Silverchain nurses stand by people with HIV

World AIDS Day is on 1 December. As many parts of the world face disruption to the funding of HIV-related treatment and research, four Silverchain nurses in South Australia continue to support people living with HIV. Angela Rutland, a Clinical Practice Consultant in the HIV team shared that while today’s treatment for HIV is simple, there’s nothing simple about living with HIV. When Angela lost contact with a client who was living a particularly chaotic lifestyle, it was the client’s belief in Angela that led the client to reach out to Angela.

Treatment for HIV is primarily antiretroviral therapy, which is highly effective when taken consistently. Silverchain clients who live with HIV in South Australia rely on our nurses for support and access to treatment.

As a Clinical Practice Consultant in one of South Australia’s longest running HIV support programs, Angela Rutland has been a frontline witness to these changes.

“Our service started as a palliative care service for those who were dying from HIV related infections. That was the reality back then: if you were diagnosed with HIV, it was a life limiting condition. You also needed to take multiple medications that had unpleasant side effects,” Angela said.

“Treatments have improved vastly since then. Now, this is seen as a chronic illness that is quite manageable. It’s absolutely possible to live with HIV and have it completely undetectable in the blood, with no risk of transmission. Women on treatment can give birth naturally with no risk of their baby having HIV.

“It just takes one tablet a day, or there’s a long-acting injectable treatment which lasts two months. Some clients love the injection because there isn’t a daily reminder that you have HIV,” Angela said.

With such a simple treatment regime, you could be forgiven for thinking people don’t need our nurses. Unfortunately, there are still many factors that mean not only are our nurses important, but they also often have to go above and beyond to support their clients.

“Our clients’ circumstances range enormously. Some are vulnerable people who live a chaotic lifestyle; some regularly have multiple sexual partners; others are intravenous drug users. Others have lived with HIV for decades and live a very normal lifestyle. It’s important not to assume. One client is in his 60s and initially contracted HIV as a result of a blood transfusion.

“Often the psychological support we provide our clients is a huge part of what we do. At times, our team of four nurses can feel like we must be counsellors, case workers, even sometimes mothers,” Angela said.

This need for psychological support can often stem from the cultural and societal implications of living with HIV.

“Many of our clients come from a culturally and linguistically diverse background. We have overseas students who discover they’re HIV positive as part of the visa application process. You can imagine the shock,” Angela said.

“In certain multicultural groups, the stigma of living with HIV is still very present. Broadly, there’s less stigma and discrimination, but it’s still there. Even within themselves, our clients feel the stigma.”

This leads to discretion being a core part of our service and another example of our nurses doing whatever it takes to support their clients.

“You can imagine if you’re living with HIV in a share house; you may not want people to know. So, we meet our clients anywhere. We have unbranded cars. And if a client needs us to drop their medication at their door, we do.”

It’s this approach that has made a difference in some of the most challenging circumstances.

“At times, we’ll keep clients on our books, knowing it’s extremely important, because this person needs us to just remain in their lives.

“A recent example was when I received a phone call from a client who had disengaged with all services, including her doctor. We were trying everything – we’d contacted her father, and mother, she had a NDIS social worker, and they had also lost contact.

“And then she called me, saying that she’d moved and had a house and she needed tablets. She had kept my contact number in an email even though she had changed mobiles a number of times.

“I just think that’s a really positive outcome that she reached out. We were able to get her treatment and let her other support people know,” said Angela.