Battling a Dual Epidemic in Africa
by Teddi Fine
As many as forty-two million people in Africa are living with HIV or AIDS. Half of them are women, an overwhelming number of whom are victims of sexual assault, whether as a result of war or an act by an intimate partner. In South Africa, a nation with the highest reported rate of sexual assault in the world, and other sub-Saharan nations, victims of rape or intimate partner violence (IPV) are at significant risk not only for event-related physical and emotional trauma, but also for HIV/AIDS. The implications can be lethal, unless anti-viral medications are made available and taken appropriately.
According to a review of ten years of research, doctoral candidate Jessica E. Draughon, MSN, RN, and associate professor Daniel J. Sheridan, PhD, RN, found that, despite guidelines advocating use of preventive anti-HIV medications, patients don’t always comply. [“Non-occupational post-exposure prophylaxis for human immunodeficiency virus in sub-Saharan Africa: A systematic review,” Journal of Forensic Nursing, June 2011.] Their review suggested a number of areas in which added research is warranted. For example, would patients be more likely to take medications regularly if instructed by a nurse rather than a physician? Should interaction between patient and clinician remain ongoing through the course of medication use? Could emotional issues, including post-traumatic stress disorder, interfere with adherence?
Nonetheless, their literature review did yield some important clues about helping patients stay on their medications. Draughon and Sheridan recommend that clinicians take more time to explain the importance of the medications and give patients the full course of medications up front. According to Draughon, “Nurses on the front lines of care are ideally positioned to support people through the full course of care.”