In Conversation with Scientia Professor Carla Treloar

Published on the 16 March 2026

Scientia Professor Carla Treloar still remembers the early days of her career. A young researcher embedded in a HIV clinical unit, watching patients battle not only a devastating disease, but a system that struggled to respond equitably.

“That experience never left me,” she says. “You could see, in real time, how structures and power shape who gets care, who gets compassion and who has to fight for both.”

It set the direction for everything that followed.

Her work now spans research, policy engagement and professional education, including short courses that translate decades of evidence into practical frameworks for people working on the ground.

We spoke with Professor Treloar about stigma, poverty and inequality, and why change requires both structural insight and everyday action.

Your work has long focused on people underserved by health and social systems.

What first drew you to that space?

It goes back to my PhD, which I sometimes joke was about 1000 years ago. It was before there were highly effective treatments for HIV. I was based in a regional hospital unit caring for people with HIV and AIDS.

I saw not just the impact of a terrible disease, but the struggle for equity and fair responses from the system. As a young researcher, that was formative. Watching inequality play out in real time has stayed with me ever since.

Was there a moment early in your career that changed how you understood inequality?

That period was the moment. Later, I researched heart disease and cancers, which are also important areas, but I realised I missed grappling with the structural aspects of inequality.

Those issues are there in every health condition, of course, but in HIV, blood-borne viruses, sex and drugs, they are so visible and confronting. When I came to UNSW to work at what was then the National Centre for HIV Social Research, it all came back to me. I remember thinking, this is where I want to be. This feels like home.

You have spent years listening to people navigating drug policy and complex health systems.

How have those relationships shaped your thinking?

One of the strengths of this work is close engagement with community. Almost every day I am speaking with someone living with or affected by these issues.

If you are listening, you never stop learning. You start to hear the ways structures and power shape people’s lives in ways you simply cannot imagine until you have walked alongside them. 

And it is not just about hearing those stories for what they are. It is also about asking, what else is out there that I do not yet understand? How do we find the right tools to unpack the structures and power that are so often taken for granted?

Those forces shape how services are delivered, how people think about them, whether they can access them, what happens when they arrive. Increasingly, they also shape how people’s information is used, how it is protected, and what control they have over very sensitive aspects of their lives. 

We often use terms like ‘disadvantage’, ‘vulnerability’ and ‘risk’.

What do those words miss?

They are easy labels to pick up and use. But they attach to people and obscure the structures that create the conditions in the first place.

Instead of asking why systems produce poverty or exclusion, we describe “disadvantaged people”. It personalises what is structural. Part of our work is constantly lifting the lens to that macro view and asking what policies and powers are creating the conditions for inequity to flourish, and then thinking about how we highlight those forces and create different pathways, different solutions, different ideas.

When we talk about poverty in Australia, what are we reluctant to confront?

There is still so much blame placed on individuals. Why don’t people just work harder? Why have they got themselves into that situation? Why can’t they manage their money better?

We are much less likely to confront those stereotypes, and even less likely to take the next step up the chain and ask how poverty has come to be structured the way it is in Australia. How do we allow one in six children to live in poverty? How on earth do we think that is acceptable?

There is a constant tension between blaming individuals and recognising that many of these circumstances are shaped by policy choices that create the conditions for poverty. They make it very hard to escape. The stereotypes often reinforced in public debate and in media make it easier to keep the focus on the individual and avoid confronting the policies further up the chain.

How do poverty and stigma reinforce one another in health and social systems?

If you are living in poverty, every decision is a trade-off. Do you pay rent or see a GP? Pay for transport to a job interview or to a hospital appointment?

People may present later with health issues because they simply could not afford to come earlier. Then the blame kicks in. Why did you wait? The system rarely asks what barriers someone had to navigate just to get through the door.

When people anticipate judgment, they may not come back at all.

If inequality is structural, what does that mean for service design?

Services themselves are often thin and overstretched, so that is part of the reality we have to acknowledge. But the way many services are designed tends to focus only on the individual moment when someone walks through the door. 

There is an important body of work around structural competency that asks health and social service workers to think about the structures behind that moment. What has shaped this person’s circumstances before they even arrive? What are you asking them to do once they leave?

If someone is told to exercise more or reduce their salt intake, but they live in an unsafe neighbourhood or in a place where fresh food is expensive and hard to access, that advice may not be achievable. It is not enough to prescribe solutions without thinking about the settings people live in and the resources they have.

It is about situating people in their real contexts, not assuming a kind of middle-class norm where everyone has control over most aspects of their lives. It also means rethinking how services are delivered. Hospitals are large institutions located in particular parts of cities. Parking is expensive. Transport can be difficult. For some people, that is enough to stop them coming at all. 

So, we need to think creatively about service design. Mobile clinics, outreach models, self-testing kits, services that go out into communities rather than waiting for people to come in. If inequality is structural, then service responses have to be structural as well.

When services work well for people experiencing disadvantage, what makes the difference?

Involving people with lived experience in design and evaluation.

Most service leaders are well intentioned, but they will not know all the barriers people face. A simple test is this. Would someone come back? And would they recommend the service to someone like them? If the answer is yes, you are probably on the right track.

You are closely connected to the Social Policy Research Centre (SPRC) and the Centre for Social Research in Health (CSRH).

What role do research centres like these play in shaping policy, practice and public debate?

What I love about working across these two centres is that we sit right in the middle of policy, practice and public debate. It is not abstract or removed. Every day I am speaking with people in government, in health services and in community organisations.

It is an invigorating place to be, hearing those different perspectives and asking what research can contribute. How can it take advocacy forward? How can it answer practical questions about equitable service design and delivery? How can it help illuminate the needs of marginalised communities and communicate those clearly to decision makers?

I would like to think our research is impactful, and we have strong examples of where it has shaped policy, practice and community debate. That is always the driving force. To produce research that is high quality, practical and useful, and that helps drive forward change.

You helped develop the courses Understanding Poverty, Inequality and Social Disadvantage in Australia (SPRC) and Combating Stigma: Strategies for Inclusive Health Services (CSRH). 

What gap were you trying to address?

With both the poverty and the stigma courses, we really wanted to bring together the expertise our centres have developed over decades. We work across lived and living experience, practice, policy and high-quality research. The aim was to package those insights in ways that are useful for people working in the field.

In the stigma course in particular, we wanted to move away from what can sometimes feel like finger wagging. It is not about telling people they are doing the wrong thing. It is about helping people understand how the ideas we hold about the world sit there almost like cultural wallpaper. They are assumed, unquestioned, and built into the way services are designed and delivered.

In the poverty and inequality course, it is similar. Poverty does not just happen. It is constructed through policy, power and systems that shift over time. We want people to understand where poverty and inequality come from, how systems and structures shape them, and what role their own organisations can play, not only in delivering services more equitably, but also in advocating for a fairer world.

When you guest speak in those sessions, what shift in perspective are you hoping participants experience?

I hope participants leave with a sense that the world is not simply the way it is by accident. Systems, policies and practices are created. They reflect particular assumptions and power structures. If that is the case, then they can also be changed.

If people can see where they have influence in their own organisations and feel equipped with some new concepts, tools and language to act on that, then that is the shift we are aiming for.

Why are courses like these important for people already working on the ground?

We know people are busy. Resources are stretched and the work is already complex and demanding. These courses are not about adding another burden. They are about offering something practical that people can use in the realities of their day-to-day work.

The people who come are already motivated and interested in these issues. What we want to provide are tools, concepts and language they can take back into their organisations. Ways of thinking that help them become change makers in their own settings and influence others around them.

We know influence does not only come from external pressure. It also comes from inside organisations. If we can support people to carry forward the ambitions they already have, with some additional frameworks and resources, then that is where real change can start to happen.

At a time of widening inequality, what collaboration feels most urgent?

We need to be able to communicate clearly about inequality. Not in a patronising way, but in a way that helps people understand what our world actually looks like.

The collaboration we need across sectors is to find clearer and more compelling ways to tell these stories and build a shared understanding that inequality affects all of us. The statistics are straightforward, and we need to communicate them clearly while countering some of the dominant narratives we hear elsewhere. Unequal societies have worse outcomes, not just economically but socially. Working together to communicate that reality, and to advocate for policies and structures that move us towards a more equitable future, feels especially urgent right now.

After decades at the intersection of research, policy and practice, what still gives you hope?

Working with colleagues in community organisations, policy and frontline services. That is where the hope comes from.

We are not lone voices sitting in a university saying things are inequitable and we should do better. We are connected to strong advocates in other spaces. Being able to bring those voices together and build a stronger collective voice for more equitable health and social systems gives me hope.

We are not alone in this work. And that matters.

Learn more about Scientia Professor Carla Treloar’s research, projects and achievements by visiting her UNSW Staff Profile.

Learn more about the Understanding Poverty, Inequality and Social Disadvantage in Australia short course. 

Learn more about the Combating Stigma: Strategies for Inclusive Health Services short course.

Learn more about the UNSW Social Policy Research Centre. 

Learn more about the UNSW Centre for Social Research in Health.