Key Affected Populations

Elizabeth Crock: Bolton Clarke HIV Program, Melbourne
Oscar Morata Ramirez: Royal District Nursing Service, Melbourne (first edition)
Sandra Gregson: Victorian Aboriginal Health Service (first edition)
Shelley Williams: Victorian Aboriginal Health Service (first edition)


Globally and in Australia, key groups of people can be especially vulnerable to contracting human immunodeficiency virus (HIV) infection and, if already diagnosed with HIV, may experience poorer outcomes, mostly related to social determinants of health such as socio-economic circumstances, gender or ethnicity.[1] [2] Typically, some groups are more likely to be diagnosed late, less likely to engage with health care, access treatment, adhere to treatment and achieve viral suppression, referred to as the HIV treatment cascade or care continuum.[3]

People with HIV who are marginalised can be at greater risk of hospitalisation and HIV-related illnesses.  International and national nursing standards of practice, codes of conduct, position statements and research affirm that nurses have a special responsibility to those most vulnerable;[4] thus, it is a primary role of nurses and community workers to help marginalised groups access HIV and mainstream health services and keep them engaged in health care.  However, there is a lack of research published by nurses documenting their practices in engaging and retaining people in HIV care in the Australasian setting, and little evidence about, or evaluation of, the effectiveness of nursing interventions.

This section therefore draws from the practical experience of nurses in the Australian setting and local and international literature. Key populations discussed include Indigenous Australians, refugees and asylum seekers, people who inject drugs and men who have sex with men (who may belong to any of these groups as well).  Key affected populations vary in different Australian states and territories and this discussion is not exhaustive. Nurses will need to focus on those most affected in their local environment, however, the principles and strategies discussed here may be helpful across settings.