Cultural safety for older people with HIV

All people accessing services and support have a right to be seen, respected and supported. Older people living with HIV are no different. They also have a right to receive care that is affirming and accessible.

In Module 2 (Client Work) we introduced the concept of cultural safety.

Cultural safety is an environment that is safe for people: where there is no assault, challenge or denial of identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience of learning, living and working together with dignity and true listening.[1]

Providing culturally safe services for older people living with HIV means delivering affirmative, responsive, person-centred and trauma-informed care.

These are important principles underpinning the role of Peer Navigators we revisited in Topic 5.1.

Five principles of trauma-informed practice include:

  • Safety:
    • Work to promote physical, psychological, emotional and cultural safety of all people living with HIV.
    • Meet intersectional needs and wishes.
  • Trustworthiness:
    • Build trust by clearly describing your role.
    • Explain and protect the rights of the person you are supporting.
    • Keep clear boundaries.
  • Choice:
    • Maximising choice and control now and in the future.
    • Provide information that helps them make informed decisions.
  • Collaboration:
    • Work in partnership through collaboration and power sharing.
  • Empowerment:
    • Take a strengths-based approach that empowers people living with HIV.
    •  Draw on skills and capabilities.
    • Strengthen internal resources and resilience.

If older people living with HIV feel culturally safe they are more likely to:

  • Disclose or not disclose their HIV status as they choose.
  • Know they won’t be discriminated against and their HIV status will not be disclosed without their permission.
  • Know that stigma and discrimination will be addressed if it occurs.
  • Have their needs regularly reviewed by clinicians and other key staff, including as new information about the impacts of HIV and ageing emerge.
  • Have their care adjusted according to changing need and up to date treatment evidence.
  • Are treated and supported by staff skilled in building trust and providing emotional support .
  • Have their specific needs as an older person living with HIV articulated .
  • Can access timely care and support provided by appropriately qualified medical staff.[2]

In order to deliver these outcomes, it is important that individual practitioners and whole services reflect on their practice.  In the next topic we will briefly revisit individual Peer Navigator self-reflective practice.

There are also several organisations working to support cultural safety particularly for LGBTIQA+ people in a range of service settings. These may also be relevant for older people living with HIV.

Examples include:

  • Rainbow Health Australia: The Rainbow Tick standards provide guidance on how to plan, implement and measure cultural safety for LGBTIQA+ people in diverse service settings.
  • LBGTIQ+ Health Australia: Silver Rainbow delivers training to aged care services, assessment teams, allied health services, and other stakeholders.
  • Intersex Human Rights Australia / Intersex Peer Support Australia: The Yellow Tick supports organisations to develop intersex inclusive and affirmative practices across all life stages.

The aged care quality landscape described in Topic 6.1 has also taken steps to make sure mainstream aged care providers respond to diverse client needs.

Val’s LGBTI Ageing and Aged Care at the Australian Research Centre in Sex, Health and Society at La Trobe University has many resources on LGBTI inclusive practice in ageing and aged care. See the end of this topic for links.


Knowledge Question

Identify two (2) strategies for each trauma-informed principle (Safety, Trustworthiness, Choice, Collaboration, Empowerment) you could apply in order to support an older person living with HIV to feel a sense of cultural safety. Describe how your strategies would support an older person living with HIV feel culturally safe.


ℹ️ MORE INFORMATION: See for example:

More information

– Val’s LGBTI Ageing and Aged Care range of resources
 – Australian Government Department of Health: Actions to support lesbian, gay, bisexual, trans and gender diverse and intersex elders: A guide for consumers
Australian Government Department of Health: Actions to support lesbian, gay, bisexual, trans and gender diverse and intersex elders: A guide for aged care providers
Australian Government Department of Health:Aged care diversity framework 2017
– Val’s LGBTI Ageing and Aged Care: LGBTI-inclusive practice review tool for services supporting or caring for older people
­– Rainbow Health Australia: Rainbow Tick
– LGBTIQ+ Health Australia: Silver rainbow LGBTIQ+ aged care awareness training
– Intersex Human Rights Australia / Intersex Peer Support Australia: The Yellow Tick


[1] Rainbow Health Australia (2020). Rainbow tick standards: A framework for LGBTIQ cultural safety

[2] Australian Government Department of Health (2019). Actions to support lesbian, gay, bisexual, trans and gender diverse and intersex elders: A guide for consumers.

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