Review of services for people living with HIV in New Zealand

As part of this review a focus group was held for PW service‐users, and 12 women attended. Thesewomen identified support as the availability of ‘understanding, acceptance, recognition’. The groupendorsed the sentiments of one member regarding peer support in particular: ‘Peer support ispowerful because we know what it is like [to live with HIV]’. The group raised the following issues ascause for concern.Accessing HIV‐related services through primary medical care surgeries – particularly for womenwith young families or those in a dependent benefit situation – is financially difficult (in Auckland,primary care costs $42 per visit, not counting prescription charges).There is a need for greater availability of ‘social’ support facilities such as social workers and legalassistance, as well as mental health services. In‐home outreach services would make life mucheasier for women with young families.Primary care practitioners vary widely in the extent of their knowledge of HIV: a free advisoryservice and hotline would save cost and time in this respect.Stigma and the fear of discrimination is a major concern, especially for Africans: one woman notedthat ‘Africans get support from non‐Africans [because of] ... fear of disclosure within Africancommunities’. Life as an immigrant, having to self‐fund treatment, offers specific additionalchallenges. PW was regarded extremely positively in this regard: one woman said ‘PWI is alistening ear when I need it. PWI are my family in New Zealand.’HIV positive women are reluctant to disclose their situation to employers, wary of fear‐baseddismissal. Occupational health and employment services need to be educated in this respect.Women are sometimes held to ransom by aggrieved or angry former partners threatening publicdisclosure of their status. The apparent lack – or ignorance – of a legal policy frameworkregarding confidentiality and manipulation of personal knowledge is seen as a significant problem.Mental health support at key times is currently inadequate – available only at diagnosis, or ifwomen report feeling suicidal. Women interviewed characterised HIV as entailing a lifetime ofconsequence: the emotional burden of living – even healthily – with HIV was described as ‘reallygruelling’. Without informed emotional and psychological support, one person stated, ‘All youcan do is cry in your house.’Mothers with young children noted that information/education materials for children with HIV arevery limited. Additionally, financial support for formula feed was identified as an important need.Figure 3: Self‐identified ethnicity of PW service‐users, February 2010REVIEW OF SERVICES FOR PLHA 31