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Learning through experience.


 After the first AIDS patients were diagnosed in 1983 in Trinidad and Tobago, every nurse attended a large group lecture on HIV/AIDS which lasted 1 or 2 days. Even though the information acquired helped them greatly in infection control, the lectures did not prepare them adequately for caring for AIDS patients. The nurses did not want to treat AIDS patients and would not make home visits. They feared infection with HIV and stigmatization through their contact with AIDS patients. They often believed God was punishing AIDS patients. They were intolerant of homosexual men and were more willing to care for HIV/AIDS patients who were children or infected by a blood transfusion. In 1990, these attitudes and beliefs prompted a modification of the design of the training program. The program now involves all participants and uses role playing to simulate reality. Each training course has only 10-15 people and is informal and relaxed. It is held 1 day a week for 8 weeks. The subject matter depends on participants' needs identified through a questionnaire they complete before the course. Group discussions often include HIV positive people, family members, and experienced nurses. The nurses leave the course with a better understanding of the feelings and needs of people with AIDS, human sexuality, and the diversity of sexual behaviors. They are also better able to separate illness from sexual practice, recognize the value of each patient, communicate with and encourage families to accept the patient, support the patient, spread the word about prevention of HIV and sexually transmitted diseases, and understand issues of HIV-positive homosexual and bisexual men. The primary health care system in Trinidad and Tobago serves HIV/AIDS patients. The nurses visit them in their homes and make sure they receive the care they need at hospitals and outpatient clinics.
