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Care of the Patient with HIV/AIDS

1 Contact Hour
Accredited for assistant level professions only
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This peer reviewed course is applicable for the following professions:
Certified Medical Assistant, Certified Nursing Assistant (CNA), Home Health Aid (HHA), Licensed Nursing Assistant (LNA), Medical Assistant (MA), Medication Aide
This course will be updated or discontinued on or before Friday, November 21, 2025

Nationally Accredited

CEUFast, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. ANCC Provider number #P0274.

Outcomes

 ≥ 92% of participants will know how to care for patients with HIV/AIDS.

Objectives

After completing this continuing education course, the participant will be able to:

  1. Define HIV/AIDS.
  2. Determine the rights of someone with HIV/AIDS.
  3. List the ways HIV is transmitted.
  4. Explain what to do after being exposed to blood.
  5. Describe the basic care often needed by HIV/AIDS patients.
CEUFast Inc. and the course planners for this educational activity do not have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
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Care of the Patient with HIV/AIDS
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Authors:    Alyssa King (DNP, APRN, CPNP-PC, PMHNP-BC, CLC, CNE) , David Tilton (RN, BSN)

What is HIV?

HIV is a virus, sometimes called a retrovirus. It can be caught and shared with other people.

For most viruses, our bodies respond by destroying the virus. Most viruses are destroyed by the body’s defender, the immune system. Unfortunately, HIV attacks and destroys the immune system. This leads the patients with HIV to have a suppressed immune system. Suppressed means the immune system does not work as well as it should.

The HIV virus is a fatal, person-to-person infection with no known cure whose final terminal stage is Acquired Immunodeficiency Syndrome (AIDS) (Myhre & Sifris, 2023). HIV and AIDS are the same disease, with AIDS being the final stage of the same viral infection right before death.

In the past few years, new medications have been developed that can extend the lifespan of an infected person by decades. So, HIV has changed from an acute terminal illness to a chronic, lingering condition requiring medication, monitoring, good nutrition, and care. Be aware HIV/AIDS remains a fatal disease.

Know the Rights of the HIV Patient

At times, our patients refuse to consider that they may have this disease because HIV is terrifying. This is a real and justified fear, given the history of HIV and AIDS in the United States and globally. HIV infection is a very serious medical condition, though no longer the sentence of an agonizing, wasting death that it was during the 1980s and 1990s. There are now medications that can slow the progression of the disease by years, even decades, in many cases.

Having HIV brings with it an unwanted stigma or a bad reputation. Federal laws exist, including the Rehabilitation Act of 1973 and parts of the 1990 Americans with Disabilities Act (ADA), to protect them from discrimination and to ensure that benefits such as social or medical services will not be withheld (HIV.gov, 2023c; Centers for Disease Control and Prevention [CDC], 2022b).

The Health Insurance Portability and Accountability Act (HIPAA) protects the privacy of health information. Information about HIV/AIDS cannot be discussed except with the care team members for that patient. You cannot discuss information about HIV/AIDS with family and friends unless the patient agrees to share the information (Badahman, 2023). HIPAA also allows the patient to see what is written about them and even ask to correct what is documented (Badahman, 2023).

Two Types of HIV

There are two significant varieties of the HIV virus. Both of these are spread through sexual contact, body fluids, or blood-sharing activities. When you hear HIV referred to without clarification as to the type, HIV-1 is being discussed.

HIV-1 (type 1) is more infectious and the primary cause of infection worldwide (Burgess, 2023; Seladi-Schulman, 2021).

HIV-2 (type 2) is less common, mainly appearing in West Africa (Burgess, 2023; Seladi-Schulman, 2021).

Both varieties of the HIV virus are treated the same way by CNAs and HHAs. There are differences in treatment by doctors.

HIV & AIDS is Common

According to the U.S. government website, HIV.gov, around 1.2 million Americans are currently infected with the HIV virus (HIV.gov, 2022b). Around 13% of them are unaware of their infection and infectious state. The following table includes a breakdown of the most recent HIV/AIDS statistics.

Table 1: HIV/AIDS Statistics

Latest StatisticsUnited StatesWorldwide
HIV annual new cases36,136

1,300,000

Total estimated living with HIV/AIDS

1.2 Million

39 Million

Annual HIV/AIDS deaths

15,810

630,000

(CDC, 2023; HIV.gov, 2023a; Myhre & Sifris, 2022a; HIV.gov, 2022b)

Gay, bisexual, and other men who have sex with men (MSM) of all races and ethnicities account for 71% of all new cases of HIV (HIV.gov, 2022b). Young to middle-aged Black American MSM remain the population most affected by HIV, accounting for around 30% of all new infections (HIV.gov, 2022b). Latinx MSM comes in second at around 20% of new infections, and white MSM amounts to about 15% of new infections (Myhre & Sifris, 2022a).

Another behavior warranting following by public health is the use of illegal injectable medications (CDC, 2023; HIV.gov, 2022a). In the United States, injection drug use in all sex and age groups accounted for around 7% of all HIV cases in 2020.

Transmission & Prevention of HIV Infection

Our HIV-positive patients can infect others unless they are careful. The understanding of how the HIV virus enters the body relates directly to the prevention of further cases of HIV.

HIV is tough, resilient, and currently impossible for the infected individuals’ body defenses to destroy. Outside the body, however, HIV is fragile and does not survive for long. Misleading rumors about the ease of viral spread have led the Centers for Disease Control and Prevention (CDC) to provide a list of ways HIV cannot be spread (CDC, 2021):

  • HIV cannot be spread in air or water
  • HIV cannot be spread by insects, including bed bugs, ticks, or mosquitoes
  • HIV cannot be spread in saliva, sweat, or tears, and no documented case exists of HIV being transmitted by spitting
  • HIV cannot be spread by casual contact, such as sharing dishes or shaking hands
  • HIV cannot be spread by closed mouth or social kissing
  • HIV cannot be spread from toilet seats

HIV can be transmitted when a person who has HIV-contaminated blood or another body fluid enters a puncture wound, open cut, or sore. This is called exposure. HIV is most often spread through anal or vaginal sexual activities. Male-to-male sexual contact, “men who have sex with men” (MSM), has several times the rate of sharing infection than dedicated heterosexuals.

HIV can also be spread during pregnancy, from mother to child, and during breastfeeding (Myhre & Sifris, 2022). Worldwide, this type of perinatal transmission accounts for most cases of childhood HIV and AIDS (Myhre & Sifris, 2022). HIV-contaminated fluid enters a break in the skin or mucous membranes that allows the virus to enter a person’s bloodstream, where the virus grows.

    The HIV patients we are caring for may continue sexual activities. Refer the patient to the nurse or doctor for education if they ask about the risk of transferring HIV to a sexual partner.

    Transmission of HIV can occur because blood and certain body fluids from a patient infected with HIV can be involved in the following (Sharkey, 2023):

    1. Needle sharing 
    2. Blood sharing rituals 
    3. Unsterilized equipment exposed to blood
    4. Improperly cleaned tools
      1. Cosmetic
      2. Body piercing
      3. Tattooing
      4. Manicure, pedicure

    Post-Exposure Prophylaxis (PEP)

    Report all exposures to the patient’s blood. An exposure is being stuck with a bloody needle or tool, getting splashed in the eye or mouth, or getting a patient’s blood in an open cut or sore.If that happens to you, wash the exposed area immediately. Then, report the exposure to the person in charge as soon as possible.

    A patient may test negative for HIV but still have HIV that is just not yet showing up on a test.

    PEP, or post-exposure prophylaxis, can be used in an emergency after a high-risk exposure (Huynh & Gulick, 2022). PEP is made up of anti-HIV or antiretroviral medications. Starting PEP as soon as possible after a potential HIV exposure is very important. Prevention of HIV infection involves taking antiretroviral medications as soon as possible. It is recommended to begin within three days of exposure.

    The Stages of HIV Infection

    Currently, there is no cure for HIV infection. Yet, with lifelong treatment, it is possible to slow the disease from progressing from one stage to the next.

    HIV infection has three distinct stages, as defined by the CDC:

    1. HIV Primary or Acute infection
    2. HIV Chronic or Asymptomatic infection
    3. HIV as AIDS

    The first stage can develop quickly with symptoms you might have if you have the flu, including generalized aches, headache, fever, and even a rash (Leonard, 2023; Myhre & Sifris, 2023).

    The second stage often includes the patient feeling and looking healthy without any symptoms.

    Acquired Immunodeficiency Syndrome (AIDS) is the final stage of HIV infection. AIDS occurs when the body’s immune system has been so severely damaged that the individual is highly vulnerable to diseases, infections, and even infection-related cancers.

    Care for the Complications of HIV/AIDS

    Common problems of individuals with HIV include:

    • Consistently taking medication
    • Avoiding other infections
    • Nutrition needs
    • Diarrhea
    • Nausea and vomiting
    • Sore mouth

    Medication Adherence

    Treatment for HIV and AIDS is medication-based.

    The correct blend of antiretroviral medications started early in the infection and continued daily throughout the course of the disease can extend the patient's life expectancy by decades. Be aware that, in general, HIV medication is harsh, causing stomach and bowel upset in many people. Undesirable and uncomfortable medication side effects, compounded by high prices and the sheer number of medications being taken, lead many to stop taking their life-extending medicines.

    Having someone to talk to, empathize with them, and encourage medication compliance makes a world of difference in many patients' lives.If you think someone is not taking their HIV medications, notify the RN. There are things the RN can do to help the patient regularly take their medications.

    Avoiding Other Infections

    Patients with HIV have suppressed immune systems. HIV causes our patients to catch infections that would not bother someone with a healthy immune system. The patient with HIV will also be sicker than someone with a healthy immune system, and simple infections can be fatal to some who have a suppressed immune system. Report any sign of fever, redness, or swelling to the RN.

    The care plan may include the following to help prevent infections:

    • Encourage and help achieve and maintain a clean, orderly environment and good personal hygiene
    • Avoid events or large groups of people during the cold and flu season
    • Make sure food is washed before preparation and cooked well
    • Avoid raw or undercooked eggs or meat
    • If a cat owner, keep pets indoors to minimize germs carried inside and have someone else handle kitty litter or dog waste
    • If a gym member, remind them to use a towel on shared equipment and a different towel to dry themselves
    • Reverse isolation

    Nutrition Needs

    HIV places the body under stresses that rob the body of the nutritional materials needed to maintain the best health possible. Pay attention to the patient’s diet and watch for lack of appetite. If you see a bad diet, notify the RN. She can do some things to help the patient and can make referrals to dieticians.

    A balanced, healthy diet will help to maintain a patient’s weight despite symptoms common to HIV that make nutrition difficult.

    The care plan may include the following to help with dietary needs:

    • Intake and output measures
    • Record food eaten (calorie count)
    • Smaller, more frequent meals
    • Frequent nutritional snacks 

    Good conversation during meals may distract from food aversion, and food that looks good can make eating a more positive experience. 

    During times when the patient has trouble moving around, be sure that both fluid and food are within easy reach.

    Diarrhea

    For many patients fighting the HIV virus, diarrhea is an unwanted gift that simply keeps on giving. During the AIDS stage of HIV, abdominal cramping with loose, watery stools is much too common. If diarrhea is new for your patient, notify the RN.

    The care plan may include the following to help with diarrhea:

    • Encourage patients to continue eating and drinking as best they can

    Nausea and Vomiting

    Some medications make nausea worse; others decrease nausea. Vomiting can quickly lead to dehydration, so encourage small, frequent sips of water, juice, or other fluids. If vomiting is new for your patient, notify the RN.

    The care plan may include the following to help with nausea and vomiting:

    • Having the person sit up when eating, even snacking
    • Drinking plenty of fluids after a meal
    • Remaining upright for one or two hours after eating
    • Try the odor of lemon peel or fresh oranges at the start of nausea to distract the body
    • Snack lightly on dry, salty carbohydrates such as crackers, pretzels, toast, or dry, unsweetened cereal

    Sore Mouth

    Having a sore mouth is a frequent situation once the HIV stage of AIDS gets worse. Mouth and swallowing pain make it difficult to eat and even take medication. If it is new for your patient to have a sore mouth, notify the RN.

    The care plan may include the following to help with mouth sores:

    • Cold fluids, chilled soups, chilled vegetable and fruit juices, or popsicles
    • Use a straw for drinking fluids
    • Smooth, moist, or soft foods are more palatable to a sore mouth
    • Toothpaste for sensitive mouths and/or rinsing the mouth with mouthwash for painful mouths

    Case Study

    Ryan is a patient in your unit currently. You notice that Ryan is very quiet, keeps to himself, and has no visitors. You have a few extra moments during your busy shift and sit down with Ryan to see if you can get him to open up.

    At first, Ryan is not interested in talking with you. You make a funny comment about the movie he is watching that you have seen before, and you notice he cracks a smile. Right before you walk out of the room to move on to check the vitals of your patient in the next room, Ryan speaks up.

    After some light, friendly conversation, Ryan tells you that he really does need someone to talk to because he has been shutting out his family and friends. Ryan shares with you that he was diagnosed with HIV about 6 months ago, and he is still having a hard time processing it all. He explains that his doctor wants him to take all of these medications, and he is feeling overwhelmed. He tells you that some of his medications are causing nausea and diarrhea, which is making his life so uncomfortable lately. He does not really understand why he has to take these medications if they are not going to cure him.

    What can you do?

    This is a great opportunity to sit and listen to this patient, even for a little while, or even for a bit with a promise to return when you have another moment to spend with him. This patient has received a life-altering diagnosis, he is afraid, and it sounds like he might be unsure about why he must take his antiretroviral medications. Ryan seems to be shutting his family and friends out, likely because he is not feeling well physically and/or emotionally, and he is struggling with his diagnosis. Having someone to talk to and empathize with them, however you can, can be so valuable. This is also a great time to encourage your patient to take his medications. It might be helpful to reach out to the RN and let them know that the patient could benefit from some additional patient teaching about their medication, the side effects, and why it is important to take. You can also let the RN know that Ryan is suffering from nausea and diarrhea that are really affecting his life. Based on what you know too, you can encourage Ryan to take small, frequent sips of fluids, try to eat smaller, more frequent meals, and maybe try snacking on dry, salty carbs like crackers or pretzels.

    Summary

    Your HIV-infected patients need you! HIV is a viral disease that those infected will have until they succumb to it in its final deadly stage of AIDS, or death comes first from another cause. There is no cure for HIV. It is very important for the CNA or HHA to carry out the care plan to make the patient feel better and keep the patient from worsening.

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    Implicit Bias Statement

    CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.

    References

    • Badahman, S. (2023). Does HIPAA provide special protections for HIV diagnosis/treatment? HIPAAtrek. Visit Source.
    • Burgess, L. (2023). Differences between HIV-1 and HIV-2. Medical News Today. Visit Source.
    • Centers for Disease Control and Prevention. (CDC). (2021). Ways HIV is not transmitted. Centers for Disease Control and Prevention (CDC). Visit Source.
    • Centers for Disease Control and Prevention. (CDC). (2022). State HIV laws. Centers for Disease Control and Prevention (CDC). Visit Source.
    • Centers for Disease Control and Prevention. (CDC). (2023). New HIV diagnoses and people with diagnosed HIV in the US and dependent areas by area of residence, 2021. Centers for Disease Control and Prevention (CDC). Visit Source.
    • HIV.gov. (2022a). HIV care continuum. HIV.gov. Visit Source.
    • HIV.gov. (2022b). U.S. statistics. HIV.gov. Visit Source.
    • HIV.gov. (2023a). The global impact of HIV and AIDS? HIV.gov. Visit Source.
    • HIV.gov. (2023b). What are HIV and AIDS? HIV.gov. Visit Source.
    • HIV.gov. (2023c). What laws protect people with HIV or AIDS from discrimination? HIV.gov. Visit Source.
    • Huynh, K., & Gulick, P. (2022). HIV prevention. NIH National Library of Medicine. Visit Source.
    • Leonard, J. (2023). HIV timeline: What are the stages? Medical News Today. Visit Source.
    • Myhre, J., & Sifris, D. (2022). HIV facts and statistics: What you need to know. VeryWell Health. Visit Source.
    • Myhre, J., & Sifris, D. (2023). What is HIV/AIDS? VeryWell Health. Visit Source.
    • Seladi-Schulman, J. (2021). How many HIV strains, types, and subtypes are there? HealthLine. Visit Source.
    • Sharkey, L. (2023). Can you contract HIV through oral sex? HealthLine. Visit Source.