The health system is a broad term used to describe the numerous services, organisations and people providing all aspects of healthcare in the community. This includes general practitioners, hospitals, social workers, interpreters, dentists and other health and welfare services.
Finding the information and services you need can seem like an overwhelming task especially if you are not well or if your English is limited. However, as a person living with HIV/AIDS, it is likely that you will need to use some health services you have not used in the past. It is important that you know which health care services are available to you and how to access them.
Your doctor and health care workers from your community have a good understanding of how the health system works. You can ask them questions about the health system without telling them you are HIV- positive.
They can tell you which hospitals, clinics and other services are available in your local area and you can approach one of these for more information about HIV.
Many health services are available free of charge if you have a Medicare card. This is called bulk billing. Many doctors and clinics will not charge you a fee for clinical service when you present your Medicare card. You may still have to pay for medication or any extra tests that are ordered for you. All details of your Medicare card are kept confidential.
If you have a Medicare card:
- Ask if bulk billing is available before you have your consultation with the doctor or any other staff member;
- Always take your card with you when visiting your general practitioner, clinic or hospital.
If you do not have a Medicare card some services such as sexual health clinics, will still provide you with free clinical services. Always ask if this is possible before you have your consultation. A health care worker from your community or staff at the Migrant Resource Centre will advise you about whether you can apply for a Medicare card.
By selecting the ‘Finding Services’ button above, you will find a lists of services you can contact for more information about HIV. You can call them and ask about services in your local area.
Following is a brief discussion of the types of services you are most likely to use.
At the moment you may visit one doctor regularly, or go to a medical centre and see whichever doctor is on duty.
However when you are HIV-positive, finding the right doctor is an important step to staying well. Think about the kinds of health services you are likely to need and choose your doctor accordingly.
The following is strongly recommended:
- that you find one doctor you are comfortable with and will visit on a regular basis for health check ups
- that your doctor has a good knowledge of HIV/AIDS
- that your doctor has experience treating HIV-positive patients
- that your doctor is able to prescribe HIV drugs (these are called s100 drugs). Not all doctors are able to prescribe s100 drugs. If your doctor doesn’t he/she may be able to refer you to a doctor who can. Or call the AIDS Council in your State or Territory or the Australasian Society for HIV Medicine for further information
- that the doctor is local or can be reached easily
- that you trust his or her judgement.
Your doctor should be someone who can:
- provide general health care
- answer your questions in a way you understand
- help you monitor your health and prescribe drugs to prevent some illnesses from developing
- refer you to other people (specialist doctors) when necessary
- make appointments with other services if needed
- prescribe s100 drugs.
Sexual health centres/clinics
These clinics offer more than just medical services, they provide counselling and support in the area of sexual and reproductive health, including HIV/AIDS.
There can be many advantages to using a sexual health clinic:
- staff will have more experience treating people with HIV/AIDS
- most are open in the evenings
- most do not insist that you present any form of identification
- most provide free service
- many do not require a Medicare card.
There may be times when you may need to stay in hospital. For example, you may have developed an opportunistic infection that requires special treatment.
Hospitals can also provide HIV-related services without you having to stay overnight. These hospital-based services can be very convenient, especially if you don’t have many specialised services in your area.
Hospitals can provide:
- Teams of experienced HIV/AIDS workers such as doctors, nurses, counsellors, dieticians and occupational therapists.
- Community nursing that can provide care and assistance in your home.
- Pharmacies that provide s100 drugs and other medications.
- Clinics where certain procedures and tests can be carried out or medication administered over one-day periods.
When you stay in hospital overnight or longer you will be admitted as an in-patient.
Hospitals can sometimes be frightening places. There will be people asking you questions, doing tests and asking that you to sign consent forms. All this can make you feel stressed and unable to control the events around you, especially when you are feeling unwell.
If you don’t speak or understand English clearly, it is important that you have a professional interpreter present when anyone is giving you information about your health, medication or the results of tests.
If you can’t read any forms you’re being asked to sign, wait until an interpreter is available to translate them for you.
Don’t be afraid to insist upon having an interpreter, or to make sure you understand about the tests, treatments and care you are receiving. It is your right to understand every aspect of your health care.
Most people don’t like being in hospital. However, be assured that during this time many highly trained people will be doing their best to make you well again.
It’s likely you will have a small team of staff looking after you, including doctors, nurses, counsellors and dieticians. Use this time to learn as much as possible about your health and the steps you can take to stay well in the future.
Some people prefer to go to the emergency or casualty room of a large hospital when they need to see a doctor. It is best to do this only when you need urgent attention, if it is late at night, or on a weekend or public holiday and you can’t contact your own doctor. If you do go to emergency when your problem is not urgent, expect long delays before you see a doctor. On future visits you are highly unlikely to be seen by the same doctors or nurses.
Other HIV/AIDS services
These organisations focus on HIV/ AIDS and provide different types of services. They include AIDS Councils, People Living With HIV/ AIDS organisations, some medical services, and support and welfare organisations such as the Bobby Goldsmith Foundation.
AIDS Councils provide:
- up to date information about HIV/ AIDS
- information and support about treatments, housing and financial support
- advice on employment and legal issues
- information on support groups for women, gay men, young people and others
- access to home care and support; and
- information about other services.
People Living with HIV/AIDS organisations provide:
- up-to-date information on HIV/ AIDS and treatments;
- a newsletter with information and activities for people living with HIV/AIDS;
- social activities for people living with HIV/AIDS; and
- information from around the world about HIV/AIDS.
Counsellors, social workers, psychologists
Living with HIV/AIDS can be hard. Even if you have friends, family and partners supporting you there will be some things they may not understand.
Many services and organisations such as AIDS Councils, hospitals and sexual health clinics have counsellors, social workers and psychologists you can talk to about being HIV-positive.
Talking to a counsellor, social worker or psychologist for the first time can be difficult. You may feel that you don’t want or need to talk to anybody about being HIV-positive or that it’s not appropriate to talk about such private matters with a stranger.
Seeing a counsellor, social worker or psychologist does not mean that you are unable to cope with your own problems. Instead, counselling provides you with an opportunity to talk about your feelings and find solutions to some of the challenges of living with HIV/AIDS. A counsellor, social worker or psychologist will not judge or condemn you for being HIV-positive, gay, lesbian or an injecting drug user. He or she may offer suggestions, but will always support you in the decisions you make.
A counsellor or social worker can:
- help you find appropriate services
- provide emotional support
- help you decide who to tell, how to tell them, and even be with you when you do tell them
- accompany you to some appointments
- explain things you don’t understand
- It’s up to you to decide if you want counselling.
Some people make a regular appointment with the same counsellor, while others choose to see a counsellor only when they feel in crisis or need extra support.
“The doctor told me I was HIV-positive. He didn’t know much about HIV. He kept saying there were places I could go for support but that he couldn’t really help me. I went home and didn’t try to find any help. Really I didn’t believe there was any. I thought I was going to die soon and no-one could help me. Then I got an opportunistic infection and ended up in hospital. The social worker came to see me and we just talked about my fears and how I was living my life. I’ve been seeing her for 2 years now. We still talk about my fears about getting sick and dying, but also about the good stuff in my life. It has helped a lot. Sometimes I still feel like I’m on the path to the unknown. But I guess we all are.”
How to find the services you need
For general information about the health system, talk to someone who has a good understanding of how it works. Your doctor or a community health worker should be able to help.
- Ask your doctor for information about HIV/AIDS related services.
- If you don’t speak or understand English well, use an interpreter. That way you will get the most benefit from the services. Use a professional – don’t allow friends and relatives to interpret for you.
- Always ask if you will need to pay for a service and if bulk billing is available.
- If you are not sure what kind of service an organisation provides, ask them or visit the service to see if it’s what you need.
- If possible, talk to other people with HIV/AIDS about the services they have found most useful.
How you use services is your decision. You may find one organisation that provides all you need, or you may use a number of different services for different things.
Sometimes, it can be difficult finding the service that’s right for you. You may experience delays, receive conflicting information and go to a number of different places to find the information/service you need.
It is important that you don’t give up. If you don’t like one service, try others until you find one that suits your needs.
“The first time I talked to a counsellor was when I got my HIV- positive test result. He really tried to help me but at the time I just couldn’t think straight. It took me about a year before I could talk to anyone and I told my sister.
She’s been in Australia for longer and she took me back to the clinic where I had my test. Now I go there regularly. They look after my health and give me lots of information about HIV/AIDS. I still feel scared about the future sometimes, but I’m enjoying my life again.”
Medical care, services and information can be hard to find if you don’t speak or understand English. However, you can have an interpreter present when you are talking with health care workers or other services. The interpreter’s job is to translate everything that you and the service provider say to each other. An interpreter does not contribute to the discussion in any other way.
By using an interpreter you can:
- understand everything you are being told
- be sure everything you say will be understood
- ask questions and get answers
- be able to understand and consent to tests or treatment. Many people don’t want to use interpreters, especially for personal or sensitive health matters. You may be worried that the interpreter will be someone you know in your community or even be a friend who doesn’t know you are HIV- positive. Like all health care professionals, interpreters must protect your confidentiality. Telephone interpreters are also available anywhere in Australia. A telephone link will be provided between you, your service provider and an interpreter.
Always try to avoid using people who aren’t qualified interpreters – they may not realise the importance of maintaining your confidentiality, and are unlikely to be trained in interpreting information (especially medical information) correctly. You can have a trusted friend or relative present during appointments with health care workers and interpreters if you like.
They can also make appointments for you and request an interpreter. However, friends and relatives should not interpret for you.
TIS - TRANSLATING AND INTERPRETING SERVICE
TIS connects you and your healthcare worker with an interpreter over the telephone. The interpreter will ensure that you and your service provider can understand each other and that all your questions can be answered. TIS is completely confidential – the interpreter does not need to know who you are or even where you are calling from.
TIS is available 24 hours a day 7 days a week. Phone 13 1450 from anywhere in Australia. Your service provider can arrange for TIS or you can call yourself.