Aboriginal and Torres Strait Islander communities continue to be dramatically affected by systemic racism. Its lasting impact can make it hard for individuals to trust health services. It is the responsibility of health services to ensure that they have adequate systems to improve and ensure cultural safety for both staff and patients who are Aboriginal and/or Torres Strait Islander.  Community involvement and local knowledge and awareness of customs are vital when developing prevention and care services. Increasing the number of Aboriginal and Torres Strait Islander staff employed, including nurses and doctors, is an important step in ensuring cultural safety whilst ensuring these staff are treated with respect. 

In many communities, HIV prevention is best provided in a general setting and not targeted to minority groups within that community.  It is important to be careful of language that may ostracise people further than what they may already feel. An example of good practice is to include HIV with all STIs, providing information for people of all genders and ages (though people may be in separate groups) during generalist health promotion and education.  

Another strategy can be to include screening for HIV and other sexually transmitted infections in ‘well persons and adult health checks’ without asking personal questions that can seem intimidating. Community screening of young people is a successful strategy that has been used across Australia. This can be developed as a modified generalist check avoiding the stigma of specific STI screening (12). 

An understanding of and access to PrEP may be limited for those not living in major cities (13). Ensure that local education materials are designed collaboratively with the community. Written material may not be the appropriate medium. Private discussion with individuals may be a better strategy in smaller communities.