Table Of ContentJerry D. Durham, Ph.D, R.N., F.A.A.N., is
professor and dean of the Barnes College
of Nursing at the University of Missouri at
St. Louis. Dr. Durham has earned six uni-
versity degrees, including three in nursing
and a doctorate in higher education admin-
istration. In addition to his role as an educa-
tor, he has held positions as a staff nurse,
clinical manager, private practitioner in
mental health nursing, and consultant in
education and research. He was among the
first researchers to investigate the nature
of private practice in psychiatric nursing.
He has received two fellowships in ethics from the National Endow-
ment for the Humanities. In addition to The Person with HIV/AIDS:
Nursing Perspectives, Dr. Durham has coedited Women, Children and
HIV/AIDS (1993), as well as The Nurse Psychotherapist in Private Practice
(1987). Together, these three books received five American Journal
of Nursing Book-of-the-Year Awards. Dr. Durham also served as coedi-
tor of Tuberculosis: A Sourcebook for Nursing Practice, which was selected
as a "Best Book of 1995" by Nurse Practitioner. He serves as a reviewer
for several nursing journals and is a member of the editorial board of
the Journal of Psychosocial Nursing. Dr. Durham chaired the Education
Committee of the Association of Nurses in AIDS Care.
Felissa R. Lashley, Ph.D, R.N., A.C.R.N.,
F.A.A.N. (formerly Felissa L. Cohen), is
professor and dean of the School of Nurs-
ing, Southern Illinois University, Edwards-
ville. She is also clinical professor of
pediatrics at the School of Medicine, South-
ern Illinois University, Springfield. Dr.
Lashley previously served as professor and
head of the Department of Medical-Surgi-
cal Nursing at the University of Illinois at
Chicago (UIC) College of Nursing, clinical
chief for Medical-Surgical Nursing at the
University of Illinois at Chicago Medical
Center, and associate professor, Department of Genetics, School of
Medicine, UIC. Dr. Lashley received her doctorate in human genetics
with a minor in biochemistry from Illinois State University. She is
certified as a Ph.D. medical geneticist by the American Board of
Medical Genetics (the first nurse to be so certified) and is a founding
fellow of the American College of Medical Genetics. Dr. Lashley
began her practice of genetic evaluation and counseling in 1973.
She has authored more than 200 publications including Clinical
Genetics in Nursing Practice, which received a Book-of-the-Year Award
from the American Journal of Nursing in its first edition, as have two
of her other books. She was a coeditor of the Association of Nurses
in AIDS Care's Core Curriculum for HIV/AIDS Nursing. Dr. Lashley is
a distinguished lecturer for Sigma Theta Tau International and an
associate editor of the journal IMAGE: The Journal of Nursing Scholar-
ship, as well as a fellow of the American Academy of Nursing. She
was the first nurse to serve on the AIDS Research Review Committee,
National Institute of Allergy and Infectious Diseases (NIH), and was
a member of the Priority Expert Panel B HIV Infection: Prevention
and Care, National Center of Nursing Research. She was a member
of the HIV Nursing Clinical Advisory Committee of the National
AIDS Education and Training Centers, HRSA Bureau of Health
Professions, and was a co-project director and co-investigator of the
award for the Midwest AIDS Training and Education Center. She is
an active member of the Association of Nurses in AIDS Care and
has served as chair of the Nominating Committee. She is president-
elect and a member of the board of directors of the HIV/AIDS
Nursing Certifying Board.
The Person with
HIV/AIDS
Third Edition
Nursing Perspectives
Jerry D. Durham
PhD, RN, FAAN
Felissa R. Lashley
PhD, RN, ACRN, FAAN
Editors
Springer Publishing Company
Copyright © 2000 by Springer Publishing Company, Inc.
All rights reserved
No part of this publication may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without the
prior permission of Springer Publishing Company, Inc.
Springer Publishing Company, Inc.
536 Broadway
New York, NY 10012-3955
Acquisitions Editor: Ruth Chasek
Production Editor: Helen Song
Cover design by James Scotto-Lavino
Library of Congress Cataloging-in-Publication Data
The person with HIV/AIDS : nursing perspectives /Jerry D. Durham
and Felissa R. Lashley, editors.—3rd ed.
p. cm.
Rev. ed. of: The person with AIDS. 2nd ed. c1991.
Includes bibliographical references and index.
ISBN 0-8261-1293-5 (hardcover)
1. AIDS (Disease)—Nursing. I. Durham, Jerry D. II. Lashley,
Felissa R., 1941- . III. Person with AIDS.
[DNLM: 1. Acquired Immunodeficiency Syndrome—
nursing. 2. HIV Infections—nursing. WY 153.5 P467 1999]
RC607.A26P47 2000
610.73'699—dc21
DNLM/DLC
for Library of Congress 99-16258
CIP
Printed in the United States of America
To Kathy, whose kindness, love, and understanding have sustained our
lives together.
Jerry D. Durham
To my wonderful and growing family—Pete, Julie, and Benjamin; Neal and
Anne; Heather; my mother, Ruth Lashley; and my friend Tony Oliver.
Benjamin, may you grow up in a world where HIV disease no longer exists.
Felissa R. Lashley
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Contents
List of Tables ix
List of Figures xi
Con tribu tors xi
Preface xv
1. The Etiology, Epidemiology, Transmission, and
Natural History of HIV Infection and AIDS 1
Felissa R. Lashley, R.N., Ph.D., A.C.R.N, F.A.A.N.
2. The Pathogenesis of HIV Infection 75
Janice M. Zeller, R.N., Ph.D., F.A.A.N.
Barbara Swanson, R.N., D.N.Sc., A.C.R.N.
3. Preventing HIV Infection 97
Barbara Burger, R.N., Ph.D., A.C.R.N.
Vida M. Vizgirda, R.N., M.S.
4. Promoting Wellness in Persons with HIV Infection 139
Susan L. Keller, R.N., M.S.
5. The Clinical Spectrum of HIV Infection and Its
Treatment 167
Felissa R. Lashley, R.N., Ph.,D., A.C.R.N., F.A.A.N.
6. Symptom Management in HIV/AIDS 271
AnthonyJ. Admolfi, R.N., M.S.N., A.N.P., A.C.R.N.
7. The Medical Treatment of HIV Disease 311
Susan L. Wightman, R.N., B.S.N., A.C.R.N.
Michael K. Klebert, R.N., M.S.N., AMP.
8. Principles of Infection Control 351
Barbara Russell, R.N., M.P.H., C.I.C., A.C.R.N.
vii
viii CONTENTS
9. Testing and Counseling 369
Richard S. Ferri, R.N., Ph.D., A.N.P., A.C.R.N.,
F.A.A.N.
10. Principles of HIV/AIDS Case Management 387
Demetrius Porche, R.N., D.N.S., C.S., C.C.R.N.
11. HIV Infection in Women 401
Mary Jo Hoyt, R.N., M.S.N., F.N.P.
Susan Holman, R.N., M.S., A.N.P.
12. HIV Disease in Children 429
Wendy M. Nehring, R.N., Ph.D.
13. Minorities Living with HIV Infection/AIDS: Stories
and Practical Strategies 511
Barbara Aranda-Naranjo, R.N., Ph.D.
14. Ethical and Legal Dimensions 523
Jerry D. Durham, R.N., Ph.D., F.A.A.N.
Appendix I: Considerations in Caring for Persons after Potential
Nonoccupational Exposure to HIV When Data Are Inadequate 551
Appendix II: Prophylaxis for First Episode of Opportunistic Disease
in HIV-Infected Adults and Adolescents 55 7
Appendix III: Prophylaxis for Recurrence of Opportunistic
Disease (After Chemotherapy for Acute Disease) in HIV-Infected
Adults and Adolescents 563
Appendix TV: Advising Patients Concerning Prevention of Exposure
to Oportunistic Pathogens 567
Appendix V: Selected Sources of Information on the World
Wide Web 57
Index 585
List of Tables
1.1 1992 Revised classification system for HIV infection
and expanded AIDS surveillance case definition for
adolescents and adults 4
1.2 Clinical categories 5
1.3 Conditions included in the 1993 AIDS surveillance
case definition 6
1.4 Selected common epidemiological definitions 7
1.5 U.S. AIDS cases by age at diagnosis reported to CDC
through December, 198 3
1.6 Reported AIDS cases worldwide as of June 20, 1998 39
1.7 Adults and children living with HIV/AIDS worldwide,
December, 198 39
1.8 United States adult/adolescent AIDS cases by
exposure category as reported to CDC through
December, 198 45
1.9 Pediatric AIDS cases in the United States as reported
to CDC through December, 198 46
3.1 Proper use of condoms to prevent sexual transmission
of HIV 105
4.1 Living with HIV disease: A summary of research on
health promotion 150
5.1 Selected opportunistic infections and conditions fre-
quently associated with CD4+ cell count categories 170
5.2 Selected HlV-related central nervous system disorders 229
5.3 Early symptoms of AIDS dementia complex/HIV-
asociated dementia 229
5.4 Clinical staging of the AIDS dementia complex 231
5.5 Selected HIV-related gastrointestinal disorders 239
5.6 Major oral disorders manifested in HIV infection 242
5.7 Selected cutaneous manifestations seen in HIV
infection 245
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