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Nursing's key role

Advancing HIV research and education

The Houston area is quickly becoming a hub of research and innovation in the treatment and prevention of HIV, and unfortunately, a relative hotspot for infections as well. 

“We don’t have huge outbreaks here, but we are still nowhere near where we need to be,” said Assistant Professor Sheryl Malone-Thomas, DNP, RN, FNP-BC. 

In January, Malone-Thomas joined the faculty of Cizik School of Nursing at UTHealth Houston after serving nine years as chief nurse and a family nurse practitioner at the Houston Health Department, where she led the Bureau of HIV, STD, and Viral Hepatitis Prevention. Her gravitas further strengthens the school’s substantial and growing focus on HIV research that includes Dean Diane Santa Maria’s NIH-funded studies of substance use, mental health, and HIV prevention among youth experiencing homelessness.

Santa Maria worked closely with colleagues at multiple institutions to support the establishment in May 2021 of the Texas Development Center for AIDS Research (TX D-CFAR). Baylor College of Medicine serves as the site lead for center, and in addition to Cizik School of Nursing, collaborating institutions include McGovern Medical School at UTHealth Houston and the Texas Biomedical Research Institution in San Antonio. 

Nurses play an important role in prevention and management of HIV, and Cizik School of Nursing’s leadership in the TX D-CFAR ensures the integration of nursing science into interdisciplinary efforts toward “Ending the HIV Epidemic,” an initiative established by the Centers for Disease Control and Prevention (CDC). 

“The creation of this center offers exciting opportunities for nurse scientists to collaborate with physicians, public health experts, community partners, and bench scientists to find ways to improve quality of life for people living with HIV and help prevent new infections,” said Santa Maria, DrPH, MSN, RN. “These collaborations are crucial in Texas, where we have seen slower adoption of measures that have proven to be effective in other parts of the U.S.” 

Santa Maria serves as co-director of the TX D-CFAR and of its Developmental Core, Mentoring Program, and Substance Use Scientific Working Group (SU-SWG). The Developmental Core helps junior investigators get a foothold in HIV-related research through mentoring, grant-writing assistance, pilot funding, and other support services. The SU-SWG was established to help fill research gaps related to the intersection of substance use and HIV prevention and treatment. 

Antiretroviral drugs have transformed HIV into a chronic disease that can be managed across the lifespan. However, any chronic condition comes with potential symptoms, and few treatments come without side effects. Of all members of a health care team, nurses often interact with patients most, putting them in a prime position to assess symptoms that affect quality of life. 

Cizik School of Nursing faculty are embracing the nurse’s role in HIV prevention and treatment at all levels, from Malone-Thomas’ work to educate undergraduate students, to nurse scientists in the Department of Research, two of whom have already received CFAR grants related to symptom science and overlapping chronic illnesses (see sidebar below). 

One program championed by Associate Dean and Chair of the Department of Undergraduate Studies Erica Yu, PhD, RN, is an interprofessional education program (IPE) organized by the Baylor College of Medicine – AIDS Education & Training Center Program (BCM-Houston AETC). The center serves as a regional office of the CDC’s National Coordinating Resource Center. Students at all educational levels in various health care programs at several Houston-area institutions can receive a certificate for participating in five monthly sessions. In each, students are presented with a complex patient case of a person living with HIV and discuss the best ways help the person, explained Malone-Thomas, who will present a prevention case in April. The hour-long sessions are conducted virtually. 

“It is such a wonderful collaboration because there are nursing, pharmacy, social work, and medical students, even a neuropsychology professor from the University of Houston,” Malone-Thomas said. “The IPE introduces our nursing students to the fact that it takes a village – it’s not just one person taking care of someone who has complex health care needs, who has HIV, high blood pressure, diabetes, and bills to pay.” 

Cizik School of Nursing leaders are committed to enhancing HIV-related programs in coming years by developing curriculum and growing research efforts. 

“As nurses, we have a great opportunity to make a positive impact on patients living with HIV or at risk for contracting it, especially here in Houston,” Santa Maria said.

“It’s one of those illnesses where we really have the mechanism to achieve zero infections,” Malone Thomas added. 


HIV research from the nurse’s perspective
 

“Characterizing symptoms among subpopulations of persons living with human immunodeficiency virus” 

Cizik School of Nursing Assistant Professor Meagan Whisenant, PhD, APRN, is principal investigator on this TX D-CFAR pilot grant funding a multidisciplinary study. “Our long-term goal is to improve the quality of life of persons living with HIV,” she said. 

The $49,996 grant will fund collection of preliminary data to support future NIH grant applications to identify molecular and genetic contributions to symptom burden, develop interventions for symptom management, and validate a measurement tool that can be used in clinical trials. Co-investigators are Roberto Arduino, MD; Jordan Lake, MD, and Karen Vigil, MD, from McGovern Medical School, and Tito Mendoza, PhD, and Xin Shelley Wang, MD, from The University of Texas MD Anderson Cancer Center.

 

Impact of depression and HIV symptoms on glycemic outcomes (A1c, BG) among patients living with HIV and type 2 diabetes. 

Assistant Professor Veronica J. Brady, PhD, RN, FNP-BC, brings her research interest in diabetes to bear in another projected funded through a CFAR led by the University of Alabama. 

Previous studies have shown that diabetes prevalence is higher among people living with HIV than the general population, and that patients with HIV and diabetes are at greater risk for depression than those with diabetes alone. The $15,000 CFAR seed grant will enable Brady’s team to further explore the intersection of HIV, diabetes, and depression and seek to answer important questions about this subpopulation with regard to symptoms and glycemic outcomes. 

Collaborating on the study with Brady are Amanda Willig, PhD, from the University of Alabama; Julie Zuniga, PhD, from The University of Texas at Austin School of Nursing; and Stan Cron, MSPH, at Cizik School of Nursing.

(Banner image courtesy Getty Images.)

Sherri Deatherage Green


In this story


Veronica J Brady, PhD, RN, FNP-BC, BC-ADM, CDCES

Sheryl L Malone-Thomas, DNP, RN, FNP-BC

Diane M Santa Maria, DrPH, MSN, RN, PHNA-BC, FSAHM, FAAN

Meagan Whisenant, PhD, RN

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