Psychobiological and social responses of NIMART trained nurses caring for people living with HIV: A scoping review

Abstract

The global burden of HIV (Human Immune Virus) continues to challenge health systems, particularly in low- and middle-income countries (LMICs), prompting the adoption of innovative service delivery strategies such as Nurse-Initiated Management of Antiretroviral Therapy (NIMART). While NIMART has expanded access to life-saving antiretroviral therapy (ART) and enhanced the decentralization of HIV care, the psychobiological and social responses of the NIMART-trained nurses implementing this strategy have been largely underexplored. NIMART-trained nurses often work in high-pressure environments, facing occupational stressors that may manifest as burnout, anxiety, emotional exhaustion, and social stigma. The focus of this scoping review was to examine and map the extent, nature, and characteristics of literature related to the psychobiological and social responses of NIMART-trained nurses providing care to people living with HIV (PLHIV). The review was conducted following the Joanna Briggs Institute (JBI) methodology for scoping reviews and guided by the Population, Concept, Context (PCC) framework. It included empirical studies published between 2010 and 2025 that focused on psychobiological responses (e.g., stress, burnout, cortisol, heart rate) and social responses (e.g., stigma, support systems) affecting these NIMART-trained nurses. Data was analysed using narrative synthesis and thematic mapping to identify patterns, knowledge gaps, and implications for future research, practice, and policy. This study was significant for foregrounding the well-being of NIMART-trained nurses and thereby contributing to more sustainable and equitable HIV service delivery.