The National Aboriginal Community Controlled Health Organisation (NACCHO) and The Torres Model of Care specific to the Torres Strait Islands are two models of care that nurses should familiarise themselves with. 

For optimal outcomes, care is provided in partnership with the PLHIV. Consideration must always be given to confidentiality, which is more difficult to manage in small communities. Unwanted disclosure may cause distress and deter people from seeking health care at all. 

Continuity of staff is very important for all but is even more so if the person is isolated around their diagnosis and does not want to share their health information with family and friends.  

Connecting people with peer support needs to be considered carefully. An individual may be concerned that if connected with an Indigenous support, group their confidentiality may be compromised – careful consideration and support are required. There are many positive benefits when this is managed well (see PATSIN).  

It is important to clarify with the person with HIV exactly with whom he or she authorises information to be shared, and strongly adhere to this authorisation.  Simply using someone’s name in the wrong setting can breach their privacy or lead someone to perceive that his or her confidentially is breached, even if it has not.  

It is the individual’s choice if the service provider is a mainstream service, a locally managed primary health centre or both. HIV, like other chronic conditions, needs to be managed by the person in a way that they can maintain over a long period. It can take time to work out what is best. 

A strength-based approach with open communication and genuine enquiry is required. HIV is still a stigmatised condition.  Regardless of whether stigmatisation is real or perceived, it needs to be considered when working with a person for their longer-term HIV management. 

Basic enquiry about the person’s social setting and home environment, including privacy for storage of medicines, and how medicines will be accessed is a key step to aid adherence. Likewise, nurses or midwives can offer to facilitate access to pathology and medical follow-up. 

Other important questions include: 

• Who are this person’s best supports, and can these people be used to contact them? 
• Are there any barriers for the person to access and remain engaged in care?   
• Do they have strategies, and supports to overcome barriers that will make it easier to manage HIV?  

In regional and remote communities, consideration to accessing some components of health care away from their community, for example, via telehealth may be beneficial. Plans for maintaining care, if they are travelling and alternative backup strategies for accessing treatments and other health services, are very useful.