Nurses have been at the forefront of care, advocacy, and research since the very beginning of the AIDS epidemic. Nurses were the driving force behind the 1983 opening of San Francisco General Hospital's Ward 5B, the nation's first dedicated AIDS inpatient unit, and a model for subsequent dedicated AIDS units across the world, such as Broderip Ward at Middlesex Hospital in London. As antiretroviral therapy in the United States obviated the need for dedicated inpatient units, nurses continued to make their voices heard and led the charge in providing care. Today, nurses lead antiretroviral therapy clinics in sub-Saharan Africa (Rabkin et al., 2017) and PrEP clinics in Australia (Schmidt et al., 2018). Further, nurse faculty develop and test evidence-based innovative curricula to prepare student nurses to effectively care for persons living with HIV (Frain, 2017). Finally, nurse scientists conduct cutting edge research to improve outcomes in adults living with HIV (Yoo-Jeong et al., 2020).
In the early years, the world took little notice of the June 5, 1981 Morbidity and Mortality Weekly Report report of five cases of Pneumocystis carinii pneumonia in previously healthy, "homosexual" gay men in the Los Angeles area. By 1985, when actor, Rock Hudson, publicly disclosed that he had AIDS, it was estimated that 425,000 Americans were already living with HIV (CDC, 2021). The failure of our country's leadership at the time to acknowledge HIV infection as a serious public health issue led to increased transmission, preventable infections, and ultimately death, spawning the rallying cry that "silence = death" (Francis, 2012).
It has been 40 years since that initial Morbidity and Mortality Weekly Report report was released. The HIV epidemic has been shaped, for the better, by dedicated nurses, nurse practitioners, and midwives who have provided direct care, questioned the status quo, advocated for patients' rights, taught the next generation of HIV clinicians, and advanced the science. Each of these activities not only saved lives but also improved the quality of the lives saved.
We are proud of and excited to present this special issue of JANAC to our readers. We invited clinical scientists to summarize the scientific literature created by and relevant to nurses to inform and improve patient care. This is the literature that has guided, shaped, and defined HIV nursing for the last 40 years. It is our enduring legacy, and the guest editors along with the editorial leadership are pleased to present these papers in this special issue.
The nine state of the science manuscripts included in this special issue examine not only what we know but also discuss priority future directions with key populations, prevalent clinical conditions, and aspects of the care continuum. Four articles focus on special populations including those from diverse sexual orientation and gender identities/expression, Black and Hispanic/Latinx, adolescent and young adults, and cisgender women. Clinically, the two articles focus on contemporary issues associated with aging with HIV, including neurocognitive issues and chronic comorbidities. The last set of articles examine issues associated with adherence, prevention, and stigma. This body of work reflects an optimism that perhaps, in the next 40 years, we will be reviewing the key role that nursing played to help end the AIDS epidemic once and for all.
Disclosures
The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest.
Author Contributions
All authors contributed the conceptualization, writing, and editing of this editorial. Michael V. Relf conceptualized and oversaw development of this special issue. B. Swanson, P. Cioe, S. R. Ramos, and A. Webel actively contributed to the special issue by coordinating peer reviews and completing the copy editing of manuscripts.
Acknowledgments
The manuscript was supported by the Duke University Center for AIDS Research (CFAR), an NIH-funded program (5P30 AI064518), and supported in part, by funding from the National Institutes of Health (R01NR018391 & 1R01AG066562 to A.R.W.).
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