Professor James Ward, the Director of the Poche Centre for Indigenous Health at The University of Queensland, discusses how HIV affects Indigenous people all over the world.
Information about the GLOWS Grant Program (in partnership with Gilead and the UQ Poche Center for Indigenous Health) can be found here.
The following is a transcript between Karl and James Ward.
JAMES
HIV is everyone’s business.
KARL
Hello there. Welcome to +Talk on +Life where we’re all about turning positive into a plus. Today, we’re talking about Indigenous peoples and HIV, and joining me from Australia is Professor James Ward. He is an infectious diseases epidemiologist and a national leader in Australia and Torres Strait Islander research. Professor, it’s great to see you. Thanks for making the time to chat with me.
JAMES
Yeah, thank you very much. Yeah.
KARL
How is HIV perceived in Indigenous communities here?
JAMES
It’s kind of like, “Oh, that’s something “that the other fellows get, the white fellows get, “or gay men get in the city.” But actually what we do have in Australia among Indigenous populations, it’s very different epidemic. We have much more cases attributable to heterosexual transmission, much more cases attributable to injecting drug use and still, the majority of cases are among men who have sex with men. When you see headlines in Australia and when our population see headlines that HIV’s almost eliminated, it kind of puts us at great comfort, I guess, but I don’t think we’re out of the woodworks yet. There’s so many factors at play that could escalate transmission very rapidly in communities.
KARL
Does the stigma play a big role in as to why those messages are not, as you say, being taken up?
JAMES
Yeah. Stigma, discrimination, racism in healthcare. Those are the three factors that impact access. They impact healthcare. There’s been many stories over the years about people who are living with HIV who are on medication but sharing with family members and who are not publicly out, who are not out, who haven’t disclosed their status and trying to hide their medications from family members. Yeah, there’s a lot of stigma still around.
KARL
What are some of the unique challenges that Indigenous folks face when it comes to health equity and care, especially as it relates to HIV?
JAMES
There’s a whole lot I could say here. Firstly, setting indicators that might be appropriate for the whole nation, but maybe not tailored for Indigenous populations. That’s one thing, and maybe focusing in on the right area to focus in on. Two, I think we need to do much better in the care cascade. The number of people who come to the clinic, they get diagnosed, and then they drop off on the cascade. They don’t come back for treatment or they don’t maintain treatment or they’re not maintaining regular visits with their doctors. That is markedly different to nonIndigenous population, and that really talks to barriers to healthcare and the issues that are in healthcare. Sometimes it’s cost. Sometimes it’s transport. Sometimes it’s availability of appointments. Sometimes it’s other comorbidities. There are other issues. There’s often a lot of comorbidities in our population. People living with diabetes who also have HIV. Going to one doctor for chronic care and another doctor for HIV care is often a barrier for people. Going to, if you live in a rural area, going to the clearly marked sexual health clinic in a rural town is problematic for people. Not just for Aboriginal and Torres Strait Islander people, but for everyone.
KARL
How important is it that Indigenous folks have a seat at the table, Professor, when it comes to the decisions that are being made around healthcare and health equity in this country?
JAMES
Without a voice at the table, it’s really very easy to sideline or policy to inadvertently affect people who are not at the table. Whether you’re a drug user or whether you’re an Aboriginal person, whether you’re HIV positive, if you’re not at that table, it’s very easy to be overlooked, and it’s quite amazing how many times an Aboriginal person will be called to the second meeting of a newly formed committee because somebody at the first meeting said, “What about Aboriginal people?” It’s really important that we do have a voice at these tables ’cause there is some unique nuances and issues that do need to be resolved through policy or through planning or through program delivery. And so, very important.
KARL
What is the GLOWS initiative? How has it come to be?
JAMES
Yeah, so GLOWS is a initiative to try and improve some of these implementation gaps of service access and service delivery that I’ve been talking about now. It’s an initiative of Gilead, and it’s a partnership between Gilead Sciences and the Lowitja Institute and the UQ Poche Center for Indigenous Health where I work. Try and improve access to treatment for those that are living with HIV, but also improve PrEP uptake among our priority populations. And so it’s really trying to address this for HIV, but also it’s got another arm, which is really about hepatitis. And often, those two things, particularly for the injecting drug user population, often those two things come together. Hepatitis C and HIV often come together, and so really important initiative. It’ll be rolled out over the next few years, and it will enable local communities to develop solutions for issues they know that need addressing in their own communities.
KARL
Professor James Ward, I really appreciate you taking the time to talk us through it and for all the fantastic work you do. Thanks for joining me.
JAMES
Great, thanks very much. Yeah. Thank you.
KARL
Thanks. That is gonna do it for this episode of +Talk. If you want more information, check out our website, pluslifemedia.com. And remember, you can follow us across social media platforms. We are @PlusLifeMedia. Until next time, be nice to one another. Give someone a hug if you feel like it. We’ll see you soon. Byebye.