Donna W. Roberson

Factors Influencing Adherence to Antiretroviral Therapy for HIV-Infected Female Inmates

&NA; New HIV cases are increasing among women, especially women of color. Moreover, the rate of infection for incarcerated women is twice that of incarcerated men. With advances in medication therapy, HIV has become a chronic illness that can be successfully treated, provided the patient is able to achieve adherence with the prescribed antiretroviral medication regimen. Incarcerated women, however, frequently come from environments burdened with violence, substance and physical abuse, homelessness, child‐care issues, and mental illness. Such burdens negatively affect the ability of these women to adhere to the medication plan. This study explored incarcerated HIV‐infected womens barriers to and facilitators of adherence to antiretroviral therapy (ART), the role of health care provider relationships in adherence, and the ways in which issues of medical privacy influence ability or desire to adhere while incarcerated. A secondary analysis of an existing set of qualitative interviews with HIV‐infected female inmates was conducted.

The Robert Wood Johnson Foundation Nurse Faculty Scholars Program: An opportunity for junior nurse faculty

The Robert Wood Johnson Foundation Nurse Faculty Scholars program provides promising junior faculty extramural funding, expert mentoring, and the training needed to be successful in the academic role. The Nurse Faculty Scholars program, which admitted its first cohort in 2008, is designed to address the nursing faculty shortage by enhancing leadership, educational, and research skills in junior nursing faculty. This article provides an overview of the program, its purpose, and its eligibility requirements. The authors give strategies for selecting mentors, developing the written application, and preparing for an oral interview. Finally, the authors provide an analysis of funded institutions, research design and methods from current and recently funded projects, and rank and positions held by nursing mentors.

Meeting the HIV prevention needs of older adults

New HIV in the United States and worldwide is increasing among older adults over the age of 50. Older adults may not perceive their risk of acquiring HIV infection but have similar risk factors as younger people including unprotected sex, multiple sex partners, lack of knowledge about HIV and substance use/abuse. This paper reviews common problems associated with effective HIV prevention among older adults and offers a case study strategy with resources to address the important prevention needs of this population. Incorporating older adults in advertising images, use of peer counseling and routine healthcare provider screening, risk assessment and counseling may improve HIV prevention efforts among older adults.

Men Living With HIV and Experiencing Sexual Dysfunction: An Analysis of Treatment Options

&NA; Men living with HIV (MLWH), especially younger MLWH, may experience sexual dysfunction in greater numbers than men without HIV infection. This manuscript describes the prevalence of two major causative factors of sexual dysfunction in MLWH: hypogonadism and erectile dysfunction. A description of assessment and evaluation is presented. Additionally, the evidence for use of pharmacological and herbal therapies is presented with recommendations for treatment. MLWH who exhibit hypogonadism and/or erectile dysfunction should receive similar care to those without HIV infection. There is evidence to support the use of testosterone replacement therapy and phosphodiesterase 5 inhibitors in this population, and there is limited evidence for the use of certain herbs such as yohimbine. The ethics of treating sexual dysfunction for MLWH are discussed. A case study follows as an example of the application of evidence‐based treatments recommended for practice.

Inequities in screening for sexually transmitted infections in African American adolescents: can health policy help?

Although rates of sexually transmitted infections (STIs) in African Americans are higher than other populations, there are disparities in the screening and treatment of STIs for African American adolescents. Many African Americans distrust the health care system, resulting in a reluctance to seek health care. Adolescents may lack access to and the resources to pay for health care. This article reviews historical events believed to influence African American distrust of the health care system, discusses socioeconomic factors influencing adolescent access to services, and offers descriptions of services available to assist adolescents in receiving preventative services. Last, potential health policy solutions for nurses are noted.

Nicaraguan and US nursing collaborative evaluation study: Identifying similarities and differences between US and Nicaraguan curricula and teaching modalities using the community engagement model.

BACKGROUND Curricula evaluation is an essential phase of curriculum development. Study describes the implementation of a formative evaluation used by faculty members between Universidad Nacional Autonóma de Nicaragua (UNAN-Leon) Escuela de Enfermeriá, Nicaragua and East Carolina University College of Nursing (ECU CON) in North Carolina, US. OBJECTIVES Program evaluation study to conduct an assessment, comparison of a medical-surgical adult curriculum and teaching modalities. Also, explore the Community Engagement (CE) Model to build a Central American-US faculty partnership. DESIGN Methodological evaluation study utilizing a newly developed International Nursing Education Curriculum Evaluation Tool related to adult medical and surgical nursing standards. Also, the CE Model was tested as a facilitation tool in building partnerships between nurse educators. DATA Nicaragua and US nursing faculty teams constructed the curriculum evaluation by utilizing the International Nursing Education Curriculum Evaluation Tool (INECET) by reviewing 57 elements covering 6 Domains related to adult medical and surgical nursing standards. METHODS Developed, explored the utilization of the INECET based on a standard of practice framework. The Community Engagement Model, a fivephase cycle, Inform, Consult, Involve, Collaborate, and Empower was utilized to facilitate the collaborative process. RESULTS Similarities between the US and Nicaraguan curricula and teaching modalities were reflective based on the 57 elements covering 6 Domain assessment tool. Case studies, lecture, and clinical hospital rotations were utilized as teaching modalities. Both schools lacked sufficient time for clinical practicum time. The differences, included UNAN-Leon had a lack of simulation skill lab, equipment, and space, whereas ECU CON had sufficient resources. The ECU school lacked applied case studies from a rural health medical-surgical adult nursing perspective and less time in rural health clinics. The UNAN-Leon nursing standards generalized based on the Ministry of Health (MINSA) and the US program was specific based on the American Nurses Association and various sub-specialties of nursing practice requirements. The CE Model was a useful framework to facilitate a collaborative partnership. CONCLUSION Collaborative evaluation study using the International Nursing Education Curriculum Evaluation Tool can be an effective method to evaluate medical and surgical curricula similarities and differences within international nursing schools. The Community Engagement Model fostered a faculty partnership.

Enhancing nursing care by understanding the bariatric patient's journey.

Patients who undergo obesity-related bariatric surgery seek a lasting solution to weight loss and a desire for a healthier lifestyle. Perioperative nurses should be prepared to provide sensitive, high-quality care to this population. Effective assessment and management of bariatric patients involves understanding the motivating factors for seeking bariatric surgery, such as to address the stigma and health problems associated with obesity. Nurses should be knowledgeable about expected outcomes of bariatric care, including long-term processes and lifestyle changes that patients must participate in to sustain weight loss. The informed perioperative nurse is essential to the successful treatment of bariatric patients in their journey to healthier living.

Measuring HIV Knowledge Among Women Incarcerated in Jail.

Incarcerated women often have arresting behaviors that are also high risk for acquiring HIV, such as drug use and sex work. Little research has been done related to HIV knowledge among women in jail. This study assessed HIV knowledge among English-speaking women 18 years and older detained in a large, Southeastern jail (N = 202). HIV knowledge was assessed using the Brief HIV Knowledge Questionnaire. HIV knowledge scores were significantly lower among women over age 50, F(3, 195) = 7.39, p < .001; those with less than a high school education, F(2, 187) = 4.10, p = .018; and those with no history of sexually transmitted infections, F(1, 200) = 7.66, p = .006. Assessment of HIV knowledge among incarcerated women revealed a need for prevention education.

The Crisis of IRIS: What Every Nurse Should Know About Immune Reconstitution Inflammatory Syndrome in Patients Infected with HIV

&NA; Most health care providers are aware that beginning combination antiretroviral therapy (ART) for patients infected with HIV has reduced morbidity of AIDS‐related opportunistic infections and subsequently reduced HIV‐related mortality. Effective ART leads to significantly reduced viral loads and increased CD4+ T cell counts, especially in the first few months after initiation. ART stimulates immune system reconstitution, thereby reducing the risk of exacerbation or acquisition of an opportunistic infection.