Review of services for people living with HIV in New Zealand

InquiryResponseChallenges to service deliveryMost significant is the challenge in securing a coherent consensus on needs andservice changes differing views of PLWHA organisations from each other as well askey PLWHA stakeholders who have disassociated from the PLWHA organisations.Purchasing a formal externally purchased research project such as HIV Futures2 isessential. Majority views do not ensure agreement for example Wellness Fund.Strong feedback to not devolve to a PLWHA organisation.HIV is now a chronic condition with almost full life expectancy on treatments. Asignificant challenge exists in assessing what is reasonable for tax payer supportwhen compared with other chronic conditions that have higher fatalities amongstspecific populations groups yet may be less resourced.Lack of MoH leadership in respect to chronic conditions and national public healthdirection.7. What obstacles – if any –exist for potential serviceusers?Times, geography,culture, information,language, ideology8. How is the service workingon an administrative level?Administrative capacity(staff numbers)Administrative needsAdministrativestrengths andweaknesses – howburdens affect outputsWhat obstacles – if any – exist for potential service users?Minority cultures and internalised HIV and homophobia/stigma in their communitiesfor: African heterosexuals – particularly men; Asian homosexuals and heterosexuals.The challenges of being a minority within a minority: sense of isolation through beingsmall marginalised within HIV. Heterosexuals, children and families.Young people who have grown up with HIV.High need complex diagnosis gay and bisexual men – often high need existing beforediagnosis. HIV complicating who is best placed to provide support and meet varietyof needs.Confusion on who is best placed as a service provider to meet the variety of needs.Uncertainty and competition.Personal views of ID clinicians as who is best placed to serve and support PLWHApatients.Administrative capacity (staff numbers) 39 staff, not FTEs, excluding admin staff (10 regular volunteers – include studentplacements) 7 administration, IT and finance staff 1 Trust Board secretary (part‐time).Administrative needs Supporting three centres that have regular client visits (i.e., 2876 HIV and syphilis testclients in 2009). Supporting six community‐based workers across the country. Supporting six national roles in communications, campaigns and technology. Supporting one international development project. Supporting finances processes for over $300,000 accounts payable/receivable permonth. Supporting 300 membership and 400+ volunteers.Administrative strengths and weaknesses – how burdens affect outputs Aim to keep administration costs to 18% or under. Vulnerable at times of sickness or high demand. IT and network time increased to full time.60 REVIEW OF SERVICES FOR PLHA