Engaging primary health in testing and PrEP Provision and HIV treatment as a strategy for reaching diverse communities

A report on the symposium session “Engaging primary health in testing and PrEP Provision and HIV treatment as a strategy for reaching diverse communities”.

The 2018 HIV AIDS Conference in Sydney has started as promised; full of challenges, opportunities and hope.

The options of proffered papers as always made it hard to choose which to attend. This year I chose not to race between individual presentations, but to immerse myself in the theme of a full session. As a Nurse Consultant working in Community Health, the theme of Engaging Primary health in Testing and PrEP Provision and HIV treatment as a strategy for reaching diverse communities appealed to me.

Dr Chris Lemoh, from Monash Health; started the session by discussing the systems in place that traditionally have been responsible for HIV testing and diagnosis, however he went on and succinctly summarised how the responsibility for HIV care is in 2018 now firmly in the domain of all health care service providers.

His statement that HIV is a disease of exclusion but also a disease of connection highlights how HIV care needs to be extended into the non-medical services.

This theme was continued by Professor Cindy Shannon’s presentation. The model that she discussed described a comprehensive primary healthcare model which has been implemented to integrate a range of allied health students to participate in student placement within the Indigenous Health services in urban Queensland.

Working in regional Victoria, I have had experience in working closely with non-medical staff to engage people in health seeking behaviour.

Then Chris Howard from Queensland Positive People discussed their model of the Peer Navigator Program. This program highlighted the importance of trained peers as a key resource for people at risk of HIV and those living with HIV and more importantly a valued consultant within the extended care team.

The final speaker Dr Sid Kaladharan discussed some preliminary findings from his team’s research Q Chapter. He discussed findings that challenged health professionals in regards to how “we” demonstrate quality consultations especially to people of CALD backgrounds.

 My learnings from this session are that in the evolution of HIV care it is apparent that a shared responsibility to reach people at risk of HIV to encourage testing and to maintain a relationship with people who live with HIV is warranted.

This will challenge the traditional medical model of managing this chronic disease. Letting go the “power” that has been held by clinicians in tertiary care will take time to become a reality. Whilst Specialist medical knowledge and treatment of PLWHIV will always be required, it is just as important for non-medical care and support to be promoted and present.

Advancements in reaching the targets for the at all people in relation to HIV testing, treatment and undetectable viral loads for those diagnosed, set by Government will only be achieved by incorporating of Peer Navigators into the health care team and providing realistic pathways of advancement for Aboriginal Health Workers.

Author bio:

Louise Holland - Clinical Nurse Consultant – Nurse Practitioner Candidate, Women’s Health and Sexual and Reproductive Health, Bendigo Community Health Services (BCHS). Louise has worked in the field of Women’s, Sexual and Reproductive Health for the last 17 years. Louise's role is to coordinate the LMR STI/BBV Program in partnership with the Victorian Aids Council. Louise also works part time at Bendigo Health as a Clinical Nurse Consultant in the Infectious Diseases Service. Louise is passionate about rural health care.