At the height of the AIDS epidemic in the mid-1980s, Professor Mark Henrickson found himself working as an HIV counsellor, helping those most at risk from a disease that was, at the time, a certain death sentence. It was not a career he could have envisioned even a few years earlier.
‘I got my undergraduate degree in psychology and religion, was ordained an Anglican priest, and was planning to have a simple career in parish church work,’ he says. ‘Then HIV came along, and things changed dramatically. After beginning as an HIV counsellor in a Northeast city of the US, I became an HIV clinic manager just north of Los Angeles, where I worked with undocumented people, including trans street sex workers. We were the first clinic in the country to do gender transformation and hormone therapies as a part of HIV treatment, because people were taking street hormones and wreaking havoc on their bodies.’
Working in HIV led to a social work degree, a PhD, and eventually to employment in Massey’s School of Social Work. Since joining Massey in 2003, Professor Henrickson has continued his focus on HIV, including researching the experiences of Black African new settlers living with HIV in New Zealand, and a Health Research Council grant to advise the Ministry of Health on HIV-related prevention and health promotion in Black African communities. ‘One of our major findings is that skin colour is used as a proxy measure for HIV status in New Zealand,’ he says. ‘While the treatment and treatment providers for HIV are good, when you move outside that sphere into other providers, and happen to be Black, people encounter tremendous racism, and it’s very problematic. We also find a lot of stigma within Black African diasporic communities themselves, because of the belief that if you have HIV, you have done something socially unacceptable.’
In 2017, Professor Henrickson was the editor in chief of Getting to Zero: Global social work responds to HIV, a book funded by UNAIDS (the Joint United Nations Programme on HIV/AIDS). He also coauthored Vulnerability and Marginality in Human Services, a book which draws together lessons from practice about how policies and cultures marginalise people under the guise of managing risk. Professor Henrickson consults widely internationally on the evaluation of HIV services, for example for the World Health Organization, UNAIDS, and UNICEF in the Pacific Islands.
He has seen a staggering change in HIV management during his career. ‘In the early days where there weren’t any drugs available, when I was telling people they were positive, I was essentially starting the clock until they died,’ he says. ‘Now, we’re really talking about a chronic manageable condition. If you have an undetectable viral load, studies are very clear that you cannot transmit HIV from one person to another sexually. It’s a stunning change. But there are still significant barriers to treatment and education.’
Outside the HIV arena, Professor Henrickson is collaborating with nursing and ethics colleagues on a study of the ways in which aged residential care institutions manage the issues of intimacy and sexuality among their residents. At present, there is little conversation or policy about this in many institutions, and care staff must rely on their own resources and values, which vary widely and are not necessarily aligned with those of the residents. The design of many institutions is also not conducive to privacy and intimacy; most rooms are single, there are usually no locks on doors, and rooms are often designed for easy viewing by nurses and care staff. Professor Henrickson believes this situation should be addressed, at the very least by questioning current practices.
There is also the issue of consent. ‘This is particularly salient for people who are intellectually compromised with dementia, for example,’ he says. ‘We want to develop better theories and ethics that will, we hope, carry over into better education and care plans, and more preparation for the future as more and more people enter care, with different expectations about sexuality. We are already seeing expanded lifespans, with people living their full life up until the last possible moment. That is certainly how the care industry is moving, and we want to help.’
Professor Henrickson sees his work as united by a strong desire for social justice, particularly for those who struggle to attain it. ‘My passion has always been working for the most marginalised and excluded people, and ensuring that social services and health care systems are accountable to providing care.’
Project AfricaNZ Health: HIV behavioural study of African communities in New Zealand
Funder Ministry of Health/Health Research Council of New Zealand Partnership Programme
Project An evaluation of the Voluntary Confidential [HIV] Counselling and Testing training programme implemented by the Pacific Counselling & Social Services in selected Pacific Island Countries and Territories
Funder Secretariat of the Pacific Community, for UNAIDS, UNFPA, UNICEF, WHO, et al.
Project Universal Access Review 2010 for the Kingdom of Tonga
Funder Technical Support Facility Southeast Asia and the Pacific, for UNAIDS
Project Evaluation of the Ninth International Congress of AIDS in Asia Pacific
Funder Technical Support Facility Southeast Asia and the Pacific, for the AIDS Society of the Asia Pacific
Project What counts as consent? Sexuality and ethical deliberation in residential aged care
Funder The Marsden Fund