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Position Statements and Resolutions

ANAC expresses and communicates our Policy Agenda through the development and dissemination of position statements and papers.  Click here to read ANAC's 2012-2013 Policy Agenda.

Below is a summary of ANAC's current position statements and resolutions.  You may download the full text of each position statement by clicking on the title of the position statement.

Position Statements

Adolescents and HIV Infection

      It is the position of ANAC that:

  • adolescents require screening for HIV as a part of routine health care in order to initiate care earlier in the infection trajectory;
  • adolescents have a right to access the full spectrum of HIV care, including prevention and harm reduction services, comprehensive reproductive health services, treatment of HIV and adherence support, and clinical trial opportunities;
  • adolescent services must be developed that are adolescent-centered, culturally competent and provide seamless transitioning into the adult health care system

Advanced Practice Nurse Prescriptive Authority of Buprenorphine

      It is the position of ANAC that:

  • Qualified advanced practice nurses should be allowed to prescribe buprenorphine for the treatment of opioid dependence;
  • The Drug Addiction Treatment Act of 2000 (DATA 2000) should be amended to allow qualified advanced practice nurses to prescribe buprenorphine; and,
  • Granting prescriptive privileges for buprenorphine to advanced practice nurses will increase patient access to substance use treatment.
     

Black Men Who Have Sex With Men at Risk for HIV/AIDS

     It is the position of the Association of Nurses in AIDS Care that:
 

  • The health care rights of Black men who have sex with other men (Black MSM) must be supported.
  • HIV and AIDS pose a significant risk to Black MSM’s.
  • Black MSM’s require access to the full spectrum of care and prevention.  
  • Services must be developed that are Black MSM specific and culturally appropriate.
  • Prevention interventions must be developed that are not only culturally appropriate but indigenous to the Black MSM population.
  • Resources (financial and human) specifically targeting the Black MSM population must be made available at the national, state, and local levels.
  • Racism, homophobia, stigma, and sexual objectification all impact the healthcare of Black MSM and must be acknowledged and addressed when working with this population.
  • Governmental agencies such as the CDC and NIH should continue to consult with informants indigenous to the Black MSM community for feedback and planning strategies related to HIV/AIDS.

CDC Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health-Care Settings

     It is the position of the Association of Nurses in AIDS Care that:

  • Voluntary counseling and testing, with referral, is an appropriate mechanism to screen for cases of HIV infection in order to provide appropriate and early care for those with HIV disease.  It also serves to provide prevention messages for both infected and uninfected individuals.  Ths is should be part of all routine health care.
  • All medical care requires consent.  Informed consent for HIV testing must involve more than an agreement with, conformity to, compliance with, or otherwise failure to reject the plan or proposal of a healthcare provide to perform the test.
  • Requirements for informed consent for HIV testing should, at minimum, require the person ordering the test to inquire openly about the patient's individual understanding and misconceptions about an HIV test.
  • New testing models should be explored and implemented when proven effective in order to reach a greater number of those at risk for HIV.
  • Results of an HIV test must be delivered confidentially in person so that the patient understands the meaning of the test result, whether positive or negative.  All patients who receive HIV positive test results should be linked into an appropriate system of care, and the provider should offer the patient information about accessing care and treatment as well as prevention information to avoid further transmission of the virus.

Discrimination Protections for People with HIV Infection

     It is the position of ANAC that:

  • People living with HIV infection are entitled to equal opportunities for education, employment (including career advancement), transportation, public accommodation and public services (including access to health insurance and health care services).
  • Nurses have a moral, legal and professional responsibility to care for all persons, with or without HIV infection.
  • Healthcare personnel living with HIV infection have a right to continue working as healthcare providers and to be assured of confidentiality about their HIV status in all cases.
  • Healthcare workers with HIV infection should not be required to disclose their HIV status to patients.

Domestic Partnership Benefits

     It is the position of ANAC that:

  • Since many HIV-infected persons live in partnerships other than marriage, domestic partnerships should be recognized.
  • Domestic partnerships are entitled to the same rights afforded married couples including but not limited to insurance coverage, hospital visitation and medical decisions, rights of survivorship, sick and bereavement leave, immigration rights/sponsorship, Federal and state tax benefits, and adoption rights and responsibilities.

Early Treatment for HIV Act (ETHA)

     It is the position of ANAC that:

  • Legislators support and pass ETHA.
  • Funds for ETHA are not taken away from other existing programs.
  • ETHA cannot replace the Ryan White HIV/AIDS Treatment Modernization Act
  • Provisions be made that ensure all states will partake in ETHA.

Health Disparities

    It is the position of the Association of Nurses in AIDS Care that:

  • There should be access to equitable HIV specialty care and general health care for all people.
  • Culturally and linguistically appropriate services should be integrated throughout an organization and in collaboration with the communities served. 
  • Cultural differences will exist but providers and patients should create an environment based on trust and honesty to dialogue about differences and share similarities.

HIV Risk Assessment and Risk Reduction Education

     It is the position of the Association of Nurses in AIDS Care that:

  • Routine HIV risk assessment be incorporated into all nursing assessments regardless of any perceived risk on the part of the nurse, and that
  • Plans of nursing care include HIV prevention and risk/harm reduction education and interventions as appropriate.
  • Nurses acquire updated training in evidence based prevention strategies to best assist their patients in developing a tailored risk/harm reduction plan.

The Impact of Political Extremism on HIV-Related Research

  • It is a moral imperative that NIH continues to support scientists in the conduct of scientifically sound and unbiased research critical to the development and testing of interventions for people with HIV.
  • The peer review and funding process of the NIH must continue without political or ideological interference.
  • Nurses have an ethical obligation to educate and lobby the public, state, and federal elected officials as to the benefits of and need for unbiased and scientifically sound resarch to provide treatment for and prevent the spread of HIV.

NEW - Joint Position Statement on Universal Access to Anti-HIV Medications

The Association for Nurses in AIDS Care (ANAC), International Association of Forensic Nurses (IAFN), National Alliance to End Sexual Violence (NAESV), and National Sexual Violence Resource Center (NSVRC) released a policy statement today, recommending that systems be established to ensure that survivors of sexual assault have universal access to medications to prevent HIV following rape.  In too many communities, access to these medications is lacking or inconsistent.  It is our joint position that:

  • Health care providers treating sexual assault patients include HIV risk assessment and potential prophylaxis as a standard component of the   medical-forensic examination.
  • Anti-HIV medications be available where and when patients present after sexual assault.
  • People who have been sexually assaulted not be expected to carry the financial burden for HIV nPEP.
  • People who have been sexually assaulted have access to advocacy and supportive services before, during and after HIV testing and nPEP provision.

Medical Use of Marijuana

  • Funding for research through federal funding sources is required to determine the safety and efficacy of marijuana as a therapeutic intervention for a variety of sympotoms in HIV/AIDS and other diseases.
  • Healthcare personnel (HCP) should not be threatened, penalized or otherwise intimidated for discussing and/or recommending the medicinal use of marijuana.
  • HCP should not be asked to report patients/clients using marijuana for medical purposes to any law enforcement agency.
  • Individuals shoul not be prosecuted for medicinal use of marijuana.

Pain Management for Persons Living with HIV/AIDS

    It is the position of the Association of Nurses in AIDS Care that:

  • All persons with HIV/AIDS, including those with addictive disorders, past or present, have the right to receive expert, compassionate assessment and treatment of their pain, based on evidence based practice.
  • Nurses must advocate for pain management for HIV infected persons and should serve as integral members of multidisciplinary pain management teams.
  • HIV infected persons, including people with addictive disorders, should be included in pain management research.
     

Palliative Care

     It is the position of ANAC that:

  • Palliative care should be part of the comprehensive care of all patients with HIV/AIDS.
  • Palliative care should be integrated into the standard of care for patients with HIV/AIDS and their families from the first diagnosis of HIV until death.
  • Every provider should be able to provide or refer patients for palliative care, while simultaneously providing therapeutic treatment.
  • Palliative care should be integrated into education about HIV/AIDS for all providers.
  • Insurance plans, including Medicaid and Medicare, should eliminate any barriers to obtaining palliative care.
  • Research in this area is lacking and should be supported and encouraged.

President's Emergency Plan for AIDS Relief (PEPFAR) Reauthorization

     It is the position of ANAC that:

  • PEPFAR be reauthorized with adequate appropriations to meet the goals of the programs.
  • Due to the global healthcare worker shortage, support is needed for healthcare workers and mechanisms for healthcare strengthening including fair compensation that affect and improve retention of healthcare workers.
  • PEPFAR invest necessary resources to ensure there are adequate numbers of healthcare workers in PEPFAR countries.
  • Comprehensive healthcare programs, such as preservice and on-going educations for healthcare workers exist and are utilized.
  • PEPFAR supports a comprehensive community health worker initiative that provides proper training and supervision to perform tasks especially in the rural areas.

Prevention With Positives:  Incorporating HIV Prevention Into Routine Care of Persons Living with HIV Infection

     It is the position of ANAC that:

  • Routine screening for at-risk sexual and needle-sharing behavior by HIV-infected persons be incorporated into nursing assessments, regardless of perceived risk on the part of the nurse;
  • Nursing plan of care for HIV-infected persons includes ongoing provision of prevention messages, education regarding risk/harm reduction, positive reinforcement of changes to safer behavior; and
  • Nurses acquire updated training in evidence-based strategies to best assist HIV-infected patients develop an individualized risk/harm reduction plan.

Requiring Annual Immunization of Health Workers Against Influenza

     It is the position of ANAC that:

  • The health care consumer has the right to assume that health workers in all settings where service is provided, and the agencies that employ them, will take all measures to prevent transmission of communicable pathogens;
  • Health workers have a responsibility to prevent harm to those for whom they care and to their coworkers, and therefore must adhere to recommended primary prevention practices, including immunization against those for which safe and effective vaccines exist.
  • Health workers should be immunized against seasonal influenza each year unless they have a medically documented contraindication to the available vaccines.
  • Healthcare organizations should require staff, regardless of pay status (i.e., whether or not they receive remuneration for their services), to be immunized against seasonal influenza unless there is medical documentation of a contraindication. This recommendation applies to all types of facilities and services, including inpatient and outpatient acute and chronic care, long-term residential care, home care, rehabilitation, counseling and other services, including independent private practitioners. It applies to all staff who may come in contact with service recipients as well as staff who routinely come in contact with such staff (e.g., in staff cafeterias, administrative offices, etc.).
  • Healthcare employers have the responsibility to offer vaccine to staff at no cost and to facilitate vaccine administration at worksites or other convenient locations and times. Thus, requirements should not place additional burden on workers, who should also be able to submit documentation of having received vaccination from other providers or facilities.
  • Service providers should publicly post their staff vaccination policy.
  • Getting vaccinated must be easier and more convenient for staff than opting out and, if exemptions are allowed, the procedures for obtaining one must be as rigorous as for getting the vaccine. Neither the perfunctory signing of a form nor online declination is adequate.
  • Unvaccinated staff should be identified and, regardless of symptoms, when there is influenza in the community, should be reassigned or expected to implement barrier precautions (such as masks) when within a specified proximity of potentially susceptible service recipients.

Ryan White HIV/AIDS Treatment Modernization Act of 2006 Reauthorization

     It is the position of ANAC that:

  • The Ryan White HIV/AIDS Treatment Modernization Act should be reauthorized before it sundowns in 2009.
  • All programs of the Ryan White HIV/AIDS Treatment Modernization Act must be adequately funded to meet the comprehensive needs of people with HIV/AIDS.
  • Multi-disciplinary teams should provide treatment, care and services with medical care being the primary funding category.
  • Ryan White HIV/AIDS Treatment Modernization Act funding continues to be the payer of last resort.

Safe Injection Facilities

     It is the position of ANAC that:

  • Safe injection facilities can be an effective component of a broad spectrum of mechanisms that can reduce the risk of harm to injection drug users.
  • Safe injection facilities can be appropriate sites for the care of injection drug users.
  • Nurses are encouraged to support the legalization and development of safe injection facilities.
  • With the institution of appropriate legal and ethical protections, nurses may consider these settings as viable options for employment.

Substance Use Treatment on Demand

     It is the position of ANAC that:

  • Drug treatment on demand, defined as the act of being able to walk into a clinic and get immediate, affordable, and appropriate treatment for drug use problems, needs to be a national health care priority.
  • Drug treatment should cover a full spectrum of physical, social, emotional and vocational services that are individualized to the care needs of each client.

Sustained Funding for the AIDS Drug Assistance Program (ADAP)

      It is the position of ANAC that:

  • The AIDS Drug Assistance Program (ADAP) is an essential program providing access to life-saving medications for thousands of people living with HIV and AIDS.
  • ADAP must be fully funded to carry out its mission and prevent adverse public health outcomes for persons living with HIV and AIDS.
  • In addition, helping patients stay on medications that lower viral load prevents new infections by decreasing HIV transmission by up to 96%.
  • As demand increases, sustainable funding solutions must be found through federal, state and cost-saving measures.

Syringe Access Programs

    It is the position of the Association of Nurses in AIDS Care that:

  • Syringe Access programs are an effective method of preventing the spread of HIV infection, Hepatitis B and C and other bloodborne pathogens among injection drug users without encouraging the use of illegal drugs.
  • Syringe Access programs should be part of a comprehensive strategy for the treatment of substance use, including drug treatment services, mental health counseling, social support services, harm reduction counseling, and competent primary health care, by providers who are knowledgeable about drug use, addiction, and prevention of bloodborne disease.
  • Federal funds should be released to support the development, implementation, and continued capabilities of Syringe Access programs around the country.

Syringe Prescription for Injection Drug Users to Prevent Disease

     It is the position of ANAC that:

  • Prescribing syringes to injection drug users can prevent blood borne diseases.
  • The benefits of syringe prescription include the ability to provide access to syringes in places where legal access is otherwise limited, the potential to improve medical care for an underserved population, and the possibility for health care providers to act as a conduit to drug treatment.
  • States that do not allow prescription of syringes to injection drug users or possession of prescribed syringes should modify their laws to do so.
  • Nursing and other medical education programs should teach their students about the health needs of injection drug users, including the need for access to sterile syringes.
  • Syringe prescription should be part of a comprehensive approach to the issue of drug injection and disease that includes outreach, prevention and treatment.

 


 
Association of Nurses in AIDS Care 3538 Ridgewood Road, Akron, Ohio 44333-3122
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