Immigrant, CALD communities and HIV - Silence and Articulation Conference, NCHSR

Presentations in this session identified key gaps in our knowledge about CALD communities affected by HIV, stimulated discussion about how to improve the HIV response among migrants and refugees, and explored questions of who is silenced and who is privileged in discussion around HIV, CALD communities and criminalisation.

Panel presenters at immigrant and CALD communities
and HIV session

Jill Sergeant who leads the AFAO African Project, provided an update on the HIV response in African communities.  Encouragingly, she described how local African community networks have been set up in most/all states and territories since the African Communities Forum that AFAO convened in 2011.  However, she highlighted key gaps in our knowledge, including where and why people from African communities become infected with HIV, and why African men in particular, avoid health services. Do you have any suggestions how these, and any other gaps in our knowledge, could be addressed?

Tadgh McMahon, from the Multicultural HIV and Hepatitis Service, NSW, questioned the use of language and terminology, suggesting that there are other ways to classify affected communities, including through the prism of language proficiency, visa-category, and immigration status. He highlighted shifts in migration, whereby there are annually 3 new temporary visa holders, for every 1 permanent visa holder, arguing the HIV response among CALD communities should address this. He posited that the HIV response among CALD communities should maintain practices that have served us well - such as work being targeted, culturally appropriate and community led, while letting go of out-dated notions - such as equating residents with migrants, the testing for HIV as part of eligibility to enter Australia, and a general hesitancy to act for fear of drawing attention to the issue.  Are there other notions that have passed their used-by-date?
Tadgh suggested areas for innovation; making the best use of the epidemiological data we have and drawing on overseas data, tackling later HIV presentation issues, integrating issues of MSM CALD, and targeting CALD heterosexuals better, perhaps by industry. What other innovative approaches do you believe would be useful? How can any of the ideas Tadgh suggested by realised?

Barbara Baird and Anne Bourne provided some very interesting insights on the case of an African man, Sam*, who was charged and convicted of exposing someone to HIV. Barbara and Anne personally supported him before, during the trial, and since his conviction. As Sam eventually pleaded guilty, resulting in the aborting of the trial, they argued that his experienced was effectively silenced. His story was not heard, nor recorded, and they questioned the silencing of someone who is already disempowered. They described how, as an African man, James had felt that he had very little support, both from his own cultural community or the HIV sector. It raises questions about what can be done to better support people, like James, who have HIV and have been caught up in the criminal justice system?

There was a fourth presentation by Alan Brotherton, ACON,  which linked in with themes of the other presenters. In particular, he contrasted the differing media responses in criminal prosecutions of Anglo-Australians and African-Australians. Following these presentations, there was a lively discussion, including in relation to what role racism plays in the HIV response among CALD communities. Do you think it is a significant factor? If so, how should it be addressed?

*Sam is a pseudonym, to protect the identity of the individual involved.