“Too Great a Risk?” — Confronting HIV Stigma in Aged Care Transition
For many older Australians living with HIV, the journey from hospital discharge to residential aged care can be a painful reminder that stigma remains one of the toughest battles yet to be won.
Take, for example, a 74-year-old man who has been living with HIV for decades. Following a brain aneurysm and a fall at home, he spent months in hospital and
rehabilitation, regaining partial strength and cognition. With his family’s support, a decision was made to move him into a residential aged care facility (RACF) where
he could receive ongoing support.
But finding a placement wasn’t easy — not because of his medical needs, but because of his HIV status.
Multiple facilities were contacted, but when one suitable placement was finally secured, everything changed once the Director of Nursing discovered his HIV status.
Despite being cared for in a shared hospital room for months, they questioned whether he could be accommodated in a four-bed room in a residential ageing
facility and even asked how he had contracted HIV — a question irrelevant to his care and deeply inappropriate.
When reassured about infection control and U=U (Undetectable = Untransmissible), the Director still refused admission, stating that “the risk to the staff and other
residents is too great.” They even disclosed the man’s HIV status to his family without consent — a serious breach of privacy.
It took escalation through hospital executives and advocacy from supportive staff to secure a place in another facility, where he is now settling well. But the damage not
only from misinformed, discriminatory behaviour but for his ongoing health and wellbeing outcomes — and the message — was clear.
Sadly, this is not an isolated case.
Another older man, aged 82, living with severe cognitive impairment and under guardianship, was declined from a facility despite the availability of dementia care
beds. The manager of the facility admitted they had to “escalate the matter” to their Head Office, only to be told that staff would likely discriminate against the resident
because of his HIV status. Even after being provided with NSW Ministry of Health guidelines confirming there was no transmission risk, the placement was still denied.
This man has had to remain in hospital despite having met the conditions for discharge, and to date has made applications to over 40 aged care facilities without
success.
These examples reflect a disturbing reality: while HIV-related stigma has diminished in some parts of the healthcare system, it remains entrenched in
aged care — often underpinned by misinformation, fear, and lack of education and training among staff and management.
Older people living with HIV face a “double stigma” – ageism and HIV discrimination. When combined with declining health and dependence on institutional care, these biases can strip people of their dignity, autonomy, and access to appropriate services.
At a time when Australia’s aged care sector is being urged to embrace inclusion and diversity, the experiences of these individuals raise an urgent question: Are we truly ready to provide compassionate, equitable care for people ageing with HIV?
The solution lies not only in policy, but in education, leadership, and empathy. Aged care providers must ensure staff understand HIV, universal precautions, and U=U. They must also recognise that every person — regardless of their health condition — deserves to age with safety and respect.
Until then, for too many older Australians living with HIV, the words “too great a risk” will continue to echo as a painful reminder of how far we still have to go.
