The changing HIV/AIDS epidemic. Emerging psychosocial challenges for nurses.

Several changes in the map of the HIV epidemic have important implications for psychiatric-mental health nurses. Increasingly women and children, members of ethnic minority groups, injection drug users, and sex workers--seen as economically and politically disadvantaged, disenfranchised, and marginalized by the larger society--are feeling the effects of HIV and AIDS. These groups of people, representative of the "new AIDS epidemic," are loosely organized and have few resources and advocates. Themes of loss, stigma, prejudice, and discrimination take on added meaning for these groups now bearing the brunt of the HIV-AIDS epidemic. Nurses can assume a stance of advocacy to ensure that these persons' voices are heard and that their needs are addressed through changes in public policy, funding, research and health care access. Psychiatric-mental health nurses also are in an excellent position to provide efficacious, cost-effective mental health services to infected clients who look to them for professional care, which must necessarily include compassion, understanding, and emotional support within individual and group contexts. Through direct care, care management, networking, support, and referral, psychiatric-mental health nurses can positively influence the quality of HIV-infected persons' lives.