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01 November 2021

Making HIV nursing care work for patients

Associate Professor

Monday 1 November • Viewing time: 1 minute

There are over 100,000 people living with HIV in the UK. Our research is helping them get the care they deserve.

Were you one of the 18.9 million people who tuned in to It’s a Sin? This landmark series — which follows a group of friends living through the HIV/Aids crisis in the 1980s — attracted record audiences and is Channel 4’s most streamed programme to date.

40 years on from the UK’s first HIV related death, it captures the fear and miseducation surrounding the early stages of the epidemic. It also brings into sharp focus the devastating physical effects of a virus that caused serious illness and, ultimately, early death.

Since then, things have changed radically. Although there is no cure, the development of antiretroviral drugs means the virus can be suppressed. So with the right medication, people with HIV can lead long and healthy lives. If the amount of HIV in the blood is kept at an undetectable level, it also means the virus can’t be transmitted to others.

But there’s still work to do. Our research looks at improving HIV care, with a focus on nursing. We wanted to make sure that the 103,800 people living with HIV in the UK get the care and support they need to stay well.

What does good HIV care look like?

In 2012, the House of Lords Select Committee report No vaccine, no cure highlighted an urgent need to adapt HIV care to the changing health needs of those living with the virus.

Most people are on treatment and medically stable. This means those needs are increasingly about the prevention and management of age-related comorbidities, such as diabetes and heart disease.

There are also a small number of people, often with social and mental health difficulties, who struggle to stay engaged with HIV services. This makes them susceptible to infections, lengthy hospital admissions and poor health outcomes.

It’s clear then, that effective HIV care must address complex needs and help people stick with their treatment. We know that nurses have a part to play here, but how could their role be maximised?

The existing HIV care landscape

To find out how to improve HIV nursing care, we needed to understand the existing system.

Working with the HIV Service at Sheffield Teaching Hospitals NHS Foundation Trust, we undertook the first large-scale study of the HIV nursing workforce in England. This involved collecting data from 21 HIV services, followed by five in-depth case studies.

It showed that HIV nurses are vital in providing routine care to stable people — and helping them stay healthy as they age. It also demonstrated the value of community HIV nursing in keeping those with psychosocial problems engaged in treatment.

But there were issues with consistency. We found four care models operating across the UK. Some HIV services offered no community nursing provision, while others had a full-time HIV community specialist nursing team. As HIV affects people all over the UK, it was essential to make sure no one fell through the cracks.

Similarly concerning were the recruitment, retention and training challenges we found in HIV nursing. Rectifying them would be a key priority.

A community nurse talking to a patient
HIV nurses provide routine care and help those with psychosocial problems stay engaged in treatment

A new care model

These findings led to some big changes.

In Sheffield, the HIV Service introduced a new healthcare delivery model extending nursing provision. This means they can now provide HIV community nursing support for those people with psychosocial problems, who risk disengaging with treatment.

It also expanded the role of nurses. Upskilling and recruitment helped to create a more effective and efficient service. What’s more, nurses became more involved in improving service delivery so their skills were being fully used to the benefit of patients.

These changes don’t only help people with HIV to maintain their health, they also reduce hospital admissions and the burden on the NHS.

So how could we build on this progress outside of Sheffield?

Building stronger services

Our research informed two new practice guides that are improving HIV care in the UK and internationally.

The first brings together guidelines on advanced HIV nursing for nurses, doctors and service providers. It sets out the evidence base and requirements for this specialist role — and is shaping workforce development in more than 12 services in England and Wales.

The second is a good practice guide for nurses carrying out annual health reviews. These are an essential part of managing HIV — picking up any risk factors or comorbid illnesses at an early stage. By creating a set of standards, we’re making sure this process is thorough, effective and consistent. The guide has been shared across Europe and is being used in daily practice by at least 40 nurses in Portugal and Spain.

Our work also helped to develop three HIV and Sexual Health education programmes. Along with our practice guidelines, these have helped the nursing workforce to develop — giving them the skills to deliver high quality, specialist care.

Caring for the community

Our research has helped to bring HIV care in line with the changing health needs of those who are living with HIV. It informed the development of HIV nursing roles and improved the skill mix across HIV services — meaning this care can be delivered in an effective, equitable way.

All people living with HIV deserve excellent care. Our work is helping to make sure current services work for them.

About this project

Explore the people and organisations behind this research, and find related publications by the research team.

Research team

Hilary Piercy

Research partners

Sheffield HIV Services

Funding partners

ViiV healthcare

Related courses

Our teaching is informed by research. Browse undergraduate and postgraduate courses with links to this research project, topic or team.

Get in touch

Find key contacts for enquiries about funding, partnerships, collaborations and doctoral degrees.

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