The Albion Street Centre Model

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The Albion Street Centre operates on a model that incorporates prevention, treament, care and support. The approach adopted within this model includes five key components.

• Ambulatory Care
• Multidisciplinary Patient-Centred Care
• The Continuum of Prevention, Treatment, Care and Support
• Infection Control and Health Care Worker Safety
• Health Care Worker Education and Training      

The Albion Street Centre is the only major Australian community-based multidisciplinary centre and ambulatory care service providing treatment, care and support of people living with HIV, their families and carers.  Established in Sydney in 1985, the Centre ’s core approach is to integrate prevention and care for patients and to train health care workers in epidemic infectious disease management. 

The Centre offers a unique model of treatment, care and support for people living with HIV that is widely applicable to different resource and cultural settings.  In responding to identified needs, relevant features and principles of the Albion Street Centre model (outlined below) can be adapted to build sustainably the capacity of health care workers and public health services to provide treatment, care and support for people living with HIV. 

Ambulatory Care

The purpose of ambulatory care is to improve services to people living with HIV through means other than hospital admission, which can be both expensive and unnecessary in many cases.  Ambulatory care enables people with HIV to access treatments and other health care needs in an outpatient rather than inpatient hospital setting. Patients can return home and lead as close to a normal life as possible and there is less demand on hospital resources. In many developing countries where HIV is having a significant impact on public health care services, ambulatory care provides a cost-effective model for the provision of care and treatment. 

Multidisciplinary Patient-Centred Care

Multidisciplinary, patient-centred care is inherent in the Albion Street Centre model. Multidisciplinary care enables a holistic approach across the continuum of treatment, care and support.  A broad range of clinical services are made available to people living with HIV to achieve comprehensive HIV management. These include: 

• Medical
• Nursing
• Counselling
• Nutrition
• Pharmacy

Provision of these services by an integrated multidisciplinary team is underpinned by the principles of patient rights to accessible, non-judgmental and confidential services, thus enabling personal, patient-centred support. Patient information services and volunteer programs are also used as a means of support. 

In low resourced settings, the integration of other disciplines with medical disciplines in the provision of HIV treatment and care can yield significant benefits.  For example:

• Counselling assumes a significant role in not only helping individuals and families cope better with their disease, but also in preventing transmission through pre and post test counselling and other targeted interventions
• Nutrition is an important intervention in HIV treatment in developing countries where antiretroviral therapy is unaffordable. Nutritional therapy can reduce morbidity, decrease the incidence of opportunistic infections and minimise hospital admissions, thereby providing cost-effective strategies for health management
• Nursing skills and roles can be strengthened through nurses equal participation in a multidisciplinary team, therefore helping to alleviate demands on doctors who are often in short supply
• Health care infrastructure and systems in general are also strengthened as a result of applying a multidisciplinary, patient-centred approach to other areas of disease management.

The Continuum of Prevention, Treatment, Care and Support

The Albion Street Centre model provides an integrated and comprehensive response to HIV in terms of:

• Integration of treatment, care and support with prevention
• Continuity of care in the health care system from home-based and community-based care to the tertiary health care level

The delivery of treatment, care and support contributes to effective prevention through voluntary and confidential counselling and testing, and by keeping people living with HIV in close contact with the health care system and information, counselling and preventive supplies. There was broad consensus at the UN General Assembly on Special Session in 2001 that the elements of treatment, care, support and prevention are mutually reinforcing.  

The community-based nature of this service facilitates a continuum of care from the tertiary level of health care to home-based care. As a community-based service, the Albion Street Centre facilitates referral linkages between the various levels of health care to ensure continuity of care for people living with HIV throughout the progression of the disease. The Albion Street Centre works with communities and non-government organisations to achieve a comprehensive approach to care. This approach is also based on actively promoting the principle of greater involvement of people with HIV. 

In low resource settings, in particular where HIV is placing enormous pressure on health systems, community-based models of care, such as that of the Albion Street Centre, provide a an effective alternative in order to alleviate demand at the tertiary level. It is recognised that the development of integrated comprehensive programs of care and support for people living with HIV can provide for coordination of services, ease of referral through health service systems, skills transfer between health care workers and between people living with HIV.

Albion Street Centre
150 - 154 Albion Street Surry Hills NSW 2010 Australia
Telephone: +61 2 9332 9600 Fax: +61 2 9331 3490