Chris Howard (Regional Coordinator, Central & Northern Queensland Positive Directions) explores the mainstreaming of HIV in Queensland, using an integrated service delivery model which addresses mainstreaming on an individual, service and structural level. This presentation was given at the AFAO Positive Services Forum 2012.

2. Infiltrating the Mainstream
The Queensland Experience
Chris Howard
Regional Coordinator (Central & Northern QLD)
Positive Directions

3. Positive Directions Program
 Funded by Queensland Health
 Care Coordination, Information & Referral Services
 Access and Advisory Services (Nutrition and Mental
Health)
 Community Nurses (Clinical Support)
 Client Liaison Officers (Psychosocial Support)
 Regional Offices and Outreach Services

4. Growing trend towards
mainstream service delivery
 Epidemiology
 Geographic & demographic considerations
 Resource constraints

5. Positive Directions
response to mainstreaming
 Review and reorientation of Service Delivery Model
 Integration across levels:
– INDIVIDUAL
– SERVICE
– SYSTEMIC
 Program restructure
 Process & resource development

6. Mainstreaming on all levels
Sustained and effective mainstreaming of HIV requires:
 Coordinated action across all levels
 A commitment of human and financial resources
 Strategic and collaborative arrangements
 Advocacy
 Education and information provision

7. Mainstreaming - Individual
Level
Self Management Framework
 Skills
 Knowledge
 Motivation
 Self-efficacy
 Resources
Addressing Barriers
 History and experiences of service provision
 Internalised stigma and fear
 Disclosure
 Individual issues that impact service engagement

8. Mainstreaming - Service Level
Professional Integration
 Multidisciplinary teams
 Care Coordination
 Training & Development
 Practice Frameworks
Organisational Integration
 Programming
 In-service education to mainstream providers
 Partnerships – QPSB
 Client Care Fund

9. Education to Mainstream
Services
 Build HIV knowledgeable and sensitive work force
 Tailored to individual and service need
 Regionally targeted to address service delivery gaps
 Partnered with QPSB
 Ongoing support and liaison from PD multidisciplinary
team to individuals and teams working with PLHIV

10. Mainstreaming – Systemic
Level
 Recognising and responding to the drivers of change in
the operating environment
 National/State Strategies – frame of reference
 Reporting unmet needs and service provision gaps
 Research Partnerships & Education
 Peak Bodies
 Strategic, collaborative partnerships

11. Summary
 A shift towards mainstreaming HIV in Queensland has
been necessitated by geographic & demographic
considerations, epidemiology, resource constraints and
changes in HIV management.
 Successful mainstreaming requires an integrated
response at individual, service and systemic levels.
 Sustained change cannot be achieved without building
capacity, skills and knowledge at all levels.
 Mainstreaming requires a commitment of resources and
the embedding of HIV into the strategic and operational
planning processes of services and organisations.