HIV: don't be complacent.

Abstract

British Journal of NursingVol. 26, No. 21 RegularsFree AccessHIV: don't be complacentIan PeateIan PeateSearch for more papers by this authorIan PeatePublished Online:23 Nov 2017https://doi.org/10.12968/bjon.2017.26.21.1149AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail It has been 20 years since the introduction of life-saving, free and effective antiretroviral therapy (ART) in the UK. While there have been many advances in HIV treatments and these advances should be celebrated, caution is needed. HIV infection remains a significant public health concern. Some 30 000 to 33 000 new infections are reported each year in Europe (European Centre for Disease Prevention and Control, 2016). In contrast, the overall number of AIDS cases has continued to steadily decline.In 2016, 5164 people were newly diagnosed with HIV in the UK (3938 men and 1226 women). This represents an 18% decline from the 6286 diagnoses reported in 2015. The decrease was most evident in gay and bisexual men. In this group, the number of HIV diagnoses reported steadily increased from 2850 in 2007 to 3570 in 2015, and then decreased by 21% to 2810 in 2016 (Public Health England, 2017).For the first time, there is a reduction in the rate of new infections among younger people; however, the epidemic may be taking a different path. Newly reported HIV cases in older people (those aged 50 years and over) have increased by 2% in Europe (Tavoschi et al, 2017).The advent of ART has resulted in a considerable reduction in the number of people living with and dying from AIDS in the UK. Those people who are diagnosed early with HIV and who commence ART early can expect a near-normal life expectancy. However, there are challenges that remain, with high rates of late HIV diagnoses, with poorer outcomes, and an ageing population.HIV is associated with significant mortality, serious morbidity and high costs of treatment and care. The infection is still seen as a stigmatising condition—one of the greatest challenges for those who are infected and those at risk (Carabini, 2017). The infection also has a prolonged ‘silent’ period during which it can often remain undiagnosed.There is no cure for HIV. It is still here and we should not be complacent or ignorant of the risks of HIV in the over-50s. The over-50s may have a low awareness of HIV and how it is transmitted and this leads to misconceptions and low perceptions of their own risk. Health professionals should not assume that older people are not running risks through engaging in unsafe sex; making such an assumption is neglect and implicit ageism.The Tavoschi et al (2017) study has demonstrated a steady increase in the rate of new HIV diagnoses among older adults in Europe over a 12-year period. Furthermore, there were stable or increasing trends for transmission modes such as heterosexual contact and injecting drug use among older adults as opposed to a substantial falling trend among younger ones. Tavoschi et al's (2017) work points towards the need to deliver more targeted testing interventions for older adults The perception that older people are not at risk is shared by some healthcare providers; HIV-related services very often focus on a younger population (Tavoschi et al 2017).Nurses are considered to be leaders in public health and, as such, they have a key role to play in increasing awareness among other health workers and expanding opportunities for testing programmes among this population. There is a need for nurses to ensure that all ages are appropriately targeted by sexual health services.As the number of older people living with HIV in the UK rises, and effective HIV treatments are available, nurses can expect to see and be required to offer care to a growing number of older people with HIV-related infection. References Carabini K. Stigma and HIV: the current situation. HIV Nursing. 2017; 17(2): 57–62 Google ScholarEuropean Centre for Disease Prevention and Control. Annual epidemiological report 2016—HIV/AIDS. 2016. http://tinyurl.com/y9fmetgu (accessed 10 November 2017) Google ScholarPublic Health England. HIV in the United Kingdom: decline in new HIV diagnoses in gay and bisexual men in London, 2017 report. Health Protection Report Advanced Access report 11(35). 3 October 2017. http://tinyurl.com/ybovvzj9 (accessed 10 November 2017) Google ScholarTavoschi L, Gomes Dias J, Pharris A. EU/EEA HIV Surveillance Network. New HIV diagnoses among adults aged 50 years or older in 31 European countries, 2004-15: an analysis of surveillance data. Lancet HIV. 2017; 4(11):e514–e521. https://doi.org/https://doi.org/10.1016/s2352-3018(17)30155-8 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetails 23 November 2017Volume 26Issue 21ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 23 November 2017 Published in print 23 November 2017 Information© MA Healthcare LimitedPDF download