More recently, it has been recognised that Asian-born men who have sex with men are over-represented in new HIV diagnoses in Australia (24-26). Gay male Asian students face many challenges and opportunities when they come to Australia – they may find that they experience a far greater level of freedom to explore their sexuality (having …
Partner notification refers to the process of informing the sexual partners of a person living with human immunodeficiency virus (HIV) (or other sexually transmissible infections (STIs)) that they are at risk of acquiring HIV or an STI, and they should seek testing and, if infected, treatment. Partners sharing injecting equipment may also be at risk of …
Early HIV diagnosis and treatment offer benefits including reduced morbidity and mortality, avoidance of hospital admission, prevention of HIV transmission and better quality of life through appropriate treatment, care, and support (9). Nurses working in a wide range of settings – sexual health, viral hepatitis and HIV, primary care, community health, custodial settings, the drug …
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Elizabeth Crock: Bolton Clarke HIV Program, Melbourne Acknowledgements: Donna Tilley: Western Sydney Local Health District, Sydney (first edition) This chapter introduces ethical principles and decision-making in practice and highlights key ethical issues that can arise in the care of people living with HIV. Introduction and background What is the purpose of nursing and midwifery ethics? Stigmatisation …
Ethical frameworks for nursing and midwifery practice provide guidance on identifying ethical issues, making ethical decisions, and taking action. The International Council of Nurses (ICN) Code of Ethics for Nurses is the guiding document for ethical decision-making for nurses in Australia (6). The code identifies ethical standards and values agreed to by the profession. It is …
The most profound ethical problem that arises in the field of HIV is stigma and its repercussions, and it therefore warrants addressing first. The word stigma comes from the Greek word meaning a mark of disgrace or shame (9). Stigmatisation can lead to discrimination resulting in unequal or unjust outcomes (10). HIV-related stigma is defined by the …
Stigmatisation and discrimination are barriers to people accessing HIV testing and treatment and are associated with poor mental and physical health outcomes (18). Fear of discrimination due to negative past experiences can deter people with HIV from accessing services. Stigma can also be internalised – a person feels shame about themselves (based on the stigma), …
There is a lack of high-quality evidence on reducing HIV-related stigma in healthcare, and a need for randomised controlled trials using validated instruments that can measure stigma and discrimination (18). Nyblade et al note that interventions to address HIV-related stigma in nursing and midwifery practice need to focus on individual, environmental and policy levels (19). …
Healthcare staff may claim they have a ‘right to know’ a patient’s HIV status to ‘protect themselves or others from infection’. There is no legal ‘right’ for a health professional to know a person’s medical diagnosis. Further, it is well established that the consistent use of Standard Precautions is the best way to protect staff …
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The principle of confidentiality is closely related to the concept of privacy and is both a legal and an ethical requirement (3). While laws about confidentiality and ethical obligations apply to people with all health conditions, confidentiality in HIV nursing and midwifery has acquired a greater significance, highlighting pre-existing weaknesses within the healthcare system. Ethical …