Challenges in the Care of Refugee Women Living with HIV in a Regional Town

By Lauren Coelli.

Refugees from DRC

Client Experiences -

Torture and trauma

Many women have been exposed to HIV through rape and may have witnessed the murder or rape of family members.  Many have fled without their children to safety or experienced the trauma of their children being kidnapped.  

Attitudes to HIV

Highly anxious about the diagnosis, fear of death, fear of transmission, fear of disclosure, discrimination, worry of children's futures and difficulty understanding the need for monitoring and management processes.

Living with HIV-

Confidentiality

Anxiety about attending for monitoring and medication especially if other people from their community or culture are also there.  Distrust of phone interpreters.

Pregnancy

Bottle feeding identifies the mother as having HIV.  Fear of disclosure during pregnancy, anxiety about family and case workers finding out during the monitoring processes.  Baby requiring ART and repeated blood tests being potentially identifying.

Strategies

Build trust and rapport, use a flexible walk-in model and spend time upskilling clinical staff.  Work arounds to avoid identifying HIV status - use of immunocompromised on medical files to reduce risk of disclosure. 

Education needs to include health professional, community, WLWHA and the Men from DRC.