The guiding principles informing this strategy are drawn from Australia’s efforts over time to respond to the challenges, threats and impacts of HIV, STIs and hepatitis C. Strategies addressing each of these diseases, including as they relate to Aboriginal and Torres Strait Islander peoples, seek to minimise their transmission and impacts on individuals and communities and establish directions based on their unique epidemiology, natural history and public health imperatives.
The guiding principles underpinning Australia’s response to these diseases in this strategy, and in the individual strategies on national hepatitis B, hepatitis C, HIV and STIs, are:
- The transmission of HIV, STIs and hepatitis C can be prevented by adopting and maintaining protective behaviours. Vaccination is the most effective means of preventing the transmission of hepatitis B. Vaccination, education and prevention programs, together with access to the means of prevention, are prerequisites for adopting and applying prevention measures. Individuals and communities have a mutual responsibility to prevent themselves and others from becoming infected.
- The Ottawa Charter for Health Promotion6 provides the framework for effective HIV, STI and viral hepatitis health promotion action and facilitates the:
- active participation of affected communities and individuals, including peer education and community ownership, to increase their influence over the determinants of their health
- formulation and application of law and public policy that support and encourage healthy behaviours and respect human rights as this protects those who are vulnerable or marginalised, promotes confidence in the system and secures support for initiatives.
- Harm reduction principles underpin effective measures to prevent transmission of HIV and viral hepatitis, including through the needle and syringe programs (NSPs) and drug treatment programs.
- People with HIV, STIs and viral hepatitis have a right to participate in the community without experience of stigma or discrimination, and have the same rights to comprehensive and appropriate healthcare as do other members of the community (including the right to the confidential and sensitive handling of their personal and medical information).
- An effective partnership of governments, affected communities, researchers and health professionals is to be characterised by consultation, cooperative effort, respectful discussion and action to achieve this strategy’s goal. This includes:
- non-partisan support for the pragmatic social policy measures needed to control HIV, STIs and viral hepatitis
- recognition that those living with, and at risk of, infection are experts in their own experience and are therefore best placed to inform efforts that address their own education and support needs
- timely and quality research and surveillance to provide the necessary evidence base for action
- a skilled and supported workforce
- leadership from the Australian Government, but also the full cooperative efforts of all members of the partnership struck to implement this strategy’s agreed directions and early adoption of a framework for monitoring and evaluation.
This strategy is unique in that it also recognises the following five main principles:
- The priority and ongoing action areas in this strategy have been articulated to guide resource allocation in the area of Aboriginal and Torres Strait Islander health.
- The role that ACCHS can play in the delivery of health programs in this area is recognised. Services should be supported in enabling outcomes and targets identified in this strategy.
- Close family ties, kinships and strengths of cultural and social organisation exist within Aboriginal and Torres Strait Islander communities. Healthcare services are often carried out in an environment where there are significant social and cultural obligations and economic burdens occurring.
- The importance of choice between healthcare providers for Aboriginal and Torres Strait Islander peoples is recognised. Wherever possible, government services, private general practitioners and ACCHS should work together to ensure Aboriginal and Torres Strait Islander peoples have options for confidential sexual healthcare and BBV healthcare.
- The following aspirations in Aboriginal and Torres Strait Islander peoples’ health and wellbeing is recognised:
- enjoyment and control of consensual sexual (and potentially) reproductive behaviour in accordance with cultural values, kinship practices and individual ethics
- freedom from shame, guilt, myths about sexual orientation and sexual behavioural choices that do not harm individuals or their sexual partners
- freedom from infectious diseases that are preventable and treatable, and that may interfere with sexual life
- freedom from harms that may interfere with the sexual health and emotional wellbeing of individuals.
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1The Ottawa Charter for Health Promotion is a 1986 document produced by the World Health Organization. It was launched at the first international conference for health promotion that was held in Ottawa, Canada.