During the past 30 years, the Journal of the Association of Nurses in AIDS Care (JANAC) has been a leading source of innovative science and clinical scholarship, helping nurses provide evidence-based, compassionate, and person-centered care. The visionary leadership of the journal's former editors-in-chief-Jeanne Kalinoski, Richard Sowell, and Lucy Bradley-Springer-has ensured that the voice of nursing had a scholarly place in the bigger HIV and AIDS landscape. I am grateful to these individuals for their commitment and hard work.
As I write my first editorial as the newly appointed Editor-in-Chief of JANAC, I am humbled to follow in the legacy of these three impressive individuals. I remain committed to ensuring that nurses and other health professionals have a place to share their science and clinical scholarship and to engage in scholarly discourse and public policy debates about critical issues associated with the epidemic.
Reflections About the Epidemic
As I reflect on my years as an HIV nurse, I am thankful that a lot has changed over the past 38 years of the epidemic! I am grateful that antiretroviral therapy is so much more effective and easier to take compared with the early years. I am grateful that persons living with HIV today can live a normal lifespan. I appreciate the daily struggles with adherence that prevents virologic suppression. I am troubled that too many young people, sexual and gender minorities, and persons from diverse racial and ethnic backgrounds continue to be inequitably burdened by HIV. I am saddened that people living with HIV experience, anticipate, perceive, and internalize stigma. I worry that America will not fulfill its obligations to ensure that the 37 million people around the world living with HIV will continue to have access to life-saving treatments. I am concerned that women's bodies and individual health choices are under attack. I struggle to understand how racism has become tolerable, how xenophobia has become increasingly prevalent around the world, and how all the other forms of bias, hate, discrimination, and oppression have become acceptable to so many. I am angered that partisan politics and divisiveness are limiting the ability of our elected politicians to do the work they were elected to do.
From my perspective, HIV is more than an infectious disease. HIV is a social disease at the intersection of culture, politics, and power. If the "end-the-epidemic era" is going to be successful, I believe that the social determinants of health must be addressed in funding and policy decisions associated with not only HIV prevention, care, and treatment but also primary health care. I believe that we must accelerate our collective efforts to guarantee an inclusive and equitable environment where all members of society, including immigrants, flourish. I believe that we need to ensure that all persons eligible for pre-exposure prophylaxis receive a prescription, can afford it, and remain adherent. Collectively, we need to work together to ensure that every person living with HIV can age successfully, not only in high-income settings but globally. We need to eliminate mother-to-child transmission in every corner of the world. We need to understand the sexual and reproductive health needs of a generation of youth living with HIV, so they can build families, if desired.
I also value that nurses are the largest cadre of health care providers globally. Professional nurses, nurse practitioners, and midwives have stepped forward throughout the epidemic to provide care, treatment, compassion, and comfort to the sick, the dying, and the scared. I have no doubt that this will continue. However, I worry about the availability and the preparedness of the HIV workforce in the future. I wonder how we are going to help our HIV clinicians care for an aging population of persons living with HIV. I also worry about the conditions in which many nurses in low- and middle-income countries provide essential primary care and HIV services. With 2020 being named the Year of the Nurse and Midwife by the World Health Organization, I believe the journal and the Association of Nurses in AIDS Care (ANAC) have the unique opportunity to showcase at the highest level the important contributions of nurses and midwives throughout the epidemic.
My Vision for JANAC
If you have read an issue of JANAC in the past few years, you may have noticed that many of the contributors are our colleagues from other disciplines-pharmacy, social work, medicine, public health, behavioral science, physical therapy, and psychology to name just a few. Similarly, the journal has become truly international in scope with a significant number of manuscripts authored by interprofessional teams from around the world. This is great news because this is exactly the purpose of JANAC.
As the newly appointed Editor-in-Chief of JANAC, I am committed to continuing the production of a journal that is cutting edge and clinically relevant while also recognizing the interprofessional nature and global scope of HIV. The journal will not only continue to address issues related to HIV prevention, care, and treatment but also explore sexual and reproductive health issues, aging, comorbid conditions, related infectious diseases, and co-occurring conditions, such as intersectional stigma and mental health. In doing so, we will ensure nursing's voice and leadership in caring for those at risk of HIV as well as those affected by and living with HIV until there is a cure or an end to the epidemic.
In an era where scientific misconduct and conflicts of interests are becoming increasingly commonplace, I plan to work with the editorial board and publisher to ensure the continued credibility of JANAC. We will be addressing issues of reproducibility of results, conflicts of interest, and data sharing to strengthen scientific inquiry. I plan to ensure that the guidelines established by the International Committee of Medical Journal Editors and the Committee on Publication Ethics are fully integrated into the operational structures of JANAC. Finally, I anticipate a reorganization of the editorial board to optimize the talent of its members and to guarantee transparent, efficient journal operations.
In closing, I would like to thank Lucy Bradley-Springer for the past 12 years of journal leadership and stewardship. As the official journal of ANAC, I look forward to collaborating with ANAC's current and future boards of directors, the journal's publisher, and the association's members to advance JANAC's relevance, scientific integrity, and reputation.