According to UNAIDS, there were 38.4 million (33.9 million-43.8 million) people living with HIV globally in 2021 (UNAIDS, 2022). By geography, 20.6 million (18.9 million-23.0 million) resided in eastern and southern Africa, whereas another 5.0 million (4.5 million-5.6 million) resided in western or central Africa. In total, nearly two thirds of the global population living with HIV resides in Africa. Overall, a large number of persons with HIV reside in limited-resource settings.
As described in the International Council of Nurses (ICN) Code of Ethics, evidence-informed care is an essential component of nursing practice. Of the standards comprising the ICN Code of Ethics, two standards address evidence-informed care-Standard I, Nurses and Patients or Other People Requiring Nurse Care or Services and Standard III, Nurses and the Profession. Specifically, three substandards-1.10, 3.1, and 3.2-convey the importance of evidence-informed care; these three substandards state the following:
1.10 Nurses provide evidence-informed person-centered care, recognising and using the values and principles of primary health care and health promotion across the lifespan (ICN, 2021, p. 8).
3.1 Nurses assume the major leadership role in determining and implementing evidence-informed, acceptable standards of clinical nursing practice, management, research, and education (ICN, 2021, p. 15).
3.2 Nurses and nursing scholars are active in expanding research-based, current professional knowledge that supports evidence-informed practice (ICN, 2021, p. 15).
Unlike evidence-based practice, evidence-informed practice encourages practitioners to be knowledgeable about findings originating from all types of studies and to use the results of these studies in their work in an integrative manner while simultaneously taking into consideration clinical experience and judgement, clients' preferences and values, and the context and setting of the intervention (Nevo & Slonim-Nevo, 2011; Woodbury & Kuhnke, 2014). This subtle distinction allows the nurse to consider the evidence while also using clinical judgement and expertise to plan, implement, and evaluate person-centered care.
The challenge is that accessing the evidence to inform practice in limited-resource settings can be difficult. Although global organizations such as UNAIDS and country-level entities such as a ministry of health publish clinical guidelines and standards of care, which are universally accessible if one has access to a computer and internet connection, accessing the most recent, peer-reviewed, scientific evidence published in a nursing or allied health journal requires journal access. In many circumstances, access is limited due to charges associated with downloading an article from a publisher, lack of access to comprehensive library resources, and the low rates of open-access publishing in nursing.
As defined by the International Council of Nurses (2021), equity is an essential component of social justice. As I shared in my November/December 2022 JANAC editorial, there are numerous social injustices associated with the global HIV epidemic. As Braveman et al. (2011) stated, "It is time to be explicit that the heart of a commitment to addressing health disparities is a commitment to achieving a more just society" (p. S154). We could argue that the lack of access to the scientific literature is an issue of equity and social justice. As such, nurses and health care professionals in limited resource settings are the casualties of systemic disadvantages associated with the barriers to accessing the contemporary scientific literature related to HIV prevention, care, and treatment.
One mechanism to increase access to the HIV prevention, care, and treatment literature is open-access (OA) publishing. According to the United Nations Educational, Scientific, and Cultural Organization, UNESCO, a publication is considered in open access if
* its content is universally and freely accessible, at no cost to the reader, through the internet or otherwise;
* the author or copyright owner irrevocably grants to all users, for an unlimited period, the right to use, copy, or distribute the article, on condition that proper attribution is given;
* it is deposited, immediately, in full and in a suitable electronic form, in at least one widely and internationally recognized open-access repository committed to open access (UNESCO, n.d., first paragraph).
Not only does publishing open access reduce the access gap related to knowledge, but it also facilitates the search for information through meta-data, enables the building of knowledge databases, reduces the duplication and facilitates the replication of scientific work, and facilitates transparency of and access to the scientific, peer-reviewed literature (UNESCO, n.d.).
Many publishers offer different types of OA publishing, including gold open-access publishing, green open-access publishing, and hybrid open-access publishing (WoltersKluwer, 2021). Please refer to Table 1, which provides a description of each of these types of open-access publishing. As an author, it is important to know the different types of open-access publishing, and the restrictions on its use and reuse if there are any. In addition, it is important for authors publishing research from externally funded studies or service delivery programs (such as PEPFAR programs) to explore inclusion of fees associated with open-access publishing in the study or project's budget. In addition, authors should explore the availability of resources to support open-access publishing through their employer, particularly those employed at a university or research organization. Finally, authors from limited resource settings should inquire with the journal's editor and publisher about the availability of discounts on fees associated with open-access publishing.
As we strive for social justice and elimination of health inequities, we also need to strive for universal access to the peer-reviewed, scientific literature for all!
Disclosures
The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest.
Author Contributions
Michael V. Relf was involved with the conceptualization, writing the original draft, and review and editing.
Acknowledgments
None.
References