The importance of ensuring that the healthcare workforce involved in HIV is sustainable and supported to provide long-term care under nationally endorsed best practice models is recognised. Workforce issues also include addressing the fluctuating distribution of Section 100 prescribers (GP based and specialist) and their patient caseloads, the recruitment and retention difficulties for Section100 GP prescribers and clinicians with an interest in HIV, and the importance of ongoing training, support and financial resources for medical, nursing and certain allied health professionals. Professional development should address multidisciplinary team roles and effective case management. Training and skills development for staff of health and community services will improve service accessibility for Indigenous and CALD populations.
Investment or the reorientation of spending is required to build workforce capacity in ambulatory care, shared care and primary healthcare for the ageing population of people living with HIV. This includes in the non-government, community and voluntary sector. Training requirements of healthcare workers and other service providers will respond to the need to mainstream some services for people with HIV, the decline in skills for recognising, diagnosing and treating HIV within some health services, and the need to reduce discriminatory practices. Policy, service protocols and training will reinforce the need to adhere to privacy principles in electronic sharing of health and other client information.
The need to maintain HIV specialist treatment, care and support services in hospitals, sexual health services and high-case load general practice as well as mainstream services to make them more accessible and appropriate for people living with HIV is supported. Improved access to mainstream health services is important, as is maintaining designated HIV services and encouraging mainstream healthcare service providers to consider the specialist needs of people living with HIV. A small number of people with HIV are likely to present complex challenges for on-the-ground service providers.
The role of the community sector, including paid and unpaid workers in education prevention, support and advocacy, has served the Australian community well. Ongoing support of this sector is therefore essential to the strength of the partnership.
It is also important to ensure that HIV awareness and education to address stigma and discrimination is included in training programs for staff in all mainstream service agencies. It is also important that training of mental healthcare workers includes building awareness of the interactions between HIV and psychiatric medications, and understanding of the nature of HIV illnesses.
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Priority actions in workforce development
- Strengthen training programs and continuing medical education in HIV for GPs, recognising the differing needs of GPs with low and high HIV caseloads.
- Facilitate the development of a primary healthcare team-based approach in collaboration with specialised services.
- Ensure high quality knowledge and skills in relation to HIV in government and non-government health and community services.
- Improve collaboration between mental health, clinical and welfare services to address the care and support needs of people living with HIV who have cognitive illness and drug and alcohol dependency issues
- Strengthen community agencies in the provision of education, prevention support and advocacy services to affected and infected communities.
Ministerial Advisory Committee on Blood Borne Viruses and Sexually Transmissible InfectionsRobert Batey
Michael Kidd (chair)
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HIV Expert Writing Reference GroupJonathan Anderson
Graham Brown (co-Chair)
John de Wit
Andrew Grulich (co-Chair)
Writing teamLevinia Crooks