“Firstly, I would like to acknowledge the traditional Custodians of the land, our Elders Past and present to which I pay my respect. I also would like to acknowledge my brothers, sisters, colleagues and friends in the room. I would also like thank Mr Tim Wilson & Senator Louise Pratt Co-Chair of the Parliamentary Friends for Action on HIV/AIDS, Blood Borne Viruses and Sexually Transmitted Diseases along with Aunty Matilda House, Dr Dawn Casey of NACCHO, Also would like to thank James Ward of SAHMRI and his staff Linda and Kathleen for your hard work and dedication for ATSIHAW.
My name is Michelle Tobin. I’m an Aboriginal woman who’s lived with HIV since 1990, I am a mother, grandmother, daughter, sister and aunty and I‘m passionate about making sure HIV isn’t added to the long list of health issues affecting our communities.
The Positive Aboriginal Torres Strait Islander Network (PATSIN) is the voice of Aboriginal Torres Strait Islander People living with HIV. And the re-established of Anwernekenhe National HIV Alliance (ANA) Committee is dedicated to ensuring that the needs of Indigenous peoples are amplified and heard when it comes to those living with HIV and messages about prevention, testing and treatment.
Aboriginal and Torres Strait Islander communities shoulder an ever larger share of Australian HIV transmission. In one of the world’s wealthiest nations, this is intolerable.
While the broader HIV prevention effort delivered Australia’s lowest rate of transmission since 2001, new transmission among Aboriginal and Torres Strait Islander people has now doubled since 2011.
The latest technology and medicine is simply not cascading into our communities. We have a different epidemic, with greater transmission through heterosexual sex and injecting drug use than non-indigenous Australians. And while the non-indigenous population experiences signs of declining stigma, this is not the case in Aboiriginal and Torres Strait Islander communities.
These dynamics demand a vastly differentiated approach to HIV prevention and treatment, with serious resourcing.
We need a tailored approach that begins with better awareness of HIV through culturally appropriate, community-level communication. This must be particularly focused on women and people who inject drugs.
The benefits of both PrEP and Treatment as Prevention also need to be thoroughly promoted and communicated. Awareness and availability of PrEP is nowhere near where it should be. Any Aboriginal or Torres Strait Islander person with a medium to high risk of HIV must be made aware of this extraordinary new medicine and given access to it.
Similarly, we need a step change in testing. An estimated 20 per cent of Aboriginal and Torres Strait Islander HIV infections are undiagnosed. This compares with only seven per cent in the non-indigenous community. This is undoubtedly fueling our epidemic and every testing tool in our arsenal must be deployed to firstly improve awareness of HIV status, and then promptly move those who are positive onto treatment.
Critically important are the skills of the Aboriginal and Torres Strait Islander HIV workforce. Despite best efforts and intentions, there is simply not enough investment. Areas such as primary and specialist care, management, surveillance and research suffer from a chronic shortfall of resources. Culturally appropriate training and skill development is an urgent priority.
Health promotion interventions targeting First Nations populations are crucial to alleviating the symptoms of stigma and discrimination felt by people living with HIV. Interventions must aim to dispel myths and correct inaccuracies surrounding HIV transmission and prevention. It is essential that development and planning processes are collaborative efforts between mainstream healthcare services and First Nations People in order to appropriately contextualise information.
The limited availability of culturally appropriate healthcare services presents as an issue that must be addressed. Cultural capacity building training for healthcare organisations may assist in bridging this gap, however it is essential that employment of First Nations HIV professionals becomes a priority. Peer navigation programs could assist in engaging with First Nations PLHIV and provide opportunities for learning and healing through peer support.
A wealthy, advanced nation such as Australia can and must do better in preventing and treating HIV among its Aboriginal and Torres Strait Islander people. By next World AIDS Day, I hope to have better news to report.