By Sotiris Doumas, Technological Nurse, MSc, Scientific Associate of ANASSA Clinic
AIDS (Acquired Immune Deficiency Syndrome), or Acquired Immune Deficiency Syndrome, refers to a series of disorders of the human body caused by the malfunctioning of the human cellular and chemical immunity. It is caused by the Human Immunodeficiency Virus (HIV-1).
Essentially, the virus interferes with the human immune system, which is responsible for the body’s defences, preventing it from functioning properly, leaving the patient susceptible to diseases such as opportunistic infections or the development of tumours. As the disease progresses, this vulnerability of the body worsens.
When a person becomes infected with HIV, he or she becomes “HIV positive” and will be HIV positive forever. Over time, HIV disease infects and kills off white blood cells called CD4+ lymphocytes (or “CD4+ T cells”) and can leave the body unable to fight off some infections and cancers.
The terms HIV and AIDS are often confused. However, they are two different concepts. HIV is the virus that causes AIDS. A person can be infected with the virus and not develop AIDS. However, they can transmit the virus to other people.
It is a fact that the AIDS disease mainly affects certain specific social groups called high-risk groups, e.g. drug addicts who inject drugs, homosexuals, polytransfusion patients, people with many changes of sexual partners, but this does not mean that it cannot occur in other cases, e.g. the children of women with AIDS are equally affected.
The HIV virus is present in the blood, in vaginal fluids, as well as in semen and pre-seminal fluids. It is transmitted by sexual intercourse (including oral sex), by sharing syringes, needles, etc. that come into contact with blood and, as mentioned above, can be transmitted from mother to child during pregnancy or childbirth. The chances of transmitting the virus by blood transfusion are minimal and limited to those cases where the blood donor is in the so-called ‘silent window’ period, which is a period of a few months after the initial infection, a period during which the virus is not detected. As is easily understood, the virus is not transmitted by shaking hands, the so-called social kiss or the sharing of non-sharp objects, e.g. soap, clothing, etc.
In Greece until December 31, 2018, 17,389 cases of HIV infection have been recorded, where 82.79% of them are men, 16.97 are women, while for 41 cases the sex was not reported. Also, in the first ten months of the same year, 4,199 have developed AIDS and 10,177 are on antiretroviral treatment. The total number of deaths stands at 2,846.
Nursing interventions aim to provide care that is special and individualised and therefore each patient must be treated as a separate personality with particular physical, spiritual, mental, psychological and social needs. The nurse should care for the AIDS patient in such a way that a climate of trust is fostered and developed between them, resulting in an effective provision of care.
The Nursing care of AIDS patients initially requires their sensitized approach by the nursing staff. The nurse should be informed about the professional duties and the manner of his/her behavior in the workplace and should have developed good interpersonal relationships both between colleagues and with the patients themselves and attendants their. The nurse should treat the patient with AIDS as a psychosomatic entity with specific needs that he or she should respect and serve, which requires awareness but also an awareness of his or her work and responsibility.
Depending on the general condition of the patient, his treatment can be done in hospital or outside (hospitalization at home). Regardless of where the nursing care will be provided, the nurse should be aware that the patient’s needs include:
- Assessment of his needs, planning of appropriate care and its implementation
- The main goal is to protect the patient from new infections and from any complications
- Avoid spreading the virus to other people
- Continuous monitoring of the patient (control of temperature, blood pressure, breathing, pulse, blood oxygen saturation)
- Strengthening his body’s defenses with proper nutrition and hydration
- Applying nursing procedures for pain relief in accordance with medical instructions
- Dialogue and psychological support both with the patient himself and with his family, for better cooperation
- Providing education about self-care, addressing basic needs and encouraging the patient to take some responsibility for their own health care
- Mobilizing it
- Calm psychological state and mental balance
- Activities (entertainment, ensuring communication, etc.)
- Psychological support
Actions for the safe hospitalization of AIDS patients
- AIDS patients are treated in separate wards to avoid transmission of infections
- The hospital staff during nursing processes are protected by wearing special uniforms, masks and gloves
- As in any nursing process, thorough hand washing before and after hospitalization is required
- Particular attention is paid to nursing procedures to avoid injuries with used needles or sharp tools, while their removal after the end of the work is required, with special non-perforated bags which are then sterilized or burned
- The tools that were used are sterilized and disinfected after thorough washing, while good cleaning and disinfection is also done in the hospital areas, e.g. floors
- Finally, special care should be taken during the hospitalization phase of patients belonging to high-risk groups, at least until it is established that they do not have AIDS
There are particularly optimistic signs of a definitive cure for the AIDS virus, as the official statement from UNAIDS, the UN agency fighting AIDS, was that “ending the AIDS epidemic is no longer just a vision, it can become a reality by 2030”. Although the virus is being treated thanks to antiretroviral drugs, HIV remains an extremely serious epidemic.
Acquired Immune Deficiency Syndrome is to this day a disease that is awe-inspiring and frightening even at the mention of it. The scientific world is trying to find ways out and to reach conclusions that will lead to the desired outcome, the cure for the disease. Until then, we must act on the basis of prevention, and the best way to prevent is to be informed.
The treatment of AIDS patients is a real challenge and awareness-based care builds human bridges, not dividing walls between people. Let us not forget that in all areas of nursing, education, clinical care and research, fulfilling the nursing duty to humanity requires knowledge and wisdom, civilized care, courage and heroism.
BIBLIOGRAPHY
Andreou E., (2016) “AIDS and nursing interventions”
ELPNO, (2017), “HIV Infection/AIDS”
Dumas S., (1994). “Nursing facing the scourge of the century”
Farmaki M., (2017). “Nursing care of patients with Human Immunodeficiency Virus (HIV)”