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Peer Practice Network — Privacy & Consent Form
1.
Your name
2.
Your preferred pronouns
3.
State or territory
ACT
NSW
NT
NZ
QLD
SA
TAS
VIC
WA
Another country
4.
I am a person living with HIV
Yes
No
5.
Are you currently working in a peer-related role?
HIV peer support worker
HIV peer education worker
HIV peer navigation worker
Volunteer peer educator
Volunteer peer support
Hoping to move into a peer role in future
None of the above
6.
What organisation(s) do you work or volunteer for?
Bobby Goldsmith Foundation
Body Positive NZ
Living Positive Victoria
Meridian
NT AIDS & Hepatitis Council
Positive Life NSW
Positive Lives SA
Positive Lives TAS
Queensland Positive People
WA AIDS Council
Other (please specify)
7.
Have you completed the HIV Peer Navigation training program offered by NAPWHA Learning?
Yes (as part of a cohort)
Yes (as a solo online learner)
Not yet but I hope to
No and no plans to
8.
Important information about joining the Peer Practice Network
The Peer Practice Network is a community of practice for HIV peer support and peer navigation workers and volunteers. It includes a WhatsApp group, occasional e-mail updates, and regular Zoom webinars on topics relevant to peer practice.
The
Terms of Reference and Group Agreement
document is available to view on the NAPWHA Learning platform. In order to join the network you must agree to the Group Agreement. It requires all participants to respect the privacy of other members and what they disclose about themselves in the group chat, e-mail conversations or Zoom discussions.
However, NAPWHA cannot guarantee your privacy, confidentiality and anonymity if you take part in the group, as there is always the possibility that someone will breach the Group Agreement.
Please consider the risks of unauthorised disclosure and whether you are in a safe place to take part in the community of practice.
There are steps you can take to minimise (but not eliminate) the risk of unauthorised disclosure. These include using a pseudonym, creating an e-mail address you only use for HIV work, not sharing face pictures, not linking to your social media, etc. You might avoid sharing your demographic information with the community of practice and only sharing your experience in general terms.
If you are unsure, the NAPWHA Learning facilitator is available to have a conversation with you exploring the potential for disclosure and how it might affect your life if it occurs. For assistance contact
learning@napwha.org.au.
I understand and I would like to take part
I have thought about it and the risks are too great
I am unsure and would like to discuss it further