Refugees and asylum seekers may have fears about sharing sensitive information about their health, especially where HIV is highly stigmatised in their country of origin, and about potential breaches of confidentiality. In order to gain trust and establish a relationship, it can be useful to provide reassurance about Australian nurses’ legal and ethical duties and responsibility to maintain privacy and only share information with explicit consent.[23]
The use of interpreters may be difficult to negotiate as asylum seekers and refugees with HIV may have extreme anxiety and concerns about privacy, especially in small communities. However, accurate health interpretation is important to ensure the person’s comprehension of health- and treatment-related information. The use of phone interpreters (rather than face-to-face) and pseudonyms when using interpreter services can help overcome this problem.[24]Having a conversation with an interpreter before meeting with them to emphasise the professional obligation they have to maintain privacy and confidentiality can also be useful.
Stigma in their own country (relating to HIV, homosexuality or sexual transmission) can result in people feeling that any discussion of HIV is taboo and can lead to isolation.[25] Using peer-led discussion and education around sexual health and HIV can be a successful model to help break down taboos.[26]
Despite many stressors, asylum seekers and refugees with HIV have been found to demonstrate resilience.[27] [28] Nurses can help to support them to build upon their strengths as they navigate their new life as well as their HIV diagnoses, and to foster hope.