The Care System Assessment Project: values-based health care planning and delivery.

This is a commentary on the Care System Assessment (CSA) Project, utilizing a values-based health care framework to review the process undertaken by the three participating Ryan White CARE Act grantee sites. The CSA Project participants' dedication to the well-being of their communities reinforced the inclusion, active involvement, and participation of all stakeholders. That key community members had previously chosen not to participate in planning efforts or seek care because of stigma and fear in new immigrant populations was noted by all three sites as a major issue to address in their future planning. The sites selected for the CSA Project demonstrated that community-based Planning Councils, engaged with representatives from the target population, can assess, identify, and provide effective interventions sensitized to the needs of underserved, resilient clients. They also demonstrated that meeting these needs to enhance the common good of the community may require an increased respect for diversity. The CSA Project is one leadership exemplar of providers and clients coming together to find the common good of quality health care for people living with HIV and AIDS These grantee providers and their clients are intimately engaged in this paradigm shift and are taking the lead to redefine the type of health and support services they must provide within the context of the U.S. health care system.

HIV/AIDS in correctional settings: a salient priority for the CDC and HRSA.

Correctional facilities constitute an excellent opportunity to provide treatment, care, and prevention services for a population that may not otherwise access these services. The Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) recognize the public health importance of correctional settings and have begun to develop formal strategies to address the HIV/AIDS-relevant needs of incarcerated individuals. The Centers for Disease Control and Prevention and HRSA have implemented policies, activities, and strategic plans to reduce the HIV/AIDS disease burden among the high-risk populations that pass through the nation's prisons and jails. They have also collaborated to address the HIV/AIDS needs of incarcerated populations and have initiated processes for expanding collaboration on these issues to include other federal agencies and prevention partners.

Quality of life in the HIV-positive patient: implications and consequences.

Many individuals newly infected with HIV struggle with psychosocial influences, such as poverty, stigma, depression, substance abuse, domestic violence, and/or cultural beliefs, which can affect their quality of life (QoL), willingness to seek medical care, and motivation to adhere to therapy, ultimately influencing health outcomes. The Health Resources and Services Administration established the Ryan White Care Act (RWCA) to provide health care to people living with HIV/AIDS (PLWH). Part F of the RWCA, the Special Projects of National Significance (SPNS) Program, focuses on identifying issues affecting care for PLWH. One cohort of SPNS grantees has identified numerous needs and vulnerabilities of underserved HIV-infected patients and supports the development of innovative HIV/AIDS ancillary services for them. In this article, a review of the underlying psychosocial sequelae of HIV infection and their impact on QoL is presented, and recommendations for providers to assist in improving the QoL of PLWH are discussed.

The Nursing Education Partnership Initiative (NEPI): innovations in nursing and midwifery education.

The nursing and midwifery workforce is key to improving the performance of the health system overall. Health workforce shortages are significantly influenced by the productive capacity of health professions education institutions. Long-standing underinvestment in preservice nursing and midwifery education severely limits the capacity of institutions to educate nurses and midwives in sufficient numbers, and with the necessary clinical skills, for current and anticipated population health needs. The Nursing Education Partnership Initiative (NEPI) was established in 2011 by the U.S. President's Emergency Plan for AIDS Relief in response to key capacity-building challenges facing preservice nursing and midwifery education in Sub-Saharan Africa. NEPI has formed partnerships with governments and key stakeholders in Ethiopia, Democratic Republic of Congo, Lesotho, Malawi, and Zambia and supports 19 nursing and midwifery education institutions and 1 nursing council. NEPI has been informed by activities that strengthen education systems, institutions, and organizations as well as faculty capacity building. Ministry of health-led advisory groups were established to provide strategic direction and oversight for the work, fostering intersectoral dialogue and ensuring country ownership and sustainability. Three illustrative examples of innovations at the system, institution, and workforce levels describe approaches for country ownership, for addressing the shortage of highly qualified faculty, and for remedying the inadequate teaching and learning infrastructure.

Essential nursing competencies related to HIV and AIDS: Executive summary.

With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug-drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of taskshifting, task-sharing, and scope of nursing practices.

Essential nursing competencies related to HIV and AIDS.

With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug-drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of task-shifting, task-sharing, and scope of nursing practices.