AIDS: Context of care

Abstract

M AJOR URBAN AREAS on the East and West Coasts have been grievously affected by acquired immunodeficiency syndrome (AIDS). Indeed, the incidence of human immunodeficiency virus (HIV) infection is so prevalent in the United States that major hospitals or health facilities in every state have already admitted their first AIDS patient. ’ More than 100,000 individuals have been diagnosed with AIDS between 1981 and 1989, and over 57% have died from this disease.2 The US Public Health Service projects a cumulative total of 365,000 AIDS cases by the year 1992.3 The epidemic proportions of HIV infection and the catastrophic nature of AIDS pose a major challenge to nursing care systems. Nurses have been providing care to this population for many years, yet that care is varied across the country and often determined by many factors external to the basic physiologic needs of the patient. The context of care, ie, the regional differences in AIDS and HIV infection distribution across the nation and the programmatic differences in the health systems providing care, influences nursing activities and nursing implications.