Overview
Clinical Frame
The nurse’s work is not finished when an HIV screening result is reactive, and it is not defined by the CD4 number alone.
The nurse’s work is not finished when an HIV screening result is reactive, and it is not defined by the CD4 number alone. The safe sequence is to confirm infection, establish immune and organ-function baselines, start effective antiretroviral therapy (ART) promptly, and recognize toxicity or inflammatory complications that change urgency. Confirmation prevents a life-changing diagnosis from resting on a screening test alone; baseline testing exposes medication hazards; viral suppression reduces illness and prevents sexual transmission when maintained. Prescribing authority is provincial rather than uniform across Canada. In Ontario, an RN who holds prescribing authority may prescribe ART medications listed in Schedule 4 of the Nursing Act, including tenofovir, emtricitabine, and integrase inhibitors, when practising in an authorized setting and meeting applicable practice requirements. RNs elsewhere must follow their provincial legislation, employer policy, and authorized collaborative arrangements.