HIV cases are increasing and health practitioners have a role to play in preventing the spread and encouraging the use of PrEP, writes Karina Reeves, Coordinator of Health Promotion at WAAC.
Recent data from the WA Department of Health show HIV notifications increased from 68 in 2023 to 77 in 2024. Between January and June 2024, 28 new diagnoses were reported, with the majority involving individuals born in South-East Asia and Sub-Saharan Africa.
People from culturally and linguistically diverse backgrounds are a priority group under both the Western Australian Sexual Health and Blood-borne Virus Strategy 2024–2030 and the Ninth National HIV Strategy 2024–2030.
Community consultations have revealed widespread gaps in knowledge about HIV risk, prevention, and treatment, particularly among migrants from Asia, Africa, and South America.
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WA’s early HIV prevention success largely stemmed from community-led campaigns targeting gay, bisexual, and other men who have sex with men. These efforts were culturally relevant and resonated with the target population.
However, as HIV demographics shift to include more heterosexual individuals and those from CaLD backgrounds, prevention strategies must evolve accordingly.
The changing nature of transmission highlights the importance of inclusive, adaptive approaches that address the specific needs of emerging at-risk groups.
Misconceptions of HIV prevention
Stigma remains a major barrier, especially around sexual health and HIV. Misconceptions persist in CaLD communities – such as the belief that PrEP is only for men.
These misunderstandings are sometimes reinforced by healthcare professionals, who may not perceive women in heterosexual relationships as being at risk.
A 2024 scoping review found many providers were unsure about prescribing PrEP to cisgender women, emphasising the need for improved education and awareness.
PrEP is highly effective when taken as prescribed, preventing sexual transmission and reducing the risk of acquiring HIV from a partner who injects drugs.
For women, it offers a way to take control of their sexual health without relying on their partner’s choices. Regular testing is also crucial, as delayed diagnoses lead to poorer health outcomes and increase the risk of further transmission.
The role of healthcare providers
Healthcare practitioners play a pivotal role in dispelling myths and initiating HIV-related conversations. In many cultural settings, patients expect providers to raise health concerns, including those related to HIV.
However, research shows clinicians may avoid such discussions for fear of offending patients from migrant backgrounds.
The Migrant and Refugee Blood Borne Virus Survey – a 2021 national study – found that most respondents would not be offended if offered an STI or BBV test by a doctor or nurse.
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Notably, only 41% of respondents knew that HIV is not automatically included in routine blood tests. This misconception can result in people wrongly believing they’ve already been tested.
When healthcare providers avoid HIV discussions, opportunities for prevention and early detection are missed, further entrenching health disparities.
Overcoming barriers
Language barriers, stigma, and limited healthcare engagement contribute to lower HIV testing rates in CaLD communities.
Addressing these requires promoting routine testing – especially for women in high-risk situations or with partners from high-prevalence regions.
Early diagnosis and prompt pre-treatment are essential to stopping transmission and improving health outcomes. It’s also critical to engage women of childbearing age to prevent vertical transmission to children.
Encouraging providers to initiate conversations about HIV risk, PrEP, and testing will help close the gap in service access and understanding. This proactive approach supports better health outcomes for CaLD women and ensures more equitable care.
Closing the knowledge gap
Creating an environment where sexual health, HIV risk, and prevention are regularly discussed in clinical settings is essential to inclusive care.
The ASHM Decision Making in HIV tool and National PrEP Guidelines offer resources for clinicians.
ED note: WAAC’s ‘Even Me?” campaign aims to empower CaLD communities with the knowledge and tools to prevent HIV and improve public health outcomes for all Australians.
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