Refugees and asylum seekers may have genuine fears of sharing their health information, especially where HIV is highly stigmatised in their country of origin, and about potential breaches of confidentiality.  To gain trust and establish a relationship, it can be useful to provide reassurance about Australian nurses’ and midwives’ legal and ethical duties and responsibility to maintain privacy and reinforce that nurses only share information with the person’s explicit consent (19). 

The use of interpreters may be difficult to negotiate because asylum seekers and refugees with HIV may have extreme anxiety and concerns about privacy, especially in small communities.  However, accurate health interpretation is important to ensure the person’s comprehension of health- and treatment-related information. The use of phone interpreters (rather than face-to-face) and pseudonyms when using interpreter services can help overcome this problem (32). Having a conversation with an interpreter before meeting with them to emphasise their professional obligation to maintain privacy and confidentiality can be useful (32). 

Stigma in their country of origin (relating to HIV, homosexuality or sexual transmission) can result in people feeling that any discussion of HIV is taboo and can lead to isolation. Using peer-led discussion and education around sexual health and HIV can be successful in helping break down taboos (32).  

Despite many stressors, asylum seekers, refugees and migrants living with HIV demonstrate resilience (33-35).  Nurses can support them to build upon their strengths as they navigate their new life and their HIV diagnosis and can assist them in accessing treatment and care.