Perspectives on AIDS

Three Kennesaw State University nursing professors were among the 23,000 attendees at the 17th annual International AIDS Conference in Mexico City in August. Each came back with individual impressions and a common resolve to work toward solutions for the disease.

Richard Sowell, dean of the College of Health and Human Services, and nursing professor Carol Holtz presented research on migrant workers returning from the United States having contracted HIV/AIDS.

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BARRY WILLIAMS / Special

Barbara Blake (from left), Richard Sowell and Carol Holtz attended the International AIDS Conference in Mexico City. At the conference, Sowell and Holtz presented a display that illustrated their exploratory study on migrant workers who contracted AIDS in the United States and returned to Mexico.

Associate nursing professor Barbara Blake, who has worked with AIDS nurses in Africa as well as with the Georgia Department of Human Resources on its HIV community services assessment and HIV prevention plan, went to the conference to stay grounded.

“When you look at HIV/AIDS from a world perspective, instead of a U.S. one, it’s very different,” said Blake, Ph.D., RN, ACRN. “People in other parts of the world are concerned about treatment, but you can’t just talk about HIV in isolation; you have to talk about adequate housing, safe food, access to care and basic human rights. In many areas, women are considered property. If a man gives her the disease, she’s the one ostracized.

“Being at a conference like this impresses on you how global this epidemic is, and how we have a long way to go to get it under control.”

For Holtz, Ph.D., RN, the conference was an eye-opener.

“It was amazing that people from all over the world would come to try to solve the problem in unity and share their knowledge,” she said. “The presentations ranged from sophisticated, hard science presentations by researchers at the CDC (Centers for Disease Control and Prevention) and WHO (World Health Organization) to sex workers talking about their worst experiences with HIV.”

Holtz has experience working with health care in Mexico; for years she has taken Kennesaw State students to Oaxaca for a practicum with the health department there.

She learned about a growing HIV/AIDS problem in Oaxaca through Gabriela Velasquez, a physician who works with COESIDA, an agency that provides prevention and treatment services for people infected with HIV. A large number of men who migrated to the United States to support their families in Oaxaca contracted AIDS in the United States and transmitted it to their wives.

“Many of these migrant workers have only a third-grade education and had never heard of HIV,” Holtz said. “They stay [in the United States] six months to five years, are lonely and meet sex workers or other women in bars or migrant communities. After they return, their wives get pregnant and learn about the virus through prenatal testing.”

AIDS study

Sowell and Holtz did an exploratory study to better understand the phenomenon and prepared a poster presentation that was accepted at the conference. They interviewed 10 HIV patients — either migrant workers or their wives — to learn how they had become at-risk for the disease and how they were coping with it.

“This was my first AIDS research,” Holtz said. “I speak Spanish and Richard had the HIV/AIDS expertise. He’s become my mentor in this field. We consider this information-gathering study Phase 1 and plan to continue our research.”

Sowell and Holtz are seeking grants to help educate rural workers in Mexico and in Hispanic communities in the United States about AIDS prevention.

Sowell, Ph.D., RN, FAAN, a veteran AIDS-care nurse and a researcher, has attended many AIDS conferences. He was encouraged by the inclusiveness of the event in Mexico City.

“The issues of conferences have mirrored the epidemic, but I was glad to see the debate of whether we put money into treatment or prevention put to rest,” he said. “It’s not an either/or situation. It will take both to solve the problem.”

He also was gratified to see representation from countries that have plenty at stake. South Africa, for example, has a significant percentage of adults who are HIV-positive. New populations, such as sex workers, also were included in the discussions.

Unified approach

Sowell hopes that the conference will help promote a unified approach to dealing with AIDS.

“For years, people have said that the cost of AIDS would break the health care system,” Sowell said. “What the epidemic has done is show us the lack of health care infrastructure in many countries, the gaps in the system, and highlighted the lack of access.

“If we can build an infrastructure that is adequate to deal with HIV, then it can deal with other ills like TB and malaria. Seeing the treatment and prevention forces coming together with one voice to strengthen health care systems made it a very different and hopeful conference.”

Another result of the conference was a statement on the rights of nurses to health and safety, developed by the Physicians for Human Rights and the Association of Nurses in AIDS Care.

“Nurses are on the front lines and, in many places, [are] the most highly trained health professionals,” Sowell said. “If we’re going to build a stronger health care infrastructure, we have to protect our nurses and give them safer working environments.”