Introduction Confusion exists with regard to the delivery of equal or equitable services. Far from providing the same care to all our clients we have delivered an enhanced, culturally secure service to a small cohort of Aboriginal people living with HIV. This paper evaluates the impact of this program. Our hypothesis is that this model of care results in improved outcomes. This paper seeks to present this model of HIV care and outline the results as a consequence of this care.
Methods Data were collected with regard to the type and number of occasions of service, medication compliance, HIV viral loads, CD4 counts, mortality and pregnancy outcomes.
Results From 1994 primary care was provided to the cohort by four doctors, demonstrating low staff turnover for a regional area. All of the current cohort of 16 people are actively engaged with the service. The most common type of service delivered was for follow up with over 350 contacts provided over 12 months. On average there were four contacts per case per month ranging from one to 30. Ninety-four percent are on medication 62.5% with undetectable HIV viral loads, and 62.5% with satisfactory CD4 counts. Since 1994 twelve of the cohort has died and there have been ten new notifications. There have been 30 pregnancies with two positive babies.
Conclusion Although challenges in obtaining ideal outcomes persist, a holistic service delivery characterised by the development and continuation of relationships with the service provided has resulted in complete engagement of this cohort and has achieved positive outcomes in 62.5% of cases. This model of care, although labour intensive, delivers results similar or better than those seen internationally in hard to reach populations It demonstrates that equal outcomes can be achieved when equitable services are provided in a culturally appropriate manner.
Disclosure of interest statement None No pharmaceutical grants were received in the development of this study.
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