E D I T O R I A L

me Fminization of AlDs

n this issue, JOGNNbreaks with its traditional for- mat of presenting separate articles by publishing

a three-part series on the human immunodeficiency virus (HIV) and pregnancy. The series describes the expert care required by pregnant women with HIV disease and their infants.

If you are not already familiar with the changing face of the HIV epidemic in the United States, then you will learn that the disease is shifting away from white men toward minority women. Both the number and percentage of women with acquired immunodefi- ciency syndrome (AIDS) are increasing. If the demo-- graphic trends continue, AIDS will become the fifth leading cause of death among women of reproductive age in the United States. If you look through a wider lens, about 2 million women around the world are infected with HIV. It is estimated that, worldwide, the number of infected women may overtake the number of infected men by the mid-1990s (Kiereini, 1990).

While incidence and prevalence statistics help us define the magnitude of the epidemic, other statistics tell us that AIDS is more than a medical problem. There have been persistent reports that nurses are re- luctant to provide care to people with AIDS. For exam- ple, in one study of nursing students, 36% said they

would refuse to treat seropositive patients if given a choice (Wiley, Heath, & Acklin, 1988). In a large sur- vey of registered nurses, more than half of the respon- dents thought that nurses should have the right to re- fuse AIDS cases, and 23% indicated that they would refuse a job where they had to care regularly for AIDS patients (Van Survellen, Lewis, & Leake, 1988). These statistics measure the professional challenge that con- fronts us.

The public will look to health-care professionals for guidance and direction in responding to people with AIDS. Nurses need to contribute in areas where their expertise has always been strongest: finding the human faces and voices behind the statistics, balanc- ing personal risks with patients’ legal rights to health care, advocating for the afflicted, and increasing aware- ness among those at risk. Above all, it is our duty to provide competent and empathetic care. Women and infants with HIV disease will enter our practices in increasing numbers, and the public will judge nursing by our collective response. As nurses working with women and infants, let our response to the feminiza- tion of the AIDS epidemic be informed and compas- sionate.

Karen B. Haller, RN, PhD Editor

References

Kiereini, E.M. (1990). AIDS impact on women and children in Africa. International Nursing Review, 3 7, 373-376.

VanSurvellen, G. M., Lewis, E., & Leake, B. (1988). Nurses’ responses to the AIDS crisis. Implications for continuing education programs. Journal of Continuing Education in Nursing, 19, 4-8.

Wiley, K., Heath, L., & Acklin, M. (1988) . Care of AIDS pa- tients: Student attitudes. Nursing Outlook, 36, 244-245.

84 J O G N N Volume 21 Number 2