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PURPOSE/OBJECTIVES To identify when fatigue is reported as a problem by people who are HIV positive, what the perception of fatigue is, and which self-care behaviors are used and with what efficacy. DESIGN Multisite descriptive study. SETTING University-based AIDS clinics, community-based organizations, and homecare agencies located in cities across the United States, in Norway, and through a university Web site. SAMPLE Convenience sample of 422 self-identified people who are HIV positive. MAIN RESEARCH VARIABLES Symptom description, symptom relief, symptom help, and self-care strategies. FINDINGS The sixth most reported symptom in this study, fatigue, was treated with a variety of self-designed strategies. In only three instances was consultation with a healthcare provider (i.e., physician) or an injection (medication not defined) mentioned. The most frequently used interventions were supplements, vitamins, and nutrition followed by sleep and rest; exercise; adjusting activities, approaches, and thoughts; distraction; and complementary and alternative therapies. In addition to self-designed strategies, the media and friends and family were sources of information. CONCLUSIONS Fatigue was reported less frequently in this study than in other HIV-, AIDS-, or cancer-related studies. This may be an artifact of the study design. The use of informal networks for assistance, let alone the prevalence of unrelieved fatigue, indicates the need for more attention to this problem among people with AIDS. IMPLICATIONS FOR NURSING Careful assessment of the pattern of fatigue and its onset, duration, intervention, and resolution is required if the varied types of fatigue are to be identified and treated successfully.

It is becoming increasingly evident that nutrition is not only an important component of health but also that levels of specific nutrients can affect disease expression. This is particularly apparent in the realm of HIV disease. Despite this knowledge, research in this area, especially pertaining to the pediatric population, has been limited. This report presents a narrative review and critique of the work that has been conducted in the area of micronutrients including descriptive, correlational, and intervention studies. Gaps in knowledge, recommendations for future research, and nursing implications are highlighted. Current information suggests a role for micronutrients in the treatment of HIV disease, and further research will help develop these adjunct therapies that can affect the overall outcomes and quality of life of these patients. Copyright © 2001 by W.B. Saunders Company

Bareback sex, or actively seeking unprotected anal intercourse is occurring in the gay male community. This represents a new phenomenon, different from previously identified "relapse" unsafe sexual behavior and poses an important HIV prevention problem. This article reviews the extant literature regarding bareback sex. The lay press and scientific literature are reviewed. Although discussion of issues surrounding bareback sex is abundant in the gay press, scientific literature regarding this phenomenon is nonexistent. The evidence-based literature addresses relapse to unsafe sexual behavior. Although this literature provides further understanding of safer sexual behaviors in gay men, barebacking is a unique issue that requires additional exploration. In this article, factors underlying bareback sexual behavior are explored, including previous HIV prevention efforts and their relationship to this phenomenon. Finally, bareback sex in the gay male community and its implications for nursing practice, research, and education are explored. The harm reduction model is offered as a useful guide for nursing assessment and intervention.