Gaining insite: harm reduction in nursing practice.

Insite, a supervised injection facility in Vancouver, British Columbia, is an evidence-based response to the ongoing health and social crisis in the city's Downtown Eastside. It has been shown that Insite's services increase treatment referrals, mitigate the spread and impact of blood-borne diseases and prevent overdose deaths. One of the goals of this facility is to improve the health of those who use injection drugs.

Predicting hospitalization among HIV-infected antiretroviral naïve patients starting HAART: determining clinical markers and exploring social pathways.

In the era of highly active antiretroviral therapy (HAART), hospitalization as a measure of morbidity has become of increasing interest. The objectives of this study were to determine clinical predictors of hospitalization among HIV-infected persons initiating HAART and to explore the impact of gender and drug use on hospitalization. The analysis was based on a cohort of HIV-positive individuals initiating HAART between 1996 and 2001.

The ethical, legal and social context of harm reduction.

Harm reduction is part of a comprehensive approach to dealing with the harms of drug use. Although the evidence to support implementation of harm reduction strategies for illicit drug use is abundant, it is unlikely that scientific knowledge alone will be enough to facilitate the adoption of harm reduction strategies in many health-care settings. The authors examine the ethical, legal and social context of harm reduction as it pertains to illicit drug use to assist nurses in providing safe, competent and ethical care.

"Being dealt with as a whole person." Care seeking and adherence: the benefits of culturally competent care.

The purpose of this study is to characterize the relationship between identity and health care experiences (including antiretroviral therapy utilization) among HIV-positive sexual minority males. This qualitative study used grounded theory with data collection occurring through focus groups and interviews. A questionnaire was used to complete a demographic profile.

Teaching about HIV/AIDS: the lessons learned.

To learn and teach about HIV/AIDS is to enter complex and sensitive territory that at times may be personally challenging. In the vast literature on HIV infection and nursing two main themes recur: nurses' lack of understanding, negative attitudes and anxieties related to HIV/AIDS and the need for education to change such attitudes and enhance nurses' knowledge and skills.

Heterogeneity of care for HIV-infected individuals decreases with the physician knowledge.

In order to gain an understanding of the determinants of clinical management of HIV disease in adults just prior to the introduction of comprehensive guidelines, we undertook the present study among members of the British Columbia Persons with AIDS Society (BCPWA). The aim of this study was to examine whether the heterogeneity of care for HIV-infected individuals decreases with physician knowledge of HIV/AIDS and the stability of the physician-patient relationship. Eligible participants had to be full members (i.

Access to health care and geographic mobility of HIV/AIDS patients.

Objective: To determine the patterns and determinants of mobility in persons with HIV infection or AIDS on a population basis.

Design: Descriptive cross-sectional population health study.

Target Population: 650 full members (i.

Patterns of care in advanced HIV disease in a tertiary treatment centre.

A retrospective chart review of all in-patient deaths in 1992 was undertaken to examine patterns of care in advanced HIV disease at St Paul's Hospital, Vancouver, Canada. St Paul's Hospital cares for approximately 75% of the Province of British Columbia's AIDS caseload. This represents about 18% of Canada's caseload.

Impact of HIV infection and AIDS on death rates in British Columbia and Canada.

Objective: To assess the impact of HIV infection and AIDS on death rates in British Columbia and Canada.

Design: Descriptive, population-based study.

Setting: British Columbia and Canada.

Trends in hospital utilization in AIDS care 1987-1991: implications for palliative care.

St. Paul's Hospital, Vancouver has the largest Canadian experience of the care of persons with HIV/AIDS. This article reviews St.