There are relatively low rates of HIV among Aboriginal and Torres Strait Islander people in Australia to date, attributed to the prevention work done by Aboriginal people themselves in their communities, and to the development of dedicated sexual health workers and nurses in communities, under an inclusive policy and partnership approach. Rates of HIV among Indigenous Australians and non-Indigenous Australians are similar, at around 4 per 100 000, but transmission modes differ, with higher rates of HIV among women, people who inject drugs and heterosexuals within indigenous populations. However, it is an enormous concern that rates of newly diagnosed HIV in the Aboriginal and Torres Strait Islander population were higher than in the non-Indigenous population between 2012-2014 (5.9 versus 3.7 per 100 000) and a third of those were determined to be late diagnoses. In 2017, there were 31 HIV notifications among Aboriginal and Torres Strait Islanders.
Aboriginal communities have been drastically affected by colonisation and its ongoing impact can make it hard for individuals to trust health systems. It is the responsibility of nurses to gain knowledge of Aboriginal history and its effect on health and specifically, on HIV-related issues among Aboriginal people. An excellent resource is the Australian Indigenous Health Infonet.
For optimal outcomes, care is provided in partnership with the individual with HIV. Consideration must always be given to confidentiality and this is even more critical when the community is small, rural or regional. It is important to clarify with the person with HIV exactly with whom he or she authorises information to be shared, and strongly adhere to this authorisation. Simply using someone’s name in the wrong setting can breach confidentiality or lead someone to perceive that his or her confidentially is broken. A community may be much smaller and more cohesive than attending health workers realise. Confidentiality around an HIV diagnosis is paramount, especially when unwanted disclosure can cause distress and deter people from seeking health care at all.