Sarah Bernays

This session illuminated the centrality of communities in developing effective, locally salient approaches. The first speaker highlighted the value of sustained investment in culturally appropriate approaches. The second speaker described how social network approaches can identify those currently undiagnosed to support their engagement in testing, including self-testing, and treatment.

The first speaker, Prof James Ward, Director of the Poche Centre at the University of Queensland described the profound influence of colonial history in shaping the trajectories of Aboriginal and Torres Strait Islanders’ STI experiences. He described the ‘deplorable conditions’ of quarantine (lock hospitals) for affected individuals. Inter-generational trauma shapes expectations of engagement with care and undergirds structural risks. Prof Ward and his community partners have focused on transforming their collective story from a deficit-model to an empowerment approach. He described six projects implemented over thirty years, starting in Central Australia in the 1990s, which demonstrated how community engagement can reframe health promotion and identify pathways to overcoming entrenched stigma. These projects include: Young, Deadly, Free; ATLAS Sentinel Surveillance Networks; Aboriginal and Torres Strait Islander HIV Awareness Week; Precision Public Health Trial; investment in research capacity within the Poche Centre. The second speaker, Virginia McDonald from WHO, described the work being done within HIV testing to simplify, de-medicalise and increase access. Drawing on the emerging evidence-base, she made the case that social networks may help locate those who do not yet know their HIV status and the role that self-testing can play in enabling empowered engagement in widespread testing access.

The HIV response has developed pioneering models to enact community-led approaches. This operates on three foundational principles: 1) enabling civil society, 2) empowering participation; and 3) creating a space where people living with HIV can rise above the pernicious effects of stigma and discrimination. The session highlighted the power of storytelling in attending to the injustices of our past and recognising its implications for our present. It also demonstrated the power of community-based connections in 1) centring Indigenous knowledge in response to HIV; and 2) identifying precision evidence-based approaches to guiding investment and tailoring locally appropriate testing for maximum impact.