The Sixth National HIV Strategy

6.3 Treatment, health and wellbeing

Page last updated: July 2010

There is increasing diversity among people living with HIV, with a growing population of newly diagnosed people whose health is relatively good, alongside an ageing cohort of people who are living long term with HIV. The HIV-positive population in Australia is made up of a large proportion of people living with manageable HIV disease. Across the population are others facing a range of clinical complexities in their health management. Clinical management of HIV is now also focused on monitoring and treating other co-morbidities— both associated with HIV and other conditions occurring as the population is ageing.

An approach that is holistic and addresses prevention of illness and the maintenance of health and wellbeing is supported. Services should respond to the needs of people living with HIV in the mainstream health sectors and in the HIV-specific healthcare, services and peer support sector, including those delivered in community settings. This approach will contribute to an evidence building response to guide where HIV treatment and care is shared across sectors.

People living with HIV continue to face complex challenges to their health and wellbeing. The complexities of clinical disease for some HIV-positive people can involve drug toxicities, psychiatric illness, drug interactions and drug and alcohol dependency issues. In many communities, people living with HIV report social isolation and discrimination. They can face barriers to social participation and may experience difficulty in accessing healthcare and welfare services, housing, insurance, employment and education. People with HIV may also experience significant challenges in forming and maintaining relationships due to issues of disclosure, stigma and discrimination as well as inaccurate perceptions of health and wellbeing.

Managing HIV requires continuous medication with life-long therapy and high levels of clinical monitoring, which can be a substantial cost and time burden. Difficulties exist in providing support to adhere to treatment combinations. These can be related to access and disclosure issues, particularly in rural and remote communities where disclosure is a concern. Everyone in Australia should have access to high-quality HIV healthcare and appropriate treatments should they need it. Health promotion activities will also respond to the specific needs of older gay men living with HIV, women with HIV, heterosexual people with HIV, Aboriginal and Torres Strait Islander communities, people who inject drugs and people from CALD communities.