Search

Understanding of HIV self-management increasingly focuses on treatment adherence and associated health-related behaviors, yet people living with HIV (PLWH) seldom perform these actions in a social vacuum. Thus, delivering comprehensive self-management support programs for PLWH requires an understanding of the social and emotional dimensions of HIV self-management. Through thematic analysis of in-depth interviews with 35 newly diagnosed PLWH, this descriptive qualitative study highlights these dimensions and their effect on experiences of HIV diagnosis and care. HIV self-management involves interpersonal interactions that affect efforts to seek support and reimagine one's personal identity in a changed reality. Managing disclosures and navigating stigma constitute everyday work for many PLWH. Because stigma continues to impede care engagement and well-being for PLWH, health practitioners must extend focus beyond viral suppression and prioritize support for emotional and social self-management. Nurses can create safe, nonstigmatizing spaces for conversations about HIV, uphold the rights of PLWH around disclosure, and ensure that PLWH are connected to peer support services.

Support networks promote care engagement and prevent social isolation for people living with HIV (PLWH). This study examined the personal support networks of recently diagnosed PLWH and explored how these networks change over time. We developed qualitative social network maps with 10 recently diagnosed PLWH in Queensland and identified unique and dynamic support networks. Network changes over time were influenced by changing support needs and experiences of stigma. Some support networks grew, whereas others remained small and close-knit or became sparse. The pivotal role of peers for information and emotional support was revealed. Socially isolated PLWH also described substantial reliance on long-term professional support. Others described reasons why health professionals were excluded from support networks, revealing the importance of nonjudgmental attitudes and HIV literacy among health professionals. Facilitating ongoing links with peers and professionals are crucial strategies to help PLWH foster effective and sustainable networks for comprehensive long-term support.

The HIV care continuum represents a linear clinical pathway from testing to viral suppression; however, it does not capture the psychosocial complexities of contemporary HIV care. We developed an innovative and appealing visual learning resource to extend the scope of HIV health literacy beyond biomedical constructs. Based on the lived experiences of recently diagnosed people living with HIV in Queensland, the “Journeys through the HIV Care Continuum” Map presents the continuum as a complex journey incorporating challenges such as poor health literacy, health service access and stigma alongside facilitators to care, including emotional and peer support. Designed for audiences who may not access academic literature, the Map can be used to facilitate conversations between recently diagnosed people living with HIV and peer navigators, and as a learning tool for health professionals, carers and students. The Map highlights opportunities to support PLHIV in meaningful ways that will reduce stigma and promote care access.

University students usually consist of young people from culturally and linguistically diverse backgrounds, and a group recognised as being at increased risk of STI. This study found lower levels of STI knowledge and STI testing among international students and to a lesser extent, domestic overseas-born students, compared with domestic Australian-born students. International students exhibited lower risk sexual behaviour but were more likely to have had a HIV test than domestic students. This diversity in sexual health knowledge, sexual health services utilisation and sexual experience indicates the need for a variety of public health approaches to improve sexual health.

Background: The HIV Care Continuum represents a linear clinical pathway incorporating HIV testing, diagnosis, care linkage, treatment initiation and viral suppression. Imagined from a provider’s perspective, rather than from the perspective of people living with HIV (PLHIV), the continuum fails to capture the lived experience of care for recently diagnosed PLHIV. To promote understanding of barriers and facilitators impacting engagement across the continuum, we developed an innovative and engaging illustrated learning resource for health professionals, peer workers, students, carers and PLHIV. Methods: Developed through a collaborative and iterative drafting process involving representatives from Queensland Positive People and a professional illustrator, the graphic-based resource presents findings from the Testing to Treatment Trajectory in Queensland longitudinal study. Two in-depth interviews conducted annually with 42 recently diagnosed (<5 years) PLHIV captured experiences of HIV testing, diagnosis, linkage to care, treatment initiation and beyond. The graphic represents key themes, including barriers and facilitators to HIV care. Results: Using imagery of a road, with hazards and short cuts, the continuum is presented as a ‘convoluted journey’, featuring complexities impacting the diagnosis experience and efforts to engage in care according to participants. Challenges highlighted include poor health literacy, health service access, disclosure, and stigma. The work of positioning HIV within the individuals’ social life and identity is captured. The importance of emotional and peer support for recently diagnosed PLHIV is emphasised. Beyond viral suppression, PLHIV move forward with resourcefulness and strength. Conclusion: As a ‘conversation starter’ this innovative and engaging learning resource encourages discussions about social factors relevant to both PLHIV and care providers. It

With widespread treatment, HIV is now considered a chronic, manageable condition, yet little is known of the social networks that support people living with HIV (PLHIV) to transition toward self-management. Using a person-centred, qualitative social network approach, this study examined the role, characteristics and evolution of social support networks from the perspective of PLHIV and key support providers in Queensland, Australia. Beyond treatment and monitoring, HIV self-management involves negotiating disclosures and navigating stigma. Alongside biomedical interventions, facilitating recently diagnosed PLHIV to develop strong and sustainable personal support networks, including linkage with peers, is an important aspect of contemporary HIV care.

Background: Social networks contribute to improved health and quality of life for people with chronic conditions, yet the networks that support people to transition from HIV diagnosis toward living well long-term are not well understood. This research highlights the contribution of peers in supporting this transition, and the interplay of peer support within clinical and existing support networks of people living with HIV (PLHIV). Methods: Social support network mapping was conducted with 10 recently diagnosed (<5 years) PLHIV in Queensland to explore their support needs and identify people perceived as key supports at diagnosis and as time progressed. In-depth interviews with 8 identified peer supports explored their perceptions of the support role. Thematic analysis identified strengths and challenges of peer support for recently-diagnosed PLHIV. Results: Peers offered meaningful support that bridged clinical and everyday worlds and was relevant from diagnosis to long-term self-management. At diagnosis, peers provided information, solidarity and crisis intervention. Over time, peers helped recently diagnosed PLHIV manage disclosures and stigma, facilitating personal support network growth. Peers who shared similar outlooks, were perceived to be living well with HIV and who normalised HIV in ‘everyday’ contexts, remained long-term supports. Peers who made themselves visible through formal and informal forums, alerted recently diagnosed PLHIV of diverse opportunities to tap into peer networks. Peers acknowledged the reciprocity of support roles, but felt their efforts were under-recognized among broader health services. Peers struggled to maintain consistent social support activities for recently-diagnosed PLHIV, many worked in casual or voluntary positions and money was a constant uncertainty. Conclusion: With HIV care becoming increasingly individualized and shifting from clinical to everyday worlds, peer networks remain

Background: Treatment advances have resulted in longer life expectancy for people living with HIV (PLHIV). With the evolution of HIV nursing roles from acute to chronic care models, greater emphasis is placed on assisting individuals to self-manage HIV. Social support is important to optimize HIV self-management, yet little is known of the social networks that support PLHIV as they transition from diagnosis, toward achieving viral suppression, and beyond to living well long-term. Purpose: This study examines PLHIV changing experiences of self-management support during the first five years following diagnosis. It highlights the structure and transformation of social support networks in this time, exploring their interface with HIV nursing care and self-management models. Methods: In-depth interviews with a convenience sample of 34 recently diagnosed (<5 years) PLHIV in Queensland, Australia were conducted. Additional network mapping was conducted with 10 of the participants. Case studies, network diagrams and thematic analysis were used to explore and identify changing support needs and networks. Conclusions: The social support networks of the participants (24-74 years), recruited from a variety of Queensland locations, are diverse, ranging from sparse connections through to close-knit groups comprised of family, friends, service providers and HIV-positive peers. Fear of disclosure was a common factor disrupting networks following diagnosis, creating challenges for sourcing and maintaining support. In some cases, nurses were pivotal in reducing these fears and assisting PLHIV to access support, including peer-linkages. Networks that helped PLHIV maintain stability and treat HIV were important on diagnosis. As time progressed, networks that allowed PLHIV a comfortable level of HIV visibility helped reduce internalised stigma, and were pivotal in helping PLHIV transition toward living well. Implications

The emergence of treatment-as-prevention has made early initiation of antiretroviral treatment (ART) a “universal” policy. This review synthesizes qualitative research findings on barriers and facilitators of ART initiation in Organization for Economic Co-operation and Development (OECD) countries published since 2010. Ten articles describing seven research studies were included in the review. Findings confirmed ART initiation as a complicated process involving careful deliberation of the personal risks and benefits of treatment within the broader contexts of everyday life for people living with HIV (PLHIV). They also highlight interpersonal dynamics and concern for the public as increasingly important factors in shaping the decision to initiate treatment. The review provides valuable information for understanding treatment behaviour and maximizing treatment options brought forth by new biomedical advances.

Background: This research explores the structure, function and transformation of personal networks that support HIV self-management from the perspective of people recently diagnosed with HIV. The findings provide insight into the factors influencing network change and the roles of family, friends, HIV positive peers and healthcare providers (HCP) within personal support networks. Methods: In-depth interviews with 35 recently diagnosed (<5 years) people living with HIV (PLHIV) in Queensland were conducted to explore their social networks and social support needs. Additional network mapping was conducted with 10 of the participants. Thematic analysis and social network diagrams were used to explore personal support network structure and evolution following diagnosis. Results: PLHIV drew on personal support networks in a range of ways as they journeyed from diagnosis toward self-management. Key elements shaping the development of supportive networks post diagnosis included: participants’ interactions with their HIV positive peers, perceptions of clinical services and willingness to disclose HIV diagnosis. Peers were vital for solidarity and information following diagnosis and those with similar age, location or interests and who were perceived to be living well with HIV became key long-term supports. Participants used existing associations, online platforms and community organisations to link with peers. Family, friends and a range of HCP were also important supports following diagnosis, but for some participants, stigma experienced using clinical services was a barrier to including HCP as part of longer-term support networks. For those not connected with peers and unwilling or unable to discuss HIV with friends and family, HCP remained vital long-term supports. Conclusion: HCP, researchers and policymakers must recognise the benefits of diverse personal networks in supporting self-management for PLHIV and potentially improvin

Background: Treatment advances have resulted in longer life expectancy for people living with HIV (PLHIV). As HIV nursing roles evolve from acute to continuing care, greater emphasis must be placed on assisting individuals to self-manage this chronic condition. Social support is important to optimise self-management and improve quality of life of PLHIV. However, there is little understanding of the role and function of social support networks and their interface with HIV nursing care and self-management models. This study examines PLHIV’s changing experiences of social support during the first five years after diagnosis. The findings provide insight into the structure and transformation of social support networks in this time, and the role of nurses within these networks. Methods: In-depth interviews with a convenience sample of 35 recently diagnosed (<5 years) PLHIV in Queensland were conducted. An additional network mapping exercise was conducted with 10 of the participants. Results: The social support networks of the participants (24-74 years), recruited from a variety of Queensland locations, were diverse. They ranged from sparse connections through to close-knit groups comprising family, friends and service providers. Fear of disclosure emerged as a common factor for disruption of social networks following diagnosis, creating challenges for sourcing and maintaining support. In some cases, nurses were pivotal in reducing these fears and assisting PLHIV to access support. The broader social challenges of living with HIV remain central areas of concern, particularly persisting societal stigma. Conclusion: This research provides insight into network support beyond the clinical environment, contributing to a broader picture of HIV care. Uniquely positioned across the clinical and community support spectrum of HIV care, nurses have key coordinating roles within the supportive networks that promote self-manage

The landscape of HIV testing has changed significantly in recent years following the rise in importance of the ‘treatment as prevention’ strategy and advancements in new HIV testing and prevention technologies. This review provides a synthesis of qualitative research findings published since 2010 on preferences and practices of men who have sex with men (MSM) surrounding HIV testing in high-income settings. MSM are one of the hardest groups to reach with standard or conventional HIV testing approaches. To develop innovative testing strategies for this particular group, a good understanding of their concerns, barriers and facilitators of accessing HIV testing is needed. This updated review provides valuable information for improving existing programs and designing new testing services for MSM.

Advances in treatment have resulted in longer life expectancy for people living with HIV (PLHIV), but ensuring people are living well remains a challenge for nursing practice (Bradley-Springer et al. 2010).