Holzemer is the dean at the Rutgers School of Nursing in New Brunswick, New Jersey.
I'm not a direct hands-on [provider,] so I want to qualify that. But I think one of the things is that people, many people with HIV, are extremely challenged for resources. They have multiple presenting issues. So, yes, they might have HIV, but they also might have hypertension or diabetes, and a foot abscess, and five other things. They might be homeless, might live on the street, and might be using drugs. So, a provider is overwhelmed with the complexity of some of the clients. ...
A lot of the people we see, in the Ryan White clinics, particularly, are multiple diagnosed. And then you overlay mental health, which is huge. ... Let alone the depression that comes from being HIV positive; there's the clinical depression from all the things they have to live with. Then there's ... homophobia, black/racial issues, et cetera.
You will hear providers say to a patient, "What shall we deal with today?" The list is so long you'd be there for two days. Often the visit is about their HIV or the medication, but [the nurse has] to figure out how to deal with the HIV but not ignore everything else.
Image credit: Association of Nurses in AIDS Care.