Review of services for people living with HIV in New Zealand

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liaison with clinicians on hospital visitsprovision of information about anti‐retroviral medicationadherence supportpsychosocial interventions, for example following new diagnosesa ‘buddy’ service.The NZAF’s testing and counselling services are contextualised by its drive for HIV prevention – allpre‐ and post‐test counselling is aimed at risk‐reduction, and conforms to guidance on counsellingcontent suggested by the Ministry of Health (2008) and the latest World Health Organization (WHO)documentation (WHO/WPRO 2009). Rapid tests used by NZAF are also WHO‐ and United States Foodand Drug Administration (FDA)‐approved.Service users and DHB colleagues alike interviewed for this review conspicuously and spontaneouslypraised the quality of NZAF counselling staff and procedures in all centres. All NZAF counsellors areprofessionally qualified and registered with the appropriate professional organisations (for examplethe New Zealand Association of Counsellors or the New Zealand Association of Psychotherapists),and externally supervised to New Zealand national standards. The NZAF also implements asophisticated programme of internal monitoring and review of case management and case notes.Alongside its 12 FTE counsellor staff, it maintains an evolving cadre of professional volunteers,including third‐year Auckland University of Technology students and student social work placements,and is currently considering making use of student nursing placements also.All staff are inducted into a programme of NZAF‐facilitated professional development.Data from NZAF centres in 2009 reveals the following testing results.1. HIV tests (22 positive results confirmed)January–December 2009 First test Second test Total % of totalAwhina (Wellington) 289 126 415 27.5Burnett (Auckland) 546 218 764 50Te Puawaitanga o te ora (Hamilton) 30 8 38 2.5Te Toka (Christchurch) 217 85 302 20TOTAL 1509 1002. Syphilis tests (18 positive results confirmed)January–December 2009 First test Second test Total % of totalAwhina (Wellington) 273 104 377 27.5Burnett (Auckland) 524 209 733 53.5Te Puawaitanga o te ora (Hamilton) 26 5 31 2.5Te Toka (Christchurch) 156 70 226 16.5TOTAL 1367 100Of those tested in 2009, 83 percent were male and 16 percent female (1 percent were nonidentifying).44 percent self‐identified as homosexual, 10 percent as bisexual, and 43 percent asheterosexual. 54 percent identified as European, 15 percent as Asian and 14 percent as Pākehā;Africans accounted for 3 percent and Māori for 5 percent.24 REVIEW OF SERVICES FOR PLHA
Auckland – Burnett CentreAuckland has the largest HIV positive population and the largest gay population in New Zealand. Inthe region in 2009, 194 individuals received a total of 1677 counselling sessions. Up to fivecounselling sessions are offered initially, and decisions on increasing this entitlement up to amaximum of 15 sessions are made as required on a case‐by‐case basis. In 2009, 490 episodes of HIVsupport services were recorded for 133 service‐users, including hospital visits (45 percent of thetotal), participating in case conferences (16 percent), advocacy (7 percent) and home visits(3 percent).The Burnett Centre – which is effectively the operational arm of the NZAF’s Positive Health services inAuckland – houses the northern and midland regional manager (one FTE) and an administrationassistant (one FTE) to deal with calls relating to the two regional areas. A 0.5 FTE therapeutic leader(psychotherapist) is also based at the Burnett Centre; although this is a national position, the roleprovides oversight of the Centre and assists in recruitment of staff and student placements.Therapeutic staff include 1.8 FTE counselling staff (two people), 0.8 FTE psychotherapist staff (twopeople) and 0.4 FTE (one person) as a paediatric social worker. This latter position is Auckland‐based,as Starship Hospital covers most paediatric HIV nationally.In addition to the HIV and syphilis screening carried out at the Burnett Centre, as shown in the tablesabove, the NZAF also operates a full sexual health screening programme at the centre, in partnershipwith ADHB SH services (as agreed in a Memorandum of Understanding [MOU] between bothorganizations). A similar service now operates in the Awhina Centre in Wellington, as does a ‘sex onsite’ testing service in Christchurch – all under MOUs with the relevant DHBs.In addition to screening and testing services, and counselling and support activities, like all suchcentres NZAF in Auckland provides the following services and activities:training on HIV for health professionals, medical and nursing students and New Zealand BloodServices, among others, and also for employers (they have also recently provided training to theDepartment of Corrections)a group established in the last year for female partners of HIV positive men – more group work isbeing developed for the 2010/2011 operational yearaccess to information about treatments and availability of funding (the head of Positive Health is amember of the treatment officer network)lobbying for new medicines both directly with Pharmac and as part of the 26‐strong NGO collationfor access to medicines (ATM)staff of the Burnett Centre are members of International Rectal Microbicide Advocacy, and act ascoordinators for national and international (Australasia and East Asia) Candlelight Memorials forthe Global Health Council (for which the Positive Health director sits on the international board).Management of the Positive Speakers Bureau has recently gone to tender with peer NGOs, as haspublication of Collective Thinking.Christchurch – Te Toka CentreThe Christchurch office currently employs six staff, including the regional manager (currently alsoacting in that capacity in Wellington), a receptionist, an outreach worker for African populations, aprevention specialist and two counsellors.REVIEW OF SERVICES FOR PLHA 25
Page 1 and 2: REVIEW OF SERVICES FORPEOPLE LIVING
Page 3 and 4: ACRONYMSAEGAMTACANCAPPARVBPCBOCSWDH
Page 5 and 6: CONTENTSACRONYMSACKNOWLEDGEMENTSEXE
Page 7 and 8: EXECUTIVE SUMMARYThis review has id
Page 9 and 10: INTRODUCTIONThe national clinical a
Page 11 and 12: The available data show that in the
Page 13 and 14: Family Planning is a not‐for‐pr
Page 15 and 16: METHODOLOGYThis review effectively
Page 17 and 18: * This does not include all DHB ser
Page 19 and 20: an adult sexual assault unit - SH r
Page 21 and 22: B. WAIKATO DISTRICT HEALTH BOARD (w
Page 23 and 24: perceived as formally (if implicitl
Page 25 and 26: The discussions in Wellington also
Page 27 and 28: informally arranged with SH colleag
Page 29 and 30: Ongoing close collaboration between
Page 31: The NZAF is the only national NGO r
Page 35 and 36: As indicated above, there is a stro
Page 37 and 38: Figure 2: Reasons for FP clinic att
Page 39 and 40: As part of this review a focus grou
Page 41 and 42: Christmas dinner serving 100 or mor
Page 43 and 44: Despite INA’s development constra
Page 45 and 46: Difficulties in maintaining quality
Page 47 and 48: 6. The need for consistent targeted
Page 49 and 50: It is evident that stigma is the el
Page 51 and 52: CONCLUSIONSFrom the foregoing, some
Page 53 and 54: APPENDIX 1: TERMS OF REFERENCEREVIE
Page 55 and 56: Modes and frequency of communicatio
Page 57 and 58: LOCATION NAME ORGANISATIONHamiltonT
Page 59 and 60: Institute of Environmental Science
Page 61 and 62: APPENDIX 5: HIV NGO WEBSITE DATAOrg
Page 63 and 64: InquiryResponseResearch, analysis,
Page 65 and 66: InquiryResponseFrequency and regula
Page 67 and 68: Inquiry5. By what criteria are need
Page 69 and 70: Inquiry9. How is impact,effectivene
Page 71 and 72: B. BODY POSITIVE INC.Inquiry1. Is t
Page 73 and 74: C. INA FOUNDATION CHARITABLE TRUSTI
Page 75 and 76: Inquiry6. What makes the service ef
Page 77 and 78: Inquiry9. How is impact, effectiven
Page 79 and 80: InquiryResponse2. Personal knowledg
Page 81 and 82: InquiryResponseMF is 26 and has ove
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InquiryResponse7. What obstacles -
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Review of services for people living with HIV in New Zealand

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