There are vast differences between HIV nursing models nationally and internationally due to epidemiological variability, differences in health system infrastructure including the scope of nursing practice and access to resources worldwide. The models of care that exist reflect the need of the population they were developed for and change according to the needs of that population.    

International models of HIV nursing care are similar in resource rich settings to the models existing in Australia, as demonstrated by the translation of HIV and sexual health guidelines from the United Kingdom into an Australian context. (9) These include similarities in access to care through hospital, outreach and collaborative care models and an emphasis on holistic HIV treatment and prevention with the contribution of nurses from all levels of practice highly valued (10-12). Nurse practitioners and nurse prescribers are well established in the HIV sector in Canada, the United States of America, and the United Kingdom, with pioneering HIV nurse practitioners from the UK first practising during the height of the AIDS crisis in the 1990’s (13). Advanced practice roles have taken longer to develop in the Australian context, and this may perhaps be more reflective of barriers imposed by State- based nursing legislation and the structural barriers to nurse practitioner expansion more broadly, such as perceptions around cost-effectiveness and fit within the existing healthcare framework, rather than the HIV sector itself. (14)  

Just as in resource-rich settings, resource-poor settings typically operate in collaborative care models, although the nuances between the models vary and appear largely driven by workforce shortages and a corresponding focus on task-shifting, and an economic imperative in resource-poor settings. This, coupled with the challenges associated with patients lost to follow-up, political instability, food insecurity, co-infection with malaria, tuberculosis and other infectious diseases, and limited access to HIV treatment and prevention strategies equate to a vastly different and challenging nursing environment. (15) Task shifting, or the up-skilling of non-physician healthcare workers, has been identified as an effective and economically viable way to manage the human resources crisis affecting HIV care in resource-poor countries in sub-Saharan Africa. (16)(17) This practice extends to up-skilling nurses to nurse practitioner-type roles, and community health workers to undertake nursing duties to increase access to HIV treatment, care, and prevention strategies. (18)  

With the human resources crisis affecting health care in resource-poor settings only further exacerbated by the advent of the COVID-19 pandemic, and ever ever-more present reality of global warming and the subsequent threat of mass population displacement, there will surely be a role for Australasian nurses to develop and strengthen relationships with nurses in resource-poor settings to support the HIV treatment and prevention scale-up efforts already in place. (19-22).