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Review of Services for
People Living with HIV
in New Zealand


David Miller

A report commissioned by the


Ministry of Health
Published in November 2010 by the
Ministry of Health
PO Box 5013, Wellington 6145, New Zealand

ISBN 978-0-478-37406-3 (online)


HP 5267
This document is available on the Ministry of Health’s website:
http://www.moh.govt.nz


ACRONYMS


AEG AIDS Epidemiology Group

AMTAC AIDS Medical and Technical Advisory Committee

ANC Antenatal care

APP Absolutely Positively Positive

ARV Anti-retroviral

BP Body Positive

CBO Community-based organisation

CSW Commercial sex worker

DHB District Health Board
ADHB – Auckland District Health Board
CCDHB – Capital and Coast District Health Board
CDHB – Canterbury District Health Board
WDHB – Waikato District Health Board

ESR Institute of Environmental Science and Research

FP Family Planning

FTE Full-time equivalent

GAPSS Gay Auckland Periodic Sex Survey

HAART Highly active anti-retroviral therapy

HCW Health care worker

ID Infectious diseases

IDU Injecting drug user

INA INA Foundation

MARP Most at-risk populations

MH Mental health

MOU Memorandum of Understanding

MPI Māori and Pacific Islands

MSM Men having sex with men

NGO Non-government organisation

NZAF New Zealand AIDS Foundation

PC Prostitutes Collective

PLHA People living with HIV/AIDS

PW Positive Women

SH Sexual health

SHC Sexual health clinic

SHP Sexual health physician

STI Sexually transmitted infection

T&C (HIV) testing and counselling

TOP Termination of pregnancy

UNAIDS United Nations Joint Programme on HIV/AIDS

UNGASS United Nations General Assembly Special Session on AIDS

WHO World Health Organization

ACKNOWLEDGEMENTS


The author wishes to thank all people contacted in the context of this review for the openness, willingness and constructive spirit they showed and the time they gave in their collaboration, despite pressing clinical and administrative schedules, and the occasional frustrations associated with travel and timings. The candour and trust shown was very gratefully received, and is here warmly and thankfully acknowledged. I want to thank particularly those people living with HIV who showed trust and sincerity in revealing their realities and offering constructive suggestions for strengthening services for people living with HIV in New Zealand.

About the author


Dr David Miller, PhD, Dip Clin Psyc, MA (Hons) is an HIV/AIDS specialist who has worked with WHO/UNAIDS programmes in clinical, public health, policy and governance settings in London, Geneva and New Delhi.
Dr Miller is a New Zealander with in-depth experience at the international professional level as a clinical psychologist, as a public health specialist and as a designer and implementer of corporate governance. He has worked in clinical, public health, policy and governance settings in London, Geneva and New Delhi and conducted training and interventions in over 50 countries (mainly Africa and Asia) across government, NGO, bilateral and multi-lateral sectors. Dr Miller has also developed clinical protocols for psychosocial management in HIV/AIDS that have been adopted and adapted globally by ministries of health, bi-lateral and United Nations agencies and NGOs.

Contents


ACRONYMS iii

ACKNOWLEDGEMENTS iv

About the author iv

Contents v

EXECUTIVE SUMMARY vii

SUMMARY OF RECOMMENDED RESPONSES TO ISSUES IDENTIFIED viii

INTRODUCTION 1

METHODOLOGY 7

1. SITE SELECTION AND REPORT DESK REVIEWS 7

2. SITE VISITS AND KEY STAKEHOLDER DISCUSSIONS 7

3. REPORT PREPARATION 7

4. FINAL DRAFT PREPARATION AND SUBMISSION 7

RESULTS 10

1. DISTRICT HEALTH BOARD SERVICES FOR PLHA 10

A. AUCKLAND DISTRICT HEALTH BOARD (www.adhb.govt.nz) 10

B. WAIKATO DISTRICT HEALTH BOARD (www.waikatodhb.govt.nz) 13

C. CAPITAL AND COAST DISTRICT HEALTH BOARD (www.ccdhb.org.nz) 16

D. CANTERBURY DISTRICT HEALTH BOARD (www.cdhb.govt.nz) 20

E. SUMMARY OF ISSUES EMERGING FROM THE REVIEW OF DHB SERVICES FOR PLHA 23

2. NON-GOVERNMENT ORGANISATION SERVICES FOR PLHA 24

A. NEW ZEALAND AIDS FOUNDATION (www.nzaf.org.nz) 24

B. FAMILY PLANNING (www.familyplanning.org.nz) 30

C. POSITIVE WOMEN INC (www.positivewomen.co.nz) 31

D. BODY POSITIVE INC (www.bodypositive.org.nz) 34

E. INA HIV/AIDS FOUNDATION CHARITABLE TRUST (www.ina.maori.nz) 37

F. SUMMARY OF ISSUES EMERGING FROM THE REVIEW OF NON-GOVERNMENT ORGANISATION SERVICES FOR PLHA 39

3. ADDITIONAL CONTRIBUTIONS FROM PEOPLE LIVING WITH HIV/AIDS 41

DISCUSSION 44

CONCLUSIONS 48

APPENDIX 1: TERMS OF REFERENCE 50

Review of HIV positive service coverage in New Zealand 50

APPENDIX 2: KEY ISSUES FOR ORGANISATIONS UNDER REVIEW 51

1. Is there a clear statement of purpose for the service and, if so, how was that determined? 51

2. Are the aims and activities of the service consonant with applicable Ministry of Health policies? 51

3. How is the service regulated internally? 51

4. Is the service structurally equipped to meet the expressed needs of people who are HIV positive? 51

5. By what criteria are needs of people with HIV prioritised? 51

6. What makes the service effective and relevant for HIV positive people? 52

7. What obstacles – if any – exist for potential service users? 52

8. How is the service working on an administrative level? 52

9. How is impact, effectiveness and value assessed, and what have those assessments indicated to date? 52

10. Are there any gaps in service coverage that need future investment? 52

11. Are there plans for service development or evolution? 52

APPENDIX 3: CONTRIBUTORS 53

APPENDIX 4: DOCUMENTATION REVIEWED 56

APPENDIX 5: HIV NGO WEBSITE DATA 59

APPENDIX 6: HIV NGO SERVICE REVIEW SELF-REPORTED DATA 60

A. New Zealand AIDS Foundation 61

B. Body Positive Inc. 71

C. INA Foundation Charitable Trust 73



D. Positive Women Inc. 81


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