Challenges in the care of refugee women living with HIV in a regional Town

Challenges in the care of Refugee women living with HIV in a  regional town

This talk was presented as part of the HIV&AIDS symposium "Who is left behind in a virtual elimination of HIV" 

I found this talk, presented by Lauren Coelli , (Sexual Health Coordinator at the Gateway Health clinic , Wodonga) very inspiring , providing a great example of how to provide care for refugee women living with HIV in regional Australia which could be translated/adopted to similar clinics and settings

The Gateway Health clinic in Wodonga was established  in 2014

The clinic is a general practice clinic set in a community health service, 

one of it's focus areas includes meeting needs of refugees 

largely from the Democratic Republic of Congo (DRC), Bhutan and Nepal

The clinic currently looks after 12 women and one child living with HIV

all the 12 women acquired HIV as a result of rape

According to the DRC family code (444) " a wife owes her obedience to her husband"

marital rape is not criminal act

The women attending the service described high levels of anxiety about their HIV diagnosis, including fear of death and worry about children's future 

Bottle feeding their babies may identify the mother as being HIV positive, and feeding therefore often takes place in private

In addition, they reported fear of transmission, disclosure to community and ostrerisation by their community if their HIV status was disclosed

These concerns and fears have contributed to reluctance to join support organisations, fear of meeting other African people working at the clinic and distrust of phone interpreters

Some of the strategies employed by Gateway Health to overcome these barrier and improve patient care and outcomes have included gaining trust and building rapport with the women, providing a flexible, walk-in model, close collaboration with other local health care providers and up-skilling clinic staff (eg undertaking s100 prescriber training) to provide care within the service for the women rather than having to refer the women to multiple external service providers.