AIDS Action Council of the ACT People Living with HIV/AIDS ACT Westlund House, 16 Gordon Street, Acton, 2601 GPO Box 229, Canberra, 2601 tel: 02 6257 2855 fax: 02 6257 4838 www.aidsaction.org.au aidsaction@aidsaction.org.au
Annual Report 2007 - 2008
The AIDS Action Council is a community organisation that was born from a grass roots response to a looming crisis. The AIDS Action Council continues to recognise its close connections with the variety of affected communities it serves.
Our Vision: Leading the World beyond HIV/AIDS
Our Mission: The AIDS Action Council of the ACT aims to minimise the social and personal impacts, and transmission, of HIV/AIDS.
Our Values: We: s s s s
3TRIVE FOR EXCELLENCE %MPOWER INDIVIDUALS AND COMMUNITIES #OMMIT TO INDIVIDUAL RESPONSIBILITY AND 0ROMOTE EQUITY OF ACCESS DIGNITY AND RESPECT
Supporters of the AIDS Action Council
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Canberra Sexual Health Centre
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Canberra Transgender Network
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Champions Mustang Ranch
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Corrections ACT
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Cube Nightclub
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Design A Bunch
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6 Sense Media
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Dowlings Canberra Pty Ltd
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ACON
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Everalls DFK Pty Limited
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ACT Division of General Practice
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Gaydar.com.au
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ACT Health
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Gel Works Pty Ltd
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ACT Hepatitis Resource Centre
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Glyde Health
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ACT Outdoors Group
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GoConnect
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ACTQueer
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Grant Heino
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All Saints Anglican Church, Ainslie
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Greater Southern Area Health Service
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Ansell International
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Hardwicke’s Chartered Accountants
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AON Risk Services Australia Ltd
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Harris Technology
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Ashley Flynn
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Headjam
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Australian Federal Police Gay and Lesbian Liaison Officers Network (GLLO)
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Interchange General Practice
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Ian Rankin
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Australian Federation of AIDS Organisations
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Ione Lewis
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Bears Canberra
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Jeni Stein
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Bent Lenses
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Jennifer Hume
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Bit Bent
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John Fulcher
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BR Design
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Kwik Kopy Canberra
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BrandNet
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Manhunt
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Brent Riddell
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Manuka Traders’ Association
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Canberra Gay and Lesbian Tennis Club
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Melissa Tetley
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Canberra Milk
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Mest Hair
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Nancy Cogan
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NAPWA
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National Archives
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National Capital Authority
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National Gallery
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National Library
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National Museum of Australia
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Nigel Featherstone
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Officeworks
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Old Parliament House
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Ozcots
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Papermoon Productions
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Questacon
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Robert Johnson
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Scarlet Alliance
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SCOPE Youth Service
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SpringOut
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Teatro Vivaldi Restaurant
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Telstra Countrywide
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The Andi and George Band
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Tip Top Bakeries
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Victorian AIDS Council
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Woden Youth Centre
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Youth Coalition of the ACT
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YWCA Canberra
SpringOut Fairday 2007
The Canberra Gay and Lesbian Qwire, one of Canberra’s longest running community organisations.
President’s Message It is my pleasure to present the annual report of the AIDS Action Council of the ACT (AAC) for 2007-08. The past year has been one of growth and strategic change for the Council. In August 2007, Andrew Burry was appointed General Manager. Andrew has brought a great deal of professionalism, commitment and enthusiasm to the role. His unique mix of experience in the commercial and HIV sectors has been an asset to the agency. Since his appointment, Andrew has led a period of incremental and strategic change and has continued to expand the diverse networks the agency enjoys. In a competitive environment, the Council continues to attract and retain a team of highquality and professional staff who are central to the agency’s success. I would particularly like to commend the Council’s management team: Andrew McLeod, who has worked tirelessly to ensure the Council continues to enjoy an enviable financial position that is well-administrated; Nada Ratcliffe, who oversees a complex area of social welfare services, and David Mills, who has managed a specialized suite of health promotion and education programs. The expertise and commitment of the management and the dedication of the staff are great assets to the Council. AAC is a membership-driven, community-based agency with a history of remaining responsive to our membership and connected to our roots. Serving the Canberra community, particularly people living with HIV/AIDS (PLWHA), should remain at the core of our work. In 2007-08, the Council has revitalized its volunteer program resulting in renewed engagement and real participation from the membership. I trust that the agency will continue to provide unique opportunities for the membership to remain engaged and for the agency to reflect the diversity of the communities it serves.
This report demonstrates that the past year has been one of internal change and consolidation for the Council. Externally, there has been the election of a new government at the federal level, with territory elections to be held later in 2008. The HIV sector is renegotiating its position and rearticulating its voice within a changing political context. The place of HIV within the Rudd Government’s social inclusion agenda and the impact of revised health sector funding arrangements on AIDS councils remain unclear. The epidemic continues to change in new and complex ways, and at a local level we are attuned to how global and national trends translate to the local context. Adjunct issues to HIV such as the health of the gay, lesbian, bisexual and transgender (GLBT) community are also gaining traction. AAC will continue to be guided by its membership and stakeholders on how it positions itself for the future. It is with regret that I will not be standing for reelection at the AGM due to an overseas move. I would like to thank my Board colleagues for their efforts in ensuring the continued good governance of the Council and their support and collegiality during the past year. My special thanks go to the members of the executive, Mike Wight, David Benger and Ross Wilson, for their continued dedication. Once again, a range of nominees for positions on the Board have come forward with diverse skills and a commitment to volunteering in the HIV/AIDS sector. A strong and coherent Board, coupled with excellent staff and committed volunteers, bodes very well for the Council’s future. In closing, I wish the Council and all associated with it, every success in its future work. Claire Drake President
General Introduction Manager’s Report Operations Review
My first year as General Manager has been remarkable for the goodwill, support and encouragement offered to me from all associated with the council; Board, staff, members and Government. As our current President stands down this year, it is particularly important that I publicly acknowledge Claire for contributing her time so generously. The whole agency has benefited from her extensive experience in this sector and with AAC. We shall miss both her and her leadership and are grateful to have so many current Board members renominating to provide an essential continuity. The General Manager works both for and with council staff, and I have been blessed to work with a talented, experienced and harmonious team. This has given us a greater capacity to adapt and change to better meet the needs of our constituent communities and at an even higher standard. Our Annual Report is an important document. It provides a detailed review of AAC over the past year, and importantly, the challenges we identify that inform our future strategies. This report represents input from the Board and all council staff and offers a window into our operating environment. Our format this year has changed so that we can better present the elements of our operations; the state of the epidemic, engaging with the community and community health and wellbeing. The report is prefaced by an operations review. It is with great pleasure that I introduce this report on behalf of the AIDS Action Council of the ACT. Andrew Burry General Manager
This year we have worked hard to ensure that community development underpinned all our work and we focussed specifically on an assetbased model, which identifies and builds on community strengths. We identified opportunities to provide support to the wider gay, lesbian, bisexual and transgender (GLBT) communities, with a focus on health. We concentrated on engaging more fully in both the ACT community sector and nationally with peak bodies and other organisations of compatible interest. There has been continuing evolution within AAC – which we have termed a “transformation”. This did not involved radical change, but instead incorporated continuing changes in the epidemic and increases our relevance to the communities we serve. Importantly, we have increased our outward view by developing more external relationships and expanding our inter-agency work. This means we are now better able to support organisations that share our objectives and provide a wider range of services and support to target communities. Our primary responsibilities are within the ACT; however we are a part of a global pandemic. AAC continues to closely monitor developments nationally and internationally recognising that we are involved in the same fight. As we learn from the experiences of others, we are also able to contribute our own experience. International: Over the last twelve months the international perspective has moved closer to reflecting the historic strengths of Australia’s response. This is seen in a growing acceptance of the importance of human rights in the prevention of HIV/AIDS. It is also seen in the increased involvement of those most at risk of infection in the development of programs and initiatives. Those most at risk include men who have sex with men (MSM), sex workers and people who inject
drugs. The concept of ‘harm minimisation’ is not, however, as internationally accepted as it is in Australia. An article published in a Swiss medical journal on viral load and HIV transmission has generated considerable discussion by presenting a summary of existing research into the implications and impact for people living long-term with undetectable viral loads. This statement specifically references monogamous heterosexual sero-discordant couples and may offer realistic hope for unassisted reproduction. Just days before World AIDS Day 2007, UNAIDS released revised numbers for the pandemic, which reduced the previous estimate of PLWHA down from nearly 40,000,000 to 33,000,000. Although this was a result of improvements in statistical techniques, there was a risk that these revised figures would undermine the importance of increasing the total international effort. The lower estimated number of PLWHA is however less significant compared to poor progress in increasing the number of infected people who have access to antiretroviral treatments. The target is 10 million people on regular treatment by 2010, yet by 2008 only 3 million are in this position. AusAID is continuing to grow its efforts to respond to the needs of our regional neighbours. Australia’s international programs focus on capacity
development and human rights. Peak bodies including AFAO and NAPWA have formed significant partnerships that assist in the transfer of Australian knowledge and experience to the international context. National: Much of Australia continues to be challenged by rising HIV infection rates and there has been considerable effort this year in trying to understand the underlying causes. The rates in the ACT have remained relatively stable in recent years and this is also true of NSW. Meanwhile, other states show worrying upward trends. This shows that Australia’s situation remains somewhat fragile. Robust evidence shows the connection between rising rates of other sexually transmitted infections (STI) and increased risk of HIV transmission. There is a need to continue to be vigilant on all STI data, and particularly rates for gay men and MSM. Queensland, NSW and Victoria have significant and expanding syphilis epidemics, and there are clear implications for the ACT. Gay Periodic Surveys are conducted every three years in our jurisdiction, which compares to twice a year in NSW and once a year in Victoria. These surveys are important tools in maintaining and increasing our understanding of national and local trends. The latest survey for the ACT was delivered in 2007. The relatively infrequency of our surveys mean we must
also rely on information from other states and territories. The new Federal Government has signalled its intentions to change its approach to Federal/ State funding arrangements and this creates uncertainty in how funding for agencies such as AAC will be determined. More than 60% of government funds extended to AAC come via a Federal Public Health Outcomes Funding Agreement (or PHOFA). There is no suggestion that funding is at risk for AIDS Councils generally, but there will be changes in how councils measure and report results. On a national perspective, there are risks that new output measures will divert attention away from maintaining subtlety and flexibility in how we collectively respond across the sector. Local: ACT’s response has always been strong because of well-integrated public and community health sectors. AAC continues to be widely recognised and respected for the quality and effectiveness of its work, and we acknowledge some key partnerships that continue to make this possible. Testing, education, client support, counselling, advocacy, organisation development and information all require us to interact with other governmental and nongovernmental agencies with which we share common goals. During this year, we strengthened existing relationships and developed
new ones as we continue to see the benefits of identifying mutual goals and objectives. Even though our outlook and purpose are largely common with the areas of government we work with, there can still be areas of disagreement. This year saw a highly publicised case of an HIV positive sex worker charged under the Prostitution Act. AAC disagreed with the ACT Government about the way this matter progressed, and we continue to have conversations with the various agencies that were involved. Our aim is to ensure more effective outcomes in the future, and from our perspective this means reducing collateral damage to PLWHA and sex workers, without any compromise on public health. The Alexander Maconochie Centre (AMC) will open late in 2008 and will provide the ACT with its first fully integrated correctional facility. The council worked hard in various aspects of this development, including submissions on the Corrections Health Services Plan. The council worked with the Community Coalition on Corrections and with other agencies to support a proposed needle and syringe program (NSP). In doing so, our primary interest is ensuring the rights and safety of constituent communities confined within the facility, including PLWHA, sex workers and GLBT individuals. AAC believes that because this facility is in the ACT jurisdiction there is every opportunity for the AMC to be a world leading ‘healthy’ prison. Our involvement here has helped us build new relationships across a range of governmental and nongovernmental organisations. We worked particularly closely with the ACT Hepatitis Resource Centre to develop proposals for establishing sustainable professional development and health promotion programs for staff and residents. The ACT has often taken a leading role in developing social policy. The election of the new Rudd Government seemed to offer the prospect that the Civil Unions Bill (with ceremonies) would be passed in the territory. The council actively supported the work of the Campaign for Civil Unions (CCU). AAC emphasised the universally accepted connection between discrimination
and health outcomes. For a minority group to have fewer rights than the majority is clearly detrimental to community and individual health. Ultimately, the bill was less than the ACT Government hoped for, and although somewhat disappointing, AAC acknowledges the courage and commitment of MLAs representing the spectrum of political interests who spoke publicly in support of the bill as originally proposed. We particularly note the efforts of Attorney General Simon Corbell, who gave his time to the media and in other forums generously, and showed the whole community that GLBT people are equally valued members of society; at least in the ACT. Refocussing our Organisation: We describe this year as being one of transformation. This has involved a high degree of change and we use the word transformation to reflect that we have built on the many strengths this agency has acquired over many years. The transformation identifies new priorities as well as effective execution of our various programs and services. Most changes are subtle and continuing, whilst others are more obvious. Our organisation must strive to be well positioned within what will be a changing and more competitive environment. Tangible outputs from our efforts have included a rejuvenated and relaunched volunteer program that includes best practice, professional development, clearly defined roles and improved communication channels. The newsletter has been redesigned and increased in scope. It provides a voice for other community members and a spotlight for ACT GLBT sporting, social and activist organisations to encourage awareness, interest and participation. Westlund House, in which AAC, PLWHA ACT and SWOP ACT are located, is an important community asset. Our continuing tenure, however, remains uncertain and relocation will follow further expansion of the Australian National University. We have completed some minor improvements and begun the development of ‘Westlund House’ as an independent brand
providing better access for GLBT and HIV affected communities and community organisations. Financial: AAC has benefitted for many years from extremely sound financial management supported by a high level of governance. This has allowed us to build reserves, which are approaching a more comfortable level and one that will provide us with greater flexibility as we shortly begin the process of developing the next three-year strategic development plan. We are ensuring that the additional flexibility provided by increased self-generated funds and efficiency dividends are invested appropriately in staff development. Human Resources: Canberra remains a difficult environment for community organisations to employ suitably qualified staff. AAC competes with an extensive public sector and has difficulty in offering competitive salaries. To improve our position, we recognise avenues we can offer for professional development and we seek ways to make employment mutually rewarding. Our services mean human resources are crucial to our health and vitality as an organisation. This means incorporating greater innovation in work practices that make our
work place more supportive, empowering and efficient. It also means emphasising the role of professional development opportunities in every position within the council and adopting a more holistic view of occupational health and safety. We have further recognised the human resource asset of our volunteers and Board members, and include similar professional development goals in our planning. For most of the year, AAC operated with vacant positions, and this increases stress and workloads on other staff. This has been accommodated by a highly regarded, experienced and committed management team who frequently go beyond the call of duty. Together with all staff, they have collectively ensured that ambitious plans are fulfilled at high quality. AAC has supported this commitment by introducing new management processes that increased cohesion and mutual support and the synergies of this approach are increasingly apparent. The Year Ahead: Changes associated with our transformation have at times been stressful but much of the hard work internally is complete or substantially so. 2008/2009 will see consolidation of current initiatives and the development of a revised quality assurance and risk management approach.
We will work to increase the visibility of the council and provide higher levels of access for our constituent communities. We will develop a new threeyear strategic development plan that will shape the ways in which the AAC will evolve to meet future challenges and to operate effectively in a new environment with changing priorities. We will continue to support our proud heritage as a grass roots community organisation by expanding our membership base and working to develop sustainable self-generated funds.
State of the epidemic and the response Rises in new infections
These rises raise some questions: What are the causes of the new infections? Why has unprotected sex risen since 2000? What has changed that is causing the recent change in the epidemic? What has been different in NSW? What can organisations like the AAC and communities do to reverse the trend? HIV/AIDS in gay men’s lives
It would have been difficult during the past year to not have seen media reports that HIV infections are on the rise in gay men and men who have sex with men (MSM) in Australia. Nationally, new HIV diagnoses have risen since about 2000, and this coincides with an increase in unprotected anal intercourse with casual partners which appears to a significant factor in the rise in infections. Similar rises have been seen in other countries with similar epidemics including New Zealand, Europe and North America. New South Wales seems to be unique in that it has defied the trend with new diagnoses being relatively flat during the same period.
Community empowerment and mobilisation have been instrumental in the Australian response to HIV/AIDS. The gradual increases in HIV infection around Australia coincides with a gradual disengagement of communities with AIDS councils. HIV and AIDS are not as relevant to gay men’s lives as they were just ten years ago. The impacts of HIV/AIDS are certainly less visible in the community, thanks to effective treatments. The same treatments also mean that a newly infected individual has a much better outlook than in the past. It is not just HIV/AIDS which is less relevant to gay men’s lives. Being gay is itself increasingly less relevant to many people in the community today. In general, gay men in Australia do not identify as strongly with the gay community as they may have 10 or 20 years ago. While the average gay man may still identify publicly as gay, being connected with the gay community may no longer seem so important. Friendships built on similar interests are likely to be more
HIV positive MSM are at particular risk of infection and transmission of syphilis, and represent a disproportionately large proportion (40%-54%) of syphilis diagnoses. This is of special concern because of the very rapid rate of progression of the infections that have been documented in PLWHA, and the very serious health risks to these individuals from the infection.
important than having gay friends. AIDS Councils cannot take for granted that community members will engage with their messages and campaigns. In some cases, this drifting away has been natural and positive, as communities find new centres and independent voices. However, some of this disengagement is because many AIDS councils are not responding adequately to the changing needs and assets of their communities. The different trends in New South Wales are likely due to a more cohesive, connected and healthy gay and lesbian community. Evidence shows this to be one of the most divergent factors between Sydney and Melbourne. It is notable that ACON’s change in direction towards a broader gay and lesbian health focus coincides with the apparent turn-around in HIV diagnoses. It is in response to these increases that AAC has shifted our focus to recognise our important role within our communities to help facilitate healthier, more supportive and cohesive communities. It is in this light that the Community Development unit (CDU) has adopted its new name to reflect our changing emphasis.
A community forum was held in October to launch the results of the 2006 Gay Community Periodic Survey. A resurgence in syphilis The ACT experienced a significant jump in syphilis diagnoses in 2007. This reflects an increase in syphilis in gay men and MSM nationally. This resurgence is a concern for the AAC. Left untreated, syphilis can cause serious damage. Syphilis infection also increases the risk of acquiring or passing on HIV.
The AAC participated in the national Drama Downunder STI campaign with the Australian Federation of AIDS Organisations (AFAO). The campaign is designed to appeal to both the gay community as well as nongay-identifying MSM. This campaign included Syphilisspecific messages targeted at Gaydar and Manhunt websites. The campaign also features a website, posters and newspaper advertising. The AAC has also worked with PLWHA to include syphilis information in newsletters and resources.
This is no great revolution: In fact it returns the agency to our roots and to what we know works and has proved effective in the past. (The Northern Territory has been left off this graph. Syphilis prevalence is much higher in remote indigenous communities than in the rest of Australia.)
Internet campaign highlighting Syphilis
Criminalisation and ‘knowingly infect’ This has been a terrible year – nationally and certainly locally – for negative and sensationalist media on HIV/AIDS, which has impacted on members of our community and on our prevention and community development efforts. The Australian gay community has long had a culture of shared responsibility with HIV/AIDS and this is a culture that we would like to encourage and enhance. Research into the experiences of recent sero-converters in Australia has found overwhelmingly that gay men do not blame others for their HIV infection in the way that other groups often do. The different attitudes to HIV infection was illustrated in the relatively frequent cases of heterosexual transmission that ended up in court, while cases involving male-to-male HIV transmission was rare despite much higher rates of infection. This completely changed in the last year, with several gay men charged with some variation of knowingly infecting another person, or in the high profile case in the ACT, with working as a sex worker while HIV positive (unfortunately reported as ‘knowingly infect’). Events such as these, especially when they involve the criminal justice system, threaten this culture of shared responsibility and risks further stigmatising people living with HIV. In this environment, the AAC’s work to build a
cohesive and supportive community has been even more critical. The CDU’s messages have been reinforcing shared responsibility for HIV. A community development campaign to place shared responsibility for safe sex within the broader context of everyday lives and issues is in development. The recent events have highlighted a need to develop voices and advocates within the PLWHA community. We are planning a project in conjunction with PLWHA and the Client Services Support Unit (CSSU) to build capacity for people living with HIV/AIDS, to speak to the media and at public events, and to provide sensitivity training to organisations. People living with HIV/AIDS Living with HIV is being conveyed more and more as a long term chronic disease however what is being decreasingly acknowledged, is the continuing stigma and discrimination that still exists. Many of our clients are now living longer with the HIV Virus and this brings to into focus many issues that are being dealt with or will need to be dealt with. In living longer with HIV, many people face the ongoing task of dealing with drug side effects - body shape change, raised cholesterol, depression, fatigue, housing, and the basics of day to day living.
Living in a small city or large country town has many advantages; for example we get to spend more time with our clients and can build lasting professional relationships. However the down side of this is that the amount of services we can offer must be built around positive people’s involvement. We are limited by the numbers in the groups we run simply because some HIV positive people choose to remain anonymous. A lot of services are also delivered on a one to one basis, and this may not be universally effective. People who are newly diagnosed are offered assistance to attend the Genesis program in Sydney, which is a weekend retreat with other newly diagnosed people, and AAC is able to offer financial and other support to encourage attendance. Treatment complexities and the ongoing need to take life saving drugs on a regular timed basis, has many challenges familiar to anyone who has tried to complete a simple course of antibiotics! Aging and HIV is another emerging issue that we have continued to work on this year, and have particularly addressed issues of the extent to which nursing homes are ready for, or have an understanding of, people who are HIV positive and issues of access to other services in the broader community remains an important and ongoing part of our work. Co-morbidities of HIV with drug and alcohol issues, mental health (including long term depression and isolation) can be solved through sustained assistance, and counselling contributes significantly to the solution. We continue to develop excellent working relationships with other agencies seeking out programs and support workers who can provide resources that integrate into our holistic program of individual and group support.
New drugs and pharmaceuticals are being developed all the time for a whole range of diseases, but can that be said for HIV drug treatment? Current treatments, post 1996, have allowed many HIV positive people the chance to control the virus and stay healthy for much longer. However for some people who are treatment experienced or just thinking about starting treatment the idea of changing or starting treatment can still be a decision made with much thought and trepidation. HIV positive people who are treatment experienced, and having to change their treatment due to side effects or growing resistance profiles are finding constructing a viable next line of treatment quite involved. If for example you are changing medications due to resistance profile then the potential to wipe out an entire class of medications is very real and with 5 main classes of drugs your available choice may shrink with every medication change. One exciting area of work is the collaboration between companies in making HIV drugs easer and more simple too take. For example Atripla is a three-in-one combination pill containing Emtriva (emtricitabine or FTC), Viread (tenofovir DF), and Sustiva (efavirenz). (There is another combination pill called Truvada that contains two of these drugs: Emtriva and Viread.) Atripla may soon become available in Australia having been launched in America some time ago. For people new to HIV treatment this would be a good starting regimen. After all, wouldn’t you want to take one pill once a day if it works for you, rather than some of the current complicated regimens? There are more new HIV drugs in the development and research phase, although whether all of them will make it to the market remains to be seen.
Positive women Globally, there are approximately as many women as men living with HIV. This is not the case in Australia; however there are many issues and challenges that are unique to women including the range of side-effects, social issues and those around pregnancy, childbirth and parenting. Despite the considerable efforts of organisations set up to provide support for women living with HIV in Australia, many women still experience isolation and are often not visible within the social and clinical representations of the epidemic. These issues are exacerbated for those living in areas of smaller population including rural Australia. In the ACT, there are a relatively small number of women and girls living with HIV. For this very reason, it is imperative that the agency continues to provide support and services for women, their families and friends and work with national bodies and other HIV services for gender inclusive policies and practices. Following last year’s inaugural Positive Women’s Forum held in Melbourne, the CSSU Manager continues to be a member of the ‘HIV Women’s Organisation Network’ that communicates regularly so as to keep up to date with issues affecting positive women. Importantly, for the second year the ACT continues to be represented on the Women’s Portfolio of the National Association of People Living with HIV/ AIDS (NAPWA). A joint forum was held in November at the Canberra Museum and Gallery in support of women living with HIV and to mark World AIDS Day. The guest speaker was Judith Orr from the HOPE Foundation in Vietnam who is working with women and children living with HIV. The CSSU manager spoke about positive women from a national and local perspective and a speaker from Amnesty International spoke about the issues for women globally. Peer support and talking to other positive women is of great importance. Locally, functions were held quarterly in a supportive environment and included a ‘lavish’ Christmas luncheon. New members were also warmly welcomed
to the group. Women have also accessed the counselling service, the specialist dietician/ treatments officer’s clinics, massage therapy, vitamins/supplements and received one on one peer support.
At the Treatments Officers’ Network (TON), AAC was represented at the re-launch of the excellent updated resource for positive women “Treat Yourself Right: Information for Women with HIV and AIDS”. Tanya Plibersek, M.P. (Federal Minister for the Status of Women) spoke at the relaunch which was very well attended by positive women from around the country as well as organisations that work with positive women. AAC was clearly seen to have a committed and cohesive approach to this important HIV poistive community. Organisational development As with all community sector organisations, the ability to attract appropriately qualified staff is within a highly competitive environment. In the ACT, this is more problematic because of the large public sector and also because some of our work involves working with highly marginalised and stigmatised communities. This requires us to seek staff with specialised skills and sensitivities. A key strategic objective is to contribute to the continued high quality output of the agency by supporting the development of our professional, expert staff, and our investment in this area was increased during the year. Our staff comprises
7 full time staff with a further 7 on part time or casual terms. Our strategy during the year has been to combine some formerly part time positions into a single full time one, which has produced clear efficiency dividends as well as creating an environment where projects have taken on a whole-of organisation structure. Further evidence of the effectiveness of this approach is seen in the substantial increase in the contracted outputs in the Service Agreement we have with ACT Health. Indeed, the review of the key functions of Community Development and Community Support are evidenced throughout this report with programs, results and rapidly increasing momentum. The core work of AAC falls within three operating units; Community Development, Client Support Services and Organisation Services. These units are supported by wholly AAC funded but more arms-length units of SWOP ACT and PLWHA ACT. The Organisation Services Unit has responsibilities and outputs that directly contribute to the outputs of all operating aspects of AAC. The work of AAC has been incredibly well supported again this year by the delivery of enhanced services including; •
Administration and project support
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Improved Information Technology including
help desk and software support and training •
Budget and financial transaction management for units and programs
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The introduction of internal auditing processes
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Management accounting and cost accounting functions for programs, staff and service contracts
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Developing a strategic approach for training needs and skills audit
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Developing new approaches in Occupational Health and Safety with a new attention to the impact of the working environment
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Providing continuous improvements to our building and fixed assets
AAC continues to strive for quality by working towards better policy documents and by ensuring that we have sufficient financial resources to be able to provide quality and current IT equipment, software and services. We are working towards a best practice model of staff retention through a strategic plan. We will continue to have difficulty in paying the most competitive salaries, but we can position ourselves to provide very specific development and training programs for our staff that will assist their career development.
Organisation Development has this year incorporated a Management Training and Mentoring program. This operated in the second half of the year, and the results were spectacular, with all managers reporting greater cohesion, a higher degree of cross-organisational work and enhanced capacity to provide dynamic input into the strategic development plan. The program was further enhanced by the development of peer support networks that involved people from outside the organisation itself.
Engaging with community Developing ways of increasing the involvement of the community in the agency’s work and supporting increased community cohesion and connectedness have been common themes across the entire agency. The AAC is very sincere in its dedication to community. Community has become an often misused and abused term, and has become meaningless in many contexts. The AAC, however, is proud to be a genuine grassroots community organisation, and sees its ties to community as its strongest asset. The AAC belongs to the community, and takes its responsibility to report to - and be directed by its members, and therefore the community, very seriously. So what then is ‘the community’? For the AAC, it means the communities affected, in a very broad sense, by HIV and AIDS. This includes people living with HIV infection, but also their friends, family, partners and colleagues. The AAC has a very special link to the gay, lesbian, bisexual and transgender (GLBT) community, as this is the community which founded the council in response to the devastating impacts AIDS was having. The community of the AAC also includes other groups affected by HIV/AIDS including injecting drug users, sex workers and their clients.
Westlund House We have begun working towards engaging with the community in a more direct and tangible way by providing greater access and use of our facilities after hours. The New Canberra Transgender Network, the Campaign for Civil Unions, Canberra Bears, SpringOut and the Long Yang Club are all examples of groups that have found Westlund House a convenient location to hold organising and social events.
AAC has long viewed its premises at Westlund House as being much more than just a home for the Council. In fact, it is viewed as an essential community resource and some minor improvements have been undertaken this year to improve its usefulness and appropriateness for the wide range of GLBTI and HIV affected community groups and organisation we have invited to consider its use. In the spirit of community development, AAC has also developed other resources to support and facilitate community organisations, including the provision of a ‘postal address’, some administration support and the opportunity of limited financial support in some cases.
Newsletter The AAC’s bi-monthly newsletter has been completely redesigned and doubled in size. It now provides a voice for other community members through opinion pieces and reports as well as providing a spotlight for ACT GLBTI sporting, social and activist organisations encouraging awareness, interest and participation. More than half of the newsletter’s content is contributed by community members and the newsletter has become an important plank in our community development platform.
SpringOut Fairday The annual SpringOut Fairday is a fantastic community event which brings the many groups within the Canberra GLBTI community together on the grounds of Westlund House. The community enthusiastically got involved with the 2007 Fairday, held on 17 November. Attendance and the number of stalls was greater than the last couple of years, and thanks to the generosity of many performers, there was plenty of entertainment throughout the day: The everpopular pet parade, a drag show, the Canberra Gay and Lesbian Qwire and The Andi and George Band, who wowed the crowd with their original music.
Stall at SpringOut Fairday 2007
The Andi and George Band were a real crowd pleaser.
Lesbian and transgender community engagement “What about the ‘L’, ‘B’ and ‘T’ (as in GLBT)?” It is a question that we are often asked, and deservedly so for a GLBT health organisation. In engaging the community we need to be creating links and connections – not creating artificial barriers and borders. The AAC recognises that we belong in a community which is much broader than just gay men, with health and wellbeing needs which are different, but very much linked and related. The AAC is inclusive and much of our community development work is open to community members regardless of sexuality and gender. Among our programs working with Canberra lesbian and transgender communities are: Counselling services, the Stepping Out workshops, In Our Own Write, SpringOut Fairday, and providing support and resources to community groups. With the support of funding through Cube Nightclub, the AAC is in the process of coordinating, with community involvement, a broad survey of the health and wellbeing needs of lesbian and bisexual women in Canberra. This survey will not only assist in identifying priority areas for the AAC, it will also be useful for other organisations and groups interested in this community and provide a useful insight into the community for community members. It is hoped that the survey will be repeated regularly, every few years, to identify trends over time, and inform more specific research needs. We were very appreciative to have received a Certificate of Appreciation from the New Canberra Transgender Network for assistance to the group. The AAC is working to increase our support and engagement with the Canberra lesbian and transgender community, and to create an organisation which reflects the broader community and with a capacity to respond to the communities needs.
Youth The AAC has been very fortunate to have great links with enthusiastic individuals and organisations within the Canberra youth sector. Our relationships help us to reach many young people in the community in various ways. In the past year we have worked with YWCA and SCOPE Youth Service, the Youth Coalition of the ACT, Junction Youth Service, Barnardos, the Belconnen and Woden youth centres and Youth in the City. In addition, we’re proud to support the Bit Bent youth groups, the Australian National University and University of Canberra sexuality departments and the Jellybabies social club, and we would also like to acknowledge the keen support we receive from these groups. Through 2007-2008 the AIDS Action Council has been involved with the development of the Youth Sexuality and Gender Diversity Network (YSGDN). This is a network made up of people from the Youth, Community, Health and Education sectors who have an interest in working to improve access to appropriate services and resources within the ACT. The network is made up of a core steering committee as well as other members who are not always able to attend core meetings but are able to work on other working groups such as providing training (The Basics: Working with Same!Sex Attracted Young People) or working on other issues such as promotion of Safe Spaces. The network was fortunate at the beginning of 2008 to secure funding from the Aurora Foundation to help pay for basic sensitivity training to be conducted by the network, as well as the production of a resource that can be distributed to workers around many of the issues that are brought up during the training.
In Our Own Write
International Candlelight Memorial
In Our Own Write began as a project by the AIDS Action Council that looked at expanding upon the Council’s earlier successful text written by and for GLBTI young people in the Canberra area, Yes, I am. The project began in 2006 with the successful application of funding for the project. SCOPE YWCA of Canberra Youth Service soon came on board as a partner in the project as they had shown an interest in collaborating with the AIDS Action Council, particularly around the issues of GLBTI young people.
The 25th International AIDS Candlelight Memorial was held on Sunday 18th of May. The theme for this year’s event was ‘Never Give Up, Never Forget’. The organising of the event was facilitated by the AIDS Action Council, with the Community Engagement Coordinator being primarily responsible for the arrangements.
The project was designed to help empower GLBTI young people through their participation in the production of the resource that would be an opportunity for them to express themselves, but also to have those expressions read by an audience. The Council worked with SCOPE to consult with groups of GLBTI young people to determine what the resource would be, what it would look like, what it needed to have to be successful and how other young people could participate to make the resource successful. The resource In Our Own Write was finally launched in September 2007 at the Woden Youth Centre. It was attended by approximately 70 young people and stakeholders from the youth, community and education sectors. The resource was officially launched by the General Manager of the AIDS Action Council, Andrew Burry, and was accompanied by readings by some of the contributors as well as music provided by one of the young people. The final document was 65 pages long with 31 pieces contributed by 18 young people. All contributors, including those writing in a professional capacity, were young people. The booklet has since been widely distributed. The AIDS Action Council, SCOPE and the YWCA of Canberra work hard to promote and further the distribution of the resource around the ACT and abroad.
AAC chose this event to make greater recognition of those affected by HIV and AIDS. For each person infected, a much larger group were affected, including parents, siblings, extended family, neighbours, workmates and friends.
Stephanie Buckle at Candlelight Memorial, Photo: John Fulcher
“Tonight, I want to acknowledge not only those who have died, but all of the people who stayed with them through the battle; partners, families and friends, all of the thousands of people who we say are affected by HIV rather than infected, as well as health care workers, educators and researchers who made their own essential contributions.”
The prayer service was held at The Anglican Parish of All Saints in Ainslie and was followed by a second service being conducted at the National Museum of Australia, Acton. Music was provided by the Canberra Gay and Lesbian Qwire, and a slide of the AIDS Quilt was on rotation in the auditorium throughout the event replacing the physically missing Quilt. Each service was attended by approximately 80 guests.
At the museum service several people were asked to take on a role. Claire Drake, the President of the AIDS Action Council provided a welcome to the service. Speeches were provided by Kenn Basham (positive perspective), Stephanie Buckle (stories of those affected more broadly by HIV/AIDS) and Dr Ionie Lewis (HIV/ AIDS in the developing world). Andrew Burry, General Manager of the AIDS Action Council, lead the remembrance of names of those lost to HIV as well as lighting the International AIDS Candle.
attracting at least 250 people. It took the message to another new mainstream audience. The event is planned to be even bigger in 2008. Another new event, a Women’s Forum, was held in order to address the global impact of the HIV/ AIDS epidemic. It coincided with the 16 Days of Action for Violence Against Women and AIDS Awareness Week and involved working with organisations such as Amnesty International, the YWCA and the Hope Foundation. It is important that AIDS Awareness Week activities reflect the broad impact of HIV/AIDS and also serves to reflect it as a global issue affecting women, men and children. Further attention can also be placed on HIV as a chronic illness rather than necessarily a fatal one. This might require more emphasis on the real impacts of living with HIV in today’s society. A specific human rights perspective of living with HIV might become a focus each year, incorporating, for example, poverty, housing, access to healthcare, discrimination, aging and co-morbidities.
Photo: John Fulcher World AIDS Awareness Week World AIDS Day (WAD) and World AIDS Awareness Week 2007 were more visible and achieved greater media coverage than previous years. Revenue from red ribbon donations during the period was almost twice that of 2006.
Bushdance was held on the same day and provided a good opportunity for the GLBTI community to participate in WAD. We appreciate the support of the organisers, the Canberra Gay and Lesbian Tennis Club, for their support in selling merchandise, and of course to the generosity of the patrons on the night.
One of the strengths of this year’s World AIDS Awareness Week was the number of events that were held by other groups in conjunction with the Council, resulting in some new relationships with organisations including the YWCA, Amnesty International, Ozcots and the Hope Foundation. In the past, the Council has felt responsible for the running of every event, but the approach taken this year was to encourage other groups and organisations to run events and feel ownership in World AIDS Awareness Week. A Night in the Palms was a new event, which was developed by some local Manuka businesspeople. Despite rain, it was a success,
Chief Minister’s Breakfast, World AIDS Awareness Week
A Night in the Palms, Manuka
World AIDS Day stall at Garema Place
Community health and wellbeing GLBTI Health and wellbeing The AIDS Action Council has always been a GLBTI health organisation, as it was the GLBTI community which founded the AAC when concerned community members were moved to act to address the serious impacts AIDS was having on the community. The GLBTI community continue to drive the work of the agency through the agency’s membership and volunteer base, and the GLBTI community continues to be a one of the communities most affected by HIV and its related health impacts. At times AAC has been less willing to embrace a GLBTI focus and felt that it should be oriented towards direct HIV/AIDS related work. This point of view was misguided at best and counterproductive at worst – a strong, connected and healthy GLBTI community is vital towards meeting the AAC’s mission towards prevention of HIV transmission and minimisation of its impacts. It should be clear that being a GLBTI health organisation does not mean that the AAC seeks to speak on behalf of the community itself. It also does not mean that we are exclusively GLBTI – we always have, and always will work with other communities: heterosexual, sex workers, injecting drug users, and others.
Out Late is a new resource developed nationally for men coming out later in life. The AAC will be will putting further emphasis on this important area of the community.
The AAC is proud to be a founding member of the GLBTI Health Alliance, a national organisation which formed in the last year, and is the only national organisation focussed on GLBTI health and wellbeing. Our membership gives us extra strength to push for healthy public policy in areas affecting the GLBTI community, including: Aging, mental health, drug and alcohol use, social stigma and discrimination, GLBTI health research and relationship recognition. The AAC also stands to benefit from the sharing of additional resources and expertise as the membership of the alliance grows.
SpringOut Fairday 2007 Sexual health screening and access to health services Regular sexual health screening is a priority for responding to both the increases in HIV and syphilis infection. A report on mathematical modelling of the HIV epidemic released in 2008 predicts that that 19% of new infections from gay men and MSM close to their own seroconversion that 31% of new HIV infections are from gay men and MSM with an undiagnosed infection, illustrating the need to increase HIV screening rates and the frequency of screening. Early diagnosis of syphilis is critical to avoid highly-infectious secondary infection however evidence suggests that many infections are going undiagnosed. Up to 33% of infections are asymptomatic and many men may be ignoring or not noticing symptoms. Some GPs that do not have high gay-male caseloads may not be aware of the current epidemic or may not request a syphilis test, especially if the individual
is not comfortable disclosing his sexual history. Indeed most doctors under 45 have probably not seen a case of syphilis and young men are less likely to be aware of the symptoms. PACT plays an important role in the response. The project has identified 9 cases of syphilis in 2007. These results show the value of cross-sectoral partnerships, and of reorienting health services to be better positioned to respond to the needs of affected communities. Through ACT Health and the ACT Division of General Practice, the AAC will be part of a clinician training programme which aims to address issues around access to health services and quality of care for the GLBTI community. The first stage of the project will be to hold a forum/seminar for general practitioners on sexual history taking. In the context of syphilis, men presenting to GPs without a high gay-male caseload may not be tested for syphilis as the GPs are either not aware of the current rises in infections, make assumptions around sexual history and behaviour or find it difficult to ask questions around sex and sexuality. Partnership Approach to Comprehensive Testing (PACT) PACT is a partnership between the AAC, the Canberra Sexual Health Centre and the ACT Division of General Practice. It is
a client-oriented program which makes sexual health care more accessible. These clinics are free and confidential, held outside of usual business hours and attended by nurses sensitive to our target groups. The PACT program includes the following clinics: •
‘STRIP’ for MSM and GLBTI community at a sex on premises venue and at Westlund House
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‘SWOP SHOP’ for sex workers
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‘T-SHIRT’ for the Youth In The City
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At the Bit Bent youth group for same-sex attracted young people.
Average attendance of STRIP clinics at Westlund House has dropped significantly since 2005. We need to look at the reasons behind this drop and develop strategies to increase patronage. At Champions we discovered that we tended to be busiest at the end of our shift, and so in 2007 we trialled holding the clinics half an hour later. This trial has been successful and we have continued these times into 2008. The last cycle of SWOP SHOP clinics in 2007 trialled rotating the clinics between several brothels in Fyshwick and Mitchell. These clinics were well attended and we
believed we had arrested the decrease in attendance shown in the graph below. Unfortunately, as discussed in the SWOP report, attendance in the first cycle in 2008 was very low, we believe due to coinciding with media from the Hector Scott case.
Safe Sex Toolbox The Sexual Health Tool Box is a series of pamphlets addressing basic understanding about STI’s (Sexually Transmitted Infections). The Tool Box began in early 2008 and was designed to address the lack of resources that separately address each of the common STI’s. The aim of the resources is to ensure that individuals have the ability to make informed decisions on their sexual health. The resources contain basic information people need to know about specific STI’s including what they are, how they are transmitted, what the symptoms are and how to get them treated. cont. over
The pamphlets have been developed to be accessible to be read by a wide spectrum of the population including young people, MSM (men that have sex with other men) and those with lower literacy levels.
Many of those that access the service are members of minority groups and may in addition be marginalised for a variety of reasons, including poverty, drug use, having diagnosed or undiagnosed mental illness or are transgendered.
Each pamphlet has two versions. One is for a general community audience, and the second targeting MSM’s. This has been achieved by using text and imagery that is appropriate for the different groups.
AAC considers counselling in its broadest context, and not in a narrow sense of one-onone sessions. Counsellor Stephanie Buckle, whose connection with AAC dates back to 1990, undertakes a range of advocacy services for clients, and in so-doing, makes a contribution in raising community awareness about needs arising from various degrees of marginalisation and stigma. This advocacy and positive representation has extended over a long time period and continue to be of high importance as AAC continues to expand and intensify its relations with other organisations.
The Tool Box series covers a range of the most common STI’s; Chlamydia, Gonorrhoea, HIV/AIDS, Crabs and Scabies, Syphilis, Herpes, Hepatitis A, B and C as well as Genital Warts.
Counselling Service
The case load this year has been heavy at times, and the range of different issues presenting quite diverse. Counselling has a special place in the life of any AIDS Council, and nowhere more so than in the AIDS Action Council of the ACT. For a vulnerable person, the counselling service provides somewhere to talk when someone fears that nobody else will listen. For many of our most vulnerable clients, the counselling service was the door through which they were welcomed.
During the last year, we have been considering ways in which to develop more integration of the counselling service into the broader spectrum of the agency’s life. Whilst it has always been true that many of our more active members and volunteers were introduced to AAC through the counselling service, there is need for clearer pathways to develop with other support services.
AAC’s counselling service has always been specifically geared to the GLBTI community, rather than for people who have sexuality or gender issues per se. Most of those that access the service identify with the GLBTI community (or wish to) and present with a diverse range of issues, including relationships, IVF, domestic violence, addiction and grief or loss. The identity of this service as being GLBTI friendly is an important factor in the excellent outcomes achieved.
Peer support groups have long been a successful area of AAC’s work and the range of groups are being reviewed to identify gaps. Of particular priority is the need to provide services for gay and lesbian people coming out later in life, many of whom have left a marriage and have children. AAC is also preparing resources in order to be able to introduce groups and other services that focus on relationships, including various forms of violence.
Of course, counselling also forms an important part of our HIV prevention program, although even at its peak, direct HIV related counselling has never accounted for more than 30-35% of total client hours. In recent years, this has fallen to between 20-25%.
The Alexander Maconochie Centre
A new prison will open in the ACT towards the end of 2008. It is an important new facility for a number of reasons. Firstly, it will replace the unsatisfactory current remand facilities. Secondly, it will stop the practice of sending persons with a custodial sentence out of state, which should facilitate ongoing family contact. Thirdly, as a new facility it has been able to incorporate modern design and structure to provide an environment more conducive to its stated aim of rehabilitation.
The AMC as it nears completion (Source: ACT Government JACS)
AAC has taken a keen interest in the development of the prison and particularly in the development of the Corrections Health Services Plan. AAC has also been an active participant in the Community Coalition on Corrections and contributed to their joint submission, although AAC also made its own submission that dealt specifically with issues relating to GLBTI communities, the provision of condoms and the way in which PLWHA prisoners would be managed. The AAC submission was effective in incorporating a number of additional aspects into the Health Services Plan. AAC hosted a forum at the Legislative Assembly to discuss the issues of fear and stigma and the impact these have on the development of effective policy.
In line with the community sector as a whole, AAC remains deeply troubled at the absence of a needle syringe program within the facility, although relieved that the Government has given a firm commitment to review this within 12 – 18 months of AMC’s commissioning date. The council is also anxious to ensure that both staff and prisoners receive adequate training on issues to do with blood borne viruses, sexuality and gender issues. Late in the year and in conjunction with the Hepatitis Resource Centre, a proposal was submitted for funding for a project officer, who would be charged with the responsibility of providing regular professional development for staff as well as health promotion to prisoners.
This proposal has yet to be accepted, but AAC has been given Authorised Visitor Status and was invited to sit on the Community Consultation Committee, which directly informs the Attorney General of matters of concern as they relate to the implementation of policies and procedures. Living Well In 2007, the Board commissioned a consultant to prepare a report identifying issues as they related to the provision of services to people living with HIV/AIDS (PLWHA). AAC delivers these services through two principle modalities; on a direct client basis through PLWHA ACT and more generally through a wide range of programs of all units of AAC, including influencing government policy on issues related to housing and access to dental and other specialist treatment. The objectives of the consultancy were to test the various programs against current trends and best practice, and to identify areas in which the totality of the service provision could be made more effective. AAC has never subscribed to a welfare model as being one of empowerment. A great many of the recommendations made in that report have now been implemented and the overall package of services whether through PLWHA ACT or by AAC are now better integrated. During 2007/2008, AAC has continued to monitor and review the effectiveness of services and the extent to which mainstream agencies can be introduced to provide a higher overall standard through synergy. Health is a common factor in all the work that AAC units, and an increasingly holistic view is being taken on what factors contribute to good health. Commonly called ‘the social determinants of health’, recognition must be given to all the environmental factors that are shown to inhibit good health or that contribute to risk factors that lead to the opposite. During the coming year, AAC will be developing its “Living Well” project which will include an
extensive period of community consultation. The result will be an integrated model of service delivery that will recognise specific service requirements for identified and potentially at risk groups and subgroups within our total constituencies.
PLWAHA ACT is a project of AAC and is a representative group of a world wide movement and works with its peak national body National Association of People with AIDS (NAPWA). Its purpose is to empower and support people living with HIV/AIDS in the ACT and surrounding areas. Particular attention is given to assist clients, partners, friends and families to live full, creative and meaningful lives free from fear, ignorance and prejudice. A broad range of services are offered, including advocacy, direct support, health and treatment information and the promotion of good health. Through the process of community development, PLWHA aims to equip clients to live their lives on their own terms, without judgement and where appropriate and necessary provide referrals to other agencies best equipped to deal with specific issues. Attention this year has centred on recognition that continuing improvements in treatment options have to a certain extent changed the landscape for many clients, although in some cases with additional challenges.
The overall level of service has demonstrated clear improvements in quality, and in the breadth and scope of activities. In terms of health promotion, we have provided regular dietician clinics with an external consultant and an STI clinic, which was developed and delivered in conjunction with the ACT Division of General Practice. In partnership with the Canberra Sexual health Centre, free check ups have been provided, which included free vaccinations for Hepatitis A and B vaccinations. Social isolation continues to be a major issue for many people living with HIV and this affects
people without regard to the length of time that they have been sero-positive. A particularly effective initiative was an art and craft project, which was funded by a special grant from ACT Health. This encouraged clients to participate in creative endeavours in a safe environment. One of the more important outcomes of this was to demonstrate creative arts have a high level of access, and it proved important to ensure that the project delivered ongoing paths for continuing artistic expression. Dental health is another issue that impacts severely on people living with a chronic condition including HIV. The Enhanced Primary Health Scheme (EPS) run by the Federal Government, which the Rudd Government has signalled it wishes to cancel, is a very useful initiative provided that dentists are available who are willing to participate. PLWHA undertook a survey of all dentists in the ACT to build a portfolio of willing participants. If the Rudd Government succeeds in cancelling the EPS, we are fortunate to still be able to access the Special Needs Dental Project offered by ACT Dental. Recognition of the changing landscape made it appropriate to give special attention to developing a new three-year strategic plan covering 2008 – 2010. The process of developing this plan, which was informed by a reference group, identified a number of emerging issues that need to be incorporated into specific projects and has implications for AAC as a whole. These issues include; Ageing and HIV •
Access to aged care services
•
Services understanding the needs of an ageing HIV population
The Law and HIV •
With high profile cases in the media, understanding what this means and the impact on our community and the wider community
Community Development •
More opportunities for people to engage with PLWHA ACT
•
Positive women and other groups as identified
•
Self advocacy
•
Continue peer support activities
Health Promotion Activities •
Work in conjunction with AAC to ensure timely responses to identified needs
•
Accessing other services as required to buy in the expertise to assist with work
Advocacy •
Effective representation
•
Build on existing relationships
•
Stigma and Discrimination issues
•
Going back to work issues
•
Fair and equal access to services - if we don’t have the services in the ACT
PLWHA ACT will continue to have a critical role in providing a voice for those directly affected by HIV and for this to be effective, it remains essential that this area of AAC continues to be peer-based and to have an independent voice where appropriate. Peer support networks must be continually developed to ensure that widest diversity of our HIV+ population is heard at all levels. PLWHA will also seek further avenues for this population to provide constructive input into the services that the project offers to ensure that it genuinely meets their needs, wants and aspirations. Reflecting the organisation wide commitment to asset-based community development, the ‘what, why and how’ of service modalities must be constantly reassessed to emphasise life beyond HIV; making HIV part of a bigger story in an individual life in other words. HIV is not a
statistic, but rather a community of individuals that have individual needs and so support must become more sensitive to those individual needs. PLWHA has continued to expand its relationships with other agencies so as to better meet evolving and complex needs. PLWHA ACT has already increased its involvement in the full range of AAC activities and resource development, providing a more effective input of positive people in the whole-of-organisation projects. This is an ongoing priority. AAC gratefully acknowledges the support it receives from NAPWA, and particularly in the opportunities it provides for our local community to feel part of and engage with the wider HIV community. NAPWA’s free newsmagazine, Positive Living’ is an important resource that keeps our PLWHA well informed of developments in treatments, public policy and emerging issues. PLWHA ACT also gratefully acknowledges the resources developed by both NAPWA and AFAO.
was primarily that of the sex worker. Not only does this go against AAC’s principle message of mutual and shared responsibility, this principle is enshrined clearly within the Prostitution ACT.
Sex Worker Outreach Project (SWOP) SWOP is a peer-based community organisation whose primary purpose is HIV/AIDS & STI prevention, education and referral for sex workers in the ACT. SWOP promotes sex industry work as a valid occupational choice, and encourages recognition of personal and occupational rights. SWOP provides services to brothels and private sex workers of the ACT, including owners and other staff. SWOP also works with other stakeholders including health services, community services and a variety of government agencies. Criminalisation and negative media In relation to the high profile case of a sex worker operating whilst HIV positive (legal in NSW but not in the ACT), SWOP faced a significant challenge. It became clear as the media intensified that both SWOP and sex workers in the ACT were negatively affected by these reports. Many sex workers stated that they became confused or unsure about their rights and responsibilities.
In response to the poor media handling of the case and the subsequent distress caused to many sex workers, SWOP placed an advertisement in the Canberra Times that focused on the clients who ask for or demand unprotected oral and penetrative sex. This was used to remind clients about the rights and responsibilities of all parties in maintaining safe services. Following evaluation of this campaign, further activity will be developed. There have been clear signs of a rebuilding of trust, and this has been evidenced by an increasing number of sex workers accessing SWOP SHOP Reaching culturally and linguistically diverse (CALD) workers
One example of this uncertainty was the increased difficulty getting workers to attend sexual health screenings provided under SWOP SHOP (Sexual Health Outreach Project). Many workers became suspicious of authority and AAC found it necessary to allocate additional resources to SWOP to allow outreach workers to rebuild trust. Increased visibility of the SWOP project has certainly been beneficial, but the challenges remain.
Sex workers from culturally and linguistically diverse backgrounds (CALD workers), particularly those with Asian backgrounds, are important for SWOP to engage with as they make up approximately a quarter of the sex worker population in the ACT. There are significant barriers both for SWOP and for the Asian sex workers. These barriers include language and cultural barriers with both parties, as well as a fear of authority, isolation and a lack of understanding of local laws by the CALD workers.
AAC and its SWOP team were particularly concerned of an implication in the reporting that suggested the responsibility for safe sex
In recognition of this, SWOP has initiated a number of ways to increase capacity to reach them. SWOP has worked at developing links with
other sex worker organisations in Australia and Asia to increase cultural awareness and skills. SWOP also used translation services to develop resources in the most common languages other than English. Projects involving service provision to Asian language speaking sex workers include a visit from an Asian sex workers’ organisation called Zi Teng. SWOP assisted the Zi Teng team in conducting a survey with Chinese sex workers in the ACT. SWOP team members are also receiving ongoing training in developing a high level of cultural awareness. Brothel outreach SWOP has developed workshops that are conducted whilst on outreach, for example for new workers. It covers safe sex practices, how to perform health checks, how to deal with difficult clients and how to be in control of each booking to ensure safety for all parties. SWOP will continue to expand the range of health promotion activities after listening and/or identifying needs. An early example has been on breast self-examination. Every two months, SWOP distributes a newsletter, which has proved to be popular and has generated a surprisingly diverse range of positive feedback, including poetry and stories. In response to this feedback, SWOP has initiated a regular survey to ensure that this newsletter has an increasing identity as a community voice. SWOP Reference Group SWOP has established a monthly reference group, which has had a positive response. Its primary purpose is ensuring that SWOP maintains its relevance and is made aware of emerging issues affecting worker health. It helps to inform the service delivery model and assisted in the development of redefined goals and objectives as part of the annual work plan preparation. SWOP also created a stakeholders’ group to help
connect interested parties that have contact with sex workers. This kind of coordination breaks down barriers and over time will help disparate groups develop congruent policies and practices, whilst also fostering a higher level of shared understanding. Education and training SWOP field work has unveiled a range of issues that are being experienced by workers as they access health services, the police and sexual support services. SWOP is concerned that these issues act as deterrence and has developed a program to improve the situation. Through the sensitivity training allied to worker empowerment, SWOP hopes to see an increase service access. As an important project of AAC, the SWOP team are uniquely placed to provide information and recommendations on projects and programs, and the team has been active in ensuring that the interests of sex workers are always extremely well represented.
Financial Summary Again this year, the AIDS Action Council of the ACT has been able to add to its reserves, and this is due to a continuing increase in self-generated funds, continuing fiscal conservatism and the establishment of a Board Finance Subcommittee. The latter, in conjunction with the management team, has been able to implement an enhanced investment program that has resulted in the interest component of the self-generated funds being enhanced. Importantly, the investment program avoids speculation, but concentrates on investment accounts in major financial institutions. The importance of maintaining healthy reserves, and particularly liquid reserves, meets the needs of future uncertainties and provides flexibility in the choices available in developing the new strategic development plan. During the year there was no major capital expenditure program and AAC’s fixed assets are reaching a point of being highly depreciated. This means that the new Board will be required to develop a capital expenditure budget, which is likely to cover several years. The addition to the Council’s reserves must be seen in light of the fact that its primary source of income is currently derived from a service agreement with ACT Health. Even though the contracted outputs have increased and AAC has exceeded them in almost all areas in recent years, the income received has not kept pace with inflation for some time. The current Service Agreement expires at the end of the 2008/2009 financial year.
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Executive Claire has served on the Board of the AIDS Action Council of the ACT since 2005. She has been involved in the HIV/AIDS sector and GLBT community development for the past ten years. Professionally, Claire works at the Department of Foreign Affairs and Trade. Claire Drake | President
________________________________________
Mike has been a volunteer of both the Victorian AIDS Council and the AAC and has been involved in the facilitation of peer education groups for young gay men.
Mike Wright | Vice President
Mike works at the Department of Foreign Affairs and Trade and was President of the AAC in 2006/2007. ________________________________________
David moved to Canberra from Adelaide in 1983, and has been involved in many aspects of the gay community and served on many committees of associated Clubs. David Benger | Secretary/Treasurer
He has been a volunteer of the AAC since the 1980s, assisting with client support, education, telephone, Trevor Daley Fund committee, and memorial quilt unfolding. David received Fabulous Membership in 2003. ________________________________________
Ross Wilson | Risk Management Group
Ross Wilson has recently retired from the Commonwealth public service after a 30 year career as an economist. He became a member of the Board in 2006 after being a volunteer for a number of years. Ross is also Vice-President of Bears Canberra Inc. ________________________________________
Ordinary Members Alexander Hood Hannah Stone (from 9/07) Ross Wilson Scott Malcolm Kevin Playford (until 9/07) Jason Scott (until 9/07)
Co Opted Nicky Seaby Hannah Stone (until 9/07) Staff Representatives David Mills / Lex Jury
PLWHA Representative Kenn Basham
General Manager Nada Ratcliffe / Andrew Burry
AIDS Action Council of the ACT People Living with HIV/AIDS ACT Westlund House, 16 Gordon Street, Acton, 2601 GPO Box 229, Canberra, 2601 tel: 02 6257 2855 fax: 02 6257 4838 www.aidsaction.org.au aidsaction@aidsaction.org.au
Annual Report 2007 - 2008