The lived experience of AIDS-related multiple losses by HIV-negative gay men.

The gay male communities of the United States have experienced the most AIDS-related deaths over the longest period of time. The burden of grief for these men is unique and largely unaddressed in nursing research and practice. This phenomenological study explored the lived experiences of six HIV-negative gay men with AIDS-related multiple losses. The analysis of the interview data uncovered rich descriptions of the men's lives as uninfected gay males in the midst of an ongoing epidemic. The two overall themes that emerged from the narratives were the meaning of multiple losses and the management of the losses. The effects of AIDS-related losses permeated the lives of these men, resulting in significant emotional, psychological, physical, and spiritual challenges. Concerns for health promotion and disease prevention, and implications for nursing practice, research, and education are offered.

Grief work of HIV positive persons and their survivors.

Grief and bereavement following the death of a loved one present clients with significant challenges to the physical, emotional, and spiritual health and well-being. The grieving process for the person with HIV infection may be compounded by shame, stigma, and lack of social support. For communities with the highest prevalence of HIV infection, AIDS-related losses have resulted in mounting, and often overlapping, bereavements. Addressing the impact of these bereavements on the physical and emotional health of clients and their survivors is imperative to designing appropriate interventions to alleviate the potential adverse health outcomes associated with epidemic loss. Facilitating the grief work of HIV positive persons and their loved ones serves to assuage unhealthy sequelae, promote effective coping skills, and provide opportunities for personal growth.

Nurse-managed care for health care workers in southern Africa.

In Swaziland, the health care system is experiencing severe scarcity of health care workers (HCWs) due to difficult working conditions, migration and the human immunodeficiency virus (HIV) pandemic. Nurses and other HCWs in Swaziland are personally as affected by communicable diseases as the general population. High levels of HIV and TB co-infection bring added complexity to care. The loss of skilled staff in key positions has had a particularly negative impact on the quality of care and service delivery. The Swaziland Nurses Association (SNA) has established a Centre for Comprehensive Wellness for HCWs in the public and private sector and their immediate families to support the health workforce.