Discuss how community nurses can use social inclusion and primary health care principles to protect and promote health for people at risk of exposure to HIV and for people living with HIV/AIDs.

Topic

This assignment requires students to use case scenario 3 HIV,

1. Include a summary of social inclusion and primary health care

2. Include a description of discrimination and stigma issues affecting people at risk of exposure to HIV and people living with HIV/AIDs

3. Include case scenario 3 HIV, in your discussion as an examples of community nursing interventions and approaches to support health promotion and social inclusion for people at risk of exposure to HIV and for people living with HIV/AIDs.

Assignment 2 is an essay

The following are required

· An introduction

· A main body

· A conclusion

Body of essay

1. Include a summary of social inclusion and primary health care

· What does social inclusion mean

· What does primary health care mean

· How is social inclusion part of primary health care

· Consider relevant chapters from textbook. (Kralik and van Loon editors)

· Consider the Declaration of Alma Ata (World Health Organisation, 1978)

· Other relevant literature

2. Include a description of discrimination and stigma issues affectiong people at risk of exposure to HIV and people living with HIV/AIDs

· Use the reference from WHO (2016)

Ø World Health Organisation. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key population.

· Who are the people at risk of exposure to HIV? Consider the key population in the WHO (2016) document

· What are the discrimination and stigma issues these people encounter (see the WHO document)

· Student will use the WHO (2016) reference

· Students will use other references relevant to discrimination and stigma issues for key population living with HIV

3. Include case scenario 3 HIV, in your discussion as an example of community nursing interventions and approaches to support health promotion and social inclusion for people at risk of exposure to HIV and for people living with HIV/AIDs

· Use scenario 3 HIV re a global focus, an Australian focus, or both if you wish , you do not need to reference the scenario

· Argue how you nominated nursing interventions would be expected to promote health and to promote social inclusion for people at risk of exposure to HIV and for people living with HIV/AIDs

· Some community interventions are listed here (students may select one or more interventions, students are not required to present each intervention listed, there may be other relevant interventions that are not listed):

Ø Health promotion

Ø Participative and inclusive approaches

Ø Counselling and testing

Ø Advocating for clients (can include a range of interventions, advocating with government and policy makers, advocating with communities and education, advocacy with healthcare professionals)

Ø Listening and helping clients through difficult times

Ø Assessing and monitoring clients’ health

Ø Providing clients, carers and family with education, advice and support to help clients live with HIV/AIDs

Ø Working with other healthcare providers to ensure clients receive the best care

Ø Providing clients with a private and respectful service

Ø Helping clients with medications

Ø Connecting clients with other services or support groups

Ø Providing some mental health and social work support

Ø Providing care and support to refugees and asylum seekers who live with HIV

Ø Assessing clients’ ability to remain at home or return to work

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Ø Supporting clients in achieving goals

Case scenario

Case Scenario 3 HIV/AIDS a global perspective (WHO, 2016)

Without addressing the needs of key populations, a sustainable response to HIV will not be achieved. The risk behaviours and vulnerabilities of specific populations and their networks determine the dynamics of HIV epidemics. Five key population groups are, in almost all settings and countries, disproportionately affected by HIV:

· Men who have sex with men  

· People in prisons and other closed settings  

· People who inject drugs  

· Sex workers  

· Transgender people  

These disproportionate risks reflect both behaviour common among members of these populations and specific legal and social barriers that further increase their vulnerability. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV. All countries should consider the importance of reaching these key populations, understanding their needs and providing equitable, accessible and acceptable services. To do so, it is essential to work with key population groups and networks as partners in developing and providing services. An effective response requires more than providing services for key populations, it also requires systemic and environmental changes. Social, legal, structural and other contextual factors increase vulnerability to HIV and obstruct access to HIV services. These factors include punitive legislation and policing practices, stigma, discrimination, poverty, violence, and high levels of homelessness in some groups.  

Epidemics of HIV in men who have sex with men continue to expand in most countries. By region, estimates of HIV prevalence among men who have sex with men range from 3% in the Middle East and North Africa to 25% in the Caribbean. In Kenya, the only African country with HIV incidence data, an annual incidence of greater than 20% was recently reported in Mombasa. Discriminatory legislation, stigma (including by health workers) and homophobic violence in many countries pose major barriers to providing HIV services for men who have sex with men and limit their use of what services do exist.  WHO (2016) provided 19 recommendations concerning key populations affected by HIV, some of these are:  

· The correct and consistent use of condoms with condom compatible lubricants  

· Availability of oral pre-exposure prophylaxis (PREP) containing tenofovir  disoproxil fumarate (antiretroviral therapy) should be offered as an additional prevention choice for key populations as part of or in combination with HIV prevention approaches  

· Post-exposure prophylaxis (PEP) (antiretroviral therapy) should be available to all eligible people from key populations on a voluntary basis after possible exposure to HIV

· People who inject drugs should have access to sterile injecting equipment through needle and syringe programs  

· Voluntary HIV testing and counselling should be routinely offered to all key populations both in the community and in clinical settings. This should be linked to prevention, care and treatment services  

· Key populations should have the same access to antiretroviral (ART) and to ART management as other populations. (WHO, 2016)  

Case Scenario 3 continued HIV/AIDS: an Australian perspective

In 1986, a not-for-profit organisation in urban Australia established an HIV/AIDs model of community nursing care. During this period there were no other models addressing the needs of people living with HIV/AIDs. In the model, specialist community nurses provide care to people living with HIV/AIDs with a focus on:

· Advocating for clients  

· Listening and helping clients through difficult times  

· Assessing and monitoring clients’ health  

· Providing clients, carers and family with education, advice and support to help  clients live with HIV/AIDS  

· Working with other healthcare providers to ensure clients receive the best care  

· Providing clients with a private and respectful service  

· Helping clients with medications  

· Connecting clients with other services or support groups  

· Providing some mental health and social work support  

· Providing care and support to refugees and asylum seekers who live with HIV  

· Assessing clients’ ability to remain at home or return to work  

· Supporting clients in achieving goals.  Specialist nurses are sensitive to issues around confidentiality, respect and empathy and will work with clients to overcome the effects of stigma and fear.  

Continuation of Case Scenario 3 HIV

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In the specialist HIV model in Australia, specialist community nurses provide care to people living with HIV/AIDs. This includes a focus on care and support for individuals living with HIV/AIDS such as in relation to: emotional support and encouragement, support to manage their own medications at home, health assessments and monitoring. These nurses also provide nursing care in relation to issues affecting the HIV/AIDS community and the Australian general community including: speaking to community groups regarding protecting against HIV/AIDS, education to community groups regarding harm minimisation, directly challenging stigma and discrimination through education to community groups and advocacy directly with politicians in government.

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Discuss how community nurses can use social inclusion and primary health care principles to protect and promote health for people at risk of exposure to HIV and for people living with HIV/AIDs.