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Future uncertainties and daunting challenges

By: Arty

Arty writes about his experience as a Thai international student living in Melbourne, and how HIV and COVID-19 have complicated his hopes to live and work here.

I came to Australia to study and practice English. I thought that gaining confidence and experience would give me better opportunities for work. I was also keen to experience a different culture and see how people live in another part of the world.

I fell in love with Melbourne right away. I love how convenient the city is. You can shop in the CBD and in 15 minutes by tram you can find yourself at the beach. I also feel very safe and secure living here. People are open-minded, and I feel that I can be myself without any judgement. I feel respected and appreciated at work and since being diagnosed with HIV I’ve met lots of friends who are willing to give support and share similar stories with me.

Since I first arrived in 2013, I’ve learned a lot about the English language. But building a life here has been harder.

I’ve had to support myself from day one. There is always rent, food and bills but my biggest expense is tuition fees. As an international student, fees can be as much as $50,000 upfront per course. After living and studying in Australia for 7 years, you can imagine how many certificates and qualifications I now have.

I always told myself it was a good investment because one day I’d be able to apply for residency and live here permanently. That all changed last year in July.

When I started feeling sick, I thought It was just a flu or a cold that I usually get when the weather is getting colder. It turned out to be HIV. I couldn’t believe what I heard. I hadn’t done anything risky and I wasn’t sure how this happened to me. Everything went slowly, I was numb, and it felt like my world and future were falling apart.

The pathway to permanent residency is narrow with HIV in Australia. People living with HIV fail the necessary health check and a waiver is only available under family sponsored visas and certain limited skills pathways. As a graduate, the best I can do is apply for a temporary visa to live and work here for another 2 years.

While I would like to stay in Australia, poor job prospects make the cost of investing in a new temporary visa daunting.

Previously, I have always been able to find work. Even outside of my profession as a software engineer, I have waited tables and worked as a cleaner in a shopping centre. That changed at the end of March when the COVID-19 epidemic hit here. Since then I have only found work cleaning an office, but my hours were drastically reduced following Stage 4 restrictions and I may lose this job entirely. Over this time, I have been ineligible for government support and I still have living expenses and course fees to pay for.

Moving back to Thailand presents its own challenges. Currently, border closures and restrictions make travel impossible. But if there is one thing that holds me back from returning it is the treatment of people living with HIV. Stigma is pervasive in a mainstream culture and media that presents people living with HIV as dirty and disgusting. This extends to widespread and discriminatory employment practices that require health checks and an HIV test during the application process. To my knowledge, this is common for jobs at every level.

In Australia we are often told that we can lead a normal life with HIV. Don’t let this virus define who you are.

I appreciate the support that I have received from Melbourne Sexual Health Centre, who have provided me with medical services and treatment. I am also grateful to community organisations like Living Positive Victoria, Thorne Harbour Health and especially my peer navigator who has guided me through a hard situation.

But why, when it comes to migration, are we faced with this kind of discrimination?

Community should be at the centre of COVID19

By: Dr Chris Lemoh

The COVID-19 pandemic, which has swept across the world since late 2019, will not be stopped by scientists and biomedical researchers alone. We need meaningful community participation in all aspects of the Australian response.

So far, the official role of the public has been to “stay home and await further orders.” Unofficially, of course, people are helping each other: from welfare checks to dropping off food or medications, to sharing information about how to protect themselves and those closest to them.

This community response to COVID-19 currently runs largely in parallel to the state response. However, those who have been involved in the Australian response to HIV have a wealth of understanding from which to explain how affected communities might contribute more substantially to the control of this new epidemic and the mitigation of its impacts on health, wellbeing and social cohesion.

Australia’s response to the HIV pandemic began with the onset of the “AIDS crisis” in the 1980s and achieved substantial public health gains even prior to the advent of effective antiviral therapy. The communities most directly threatened were gay and bisexual men, sex workers and people who injected drugs. They worked intensely with each other and their allies in health, academia – and crucially, politicians and public servants – to learn all they could about how to avoid exposure, recognise symptoms and care for people who fell ill.

Over the ensuing decades, the ongoing involvement of affected communities has been a key factor contributing to advances in both prevention and treatment of HIV and research into mental and physical health challenges for people living with HIV. This partnership also transformed health care, making clinical workplaces safer for both patients and staff. Meanwhile, communities developed innovative ways of making their voices heard in public spaces and in the media: our culture evolved, showing us to ourselves in new ways more reflective of our actual lives in all their breadth of diversity.

Australia’s HIV partnership approach has been justly praised around the world. It has influenced several national responses in the Asia-Pacific region, such as Malaysia, whose approach to injecting drug use is exploring harm reduction and now actively engages its conservative religious establishment in productive discussions about sexuality and drug use.

Most recently, in Australia the active involvement in research and policy of people who use drugs has enabled the rapid accumulation of scientific evidence to support the feasibility of government-subsidised curative treatment for Hepatitis C, paving the way toward elimination. The projected public health and economic benefit to be expected from the prevention of cirrhosis and liver cancer is substantial.

So, what lessons can we learn to apply to COVID-19?

First Nations have already shown strong leadership. The willingness of state, territory and Commonwealth governments to work with these communities as equal partners in the response to COVID-19 in Australia has resulted in a gratifyingly low number of COVID-19 cases among Aboriginal and Torres Strait Islander people, despite the high prevalence of chronic health conditions associated with increased risk of severe disease and death. This stands in stark contrast to the unfortunate experiences of indigenous populations in countries such as the United States and Brazil.

The unfortunate consequences of a lack of timely or meaningful engagement with local communities have been clearly seen in the Victorian epidemic. Migrant communities and communities of people living in public housing were not adequately consulted or closely involved in the planning or implementation of the public health response to COVID-19. The absence of timely, meaningful consultation and collaboration compromised prevention, testing and the response to outbreaks in public housing, aged care and health care facilities and amongst people from culturally and linguistically diverse backgrounds. Victoria’s experience is a clear warning to other states and territories about the potential for explosive outbreaks which are difficult to prevent, detect or control without strong partnerships and good two-way communication between all stakeholders.

Many local partnerships between communities, health services and governments have subsequently been established in Victoria and are rapidly evolving, benefitting affected communities and the Victorian public. However, there is much to be done to strengthen these partnerships and build community capacity to work with government, the health sector and researchers so that all states are better positioned to deal with the current epidemic and the complex socioeconomic challenges that lie ahead.

It is time for the Commonwealth, state and territory governments to make strong commitments to the meaningful involvement of affected communities as equal partners in the planning, implementation, monitoring and evaluation of public health responses as well as research in relation to COVID-19. Governments should also acknowledge that this will require clear and transparent processes to guarantee and demonstrate that such meaningful community participation occurs.

Meaningful community involvement requires substantial financial investment on the part of government, a willingness to change established processes and a readiness to accept constructive criticism of current approaches. However, these costs to government will be far outweighed by the benefits.

It is not too late to learn.

Dr Chris Lemoh is an infectious disease and general physician at Monash Health and adjunct senior lecturer at the School of Clinical Sciences at Monash University, with experience in refugee health. His doctoral research was on HIV in Victoria’s African communities. He is a former Board member of the Australian Federation of AIDS Organisations and is current President of the Victorian African Health Action Network.

Image: People living in public housing were not adequately involved in the planning or implementation of the public health response to COVID-19, writes Chris Lemoh. (Chris McLay, Unsplash).



Life in Lockdown

By: LPV volunteers Daniel, Jimi and Jackie

We’re all doing it tough in lockdown, some more than others.

As the second wave of COVID-19 triggered even stricter limitations on our ability to work and stay connected, we at Living Positive Victoria wanted to pool the emotional resources of our community.

Life in Lockdown is a short clip showing members, volunteers and staff living across Melbourne and Victoria as we carry on and still try to have some fun. This illustrates a collage of our burdens and challenges, but mainly our creativity, our resourcefulness and our positivity.

Some of the people featured tell us a bit more about their lives, how they’re travelling and what they chose to submit to Life in Lockdown.

By: Daniel Cordner

I’m a freelance graphic designer and artist. I’m also a member of the Positive Speakers Bureau and a Positive Leadership Development Institute (PLDI) alumni.

Living though lockdown has had some challenges. When it first hit, I was housesitting in Melbourne. I didn’t have a place to live, so I came to my parent’s holiday home in Nelson. It’s a place where I have spent a lot of time over my life. There is the river, the sea and the national park. It’s beautiful.

It’s also 5 hours from Melbourne. As a township of 190 people, Nelson is isolated even when not in lockdown. I’m good at spending time alone but this is an extreme version. I am still unsure when I will next be able to touch another human being.
My garden has kept me grounded. It allows me to take control of things when there is so much beyond our control right now. Every day the garden has brought me great joy and a sense of purpose.

I started collecting ocean beach rubbish before lockdown. It’s even more important to me now.

There are a lot of issues in the world that need our attention. Even though COVID-19 has taken the lead they all still exist. One does not negate the other.

I am not an essential worker, a nurse or a scientist. I have felt somewhat helpless with the current pandemic being disconnected from Melbourne, my friends and my community. By collecting this rubbish, I know that I am still helping the world in some way.

To date, 110kg collected, sorted and recycled or in landfill, instead of on our beaches and in our oceans.

By: Jimi

My connection to Living Positive Victoria began as a volunteer receptionist at the office in Southbank.

I have been working as a professional freelance dancer and dance teacher for the past 6 years. I currently work for an insurance company in client administration.

Stage 4 lockdown has been pretty tough, especially with dancing and dance teaching. All my performance work was put on hold and a portion of my classes transferred onto Zoom. It’s been pretty isolating working from a computer, however, I have been utilising the free time to re-explore my hobbies and passions.

I used to live in Japan, so I have been using this down time to continue my Japanese language studies. I have also been doing heaps of gardening and home improvement work!

It’s actually been a great time to slow down and take an inventory on my life: to remember what’s important and take a break from the fast-paced performance industry.

Sometimes I’ve really enjoyed a bit of an improvised boogie. Dancing is a great creative outlet for me and beneficial to my mental and physical health. It helps relax my mind and let go of tension and stress. I’ve chosen to do some improvised dance for the video, to give people some insight on how dance has helped me through this time.

By: Jackie

I’ve been involved with Living Positive Victoria as a member and volunteer for around 5 years now. In that time, I’ve done things like pack Christmas Hampers, stuff envelopes for mail outs, and staffed the front reception desk.

Stage 4 lockdown has been a real ‘Coronacoaster.’ I am a single mum to Ella, who is in Grade 3. The different iterations of remote learning have been… interesting. Thankfully, her school has been great at hearing feedback and have changed the way they do things to take pressure off parents delivering content. Lucky for Ella, because my maths ability is not up to a Grade 3 standard!

We’re both navigating our own anxieties and feelings around this pandemic, which has fostered some open and honest conversations that we may not otherwise have had. I’m grateful for that.

In our portion of the video, Ella and I are showing off our masks and skipping off to school.

We have both been at home since 20 March and I have been trying to juggle my full-time job in community services. Recently, we started to really struggle. Something had to give. I applied to have Ella attend her school campus for 3 days a week. The change in her (and me) has been huge. It’s helped both of us feel connected with our respective peer groups.