Photo Credit: AlxeyPnferov
Our columnists from ETR discuss the status-neutral approach in HIV, which puts the person—not their HIV status—at the center of prevention and care.
Historically, HIV services have been divided into two distinct pathways: prevention for people with non-reactive HIV tests and treatment for those with reactive results. Often, additional services like primary care and housing support have been more readily accessible to people receiving treatment. This bifurcated system has been shaped by various factors, including the organization of funding streams, staff training, and the pervasive stigma surrounding HIV.
Today, a transformative concept is reshaping how we approach HIV prevention and care: the status-neutral approach. This innovative framework has the potential to revolutionize HIV services, improve patient outcomes, and foster more significant equity in healthcare delivery.
What Is a Status Neutral Approach?
At its core, the status-neutral approach places the person—not their HIV status—at the center of care. Regardless of test results, all people are offered effective prevention or treatment options and connected with comprehensive support services tailored to their unique needs. This approach addresses the social determinants of health, such as income stability, education access, and healthcare availability, recognizing that meeting these needs is essential for achieving optimal health outcomes.
In the status-neutral framework, every interaction and service is ultimately part of prevention, fostering a system that supports people living with HIV and those at risk for acquiring it.
Why Shift to a Status Neutral Approach?
Implementing a status-neutral model has profound implications for the healthcare landscape. Here’s how it can positively impact your patients and community:
- Reduce HIV Stigma: By focusing on the person rather than their HIV status, this model helps rehumanize people and combat stigma. When healthcare professionals treat every patient with respect, compassion, and cultural humility, the discrimination and prejudice often associated with HIV are diminished.
- Enhance Accessibility to Care: The status-neutral approach meets people where they are, tailoring services to their specific needs. For example, mental health support can range from monthly outpatient sessions to more intensive, home-based interventions, depending on the patient’s circumstances. By aligning services with individual needs, this approach ensures that care is accessible and effective.
- Promote Optimal Health Outcomes: When patients feel respected and welcomed, they are more likely to remain engaged with health and social service systems. Continuous engagement supports long-term health, helping people achieve and maintain their healthcare goals.
- Streamline Service Delivery: In a status-neutral system, services are integrated and interconnected. Patients are seamlessly connected to care through in-house programs or a warm handoff, reducing delays and inefficiencies in service delivery. This holistic approach ensures patients receive the support they need promptly.
- Advance Health Equity: Marginalized communities often face significant disparities in access to care and health outcomes. The status-neutral model emphasizes culturally and linguistically sensitive services, ensuring that those who experience the greatest inequities are better positioned to stay healthy and thrive. Over time, this approach can help eliminate disparities and foster greater equity.
Applying a Status-Neutral Approach in Clinical Practice
Transitioning to a status-neutral model requires a shift in mindset and practices, but the results are well worth the effort. Here’s how healthcare professionals and clinical staff can adopt this approach:
- Take a Person-Centered Perspective: Assess each patient’s needs holistically, considering their health, social, and emotional well-being. Navigate patients to the appropriate local resources and services based on these needs.
- Normalize HIV Testing & Conversations: Make HIV testing a routine part of care and openly discuss prevention and treatment options. Normalize these discussions to reduce stigma and encourage patients to seek the care they need without hesitation.
- Focus on Health & Well-Being: Expand the conversation beyond disease prevention and treatment. Encourage patients to explore various ways to care for their bodies, minds, and spirits, incorporating both medical interventions and broader wellness strategies.
- Identify Comprehensive Service Networks: Build partnerships with local organizations to ensure patients can access housing support, income stabilization, education, and job training.
- Ensure Services Are Universally Available: Commit to providing comprehensive services to all patients, regardless of their HIV status, ensuring no one is excluded from the care and support they need.
The Road Ahead: Why It Matters
The status-neutral approach has the potential to transform the way HIV services are delivered, making them more equitable, efficient, and patient-centered. By addressing stigma, enhancing accessibility, and fostering engagement, this model empowers people to achieve their health goals and supports the broader goal of ending the HIV epidemic.
As clinicians, adopting a status-neutral approach aligns with a commitment to delivering compassionate, inclusive, and high-quality care. It’s more than just a model—it’s a promise to prioritize the health and dignity of every individual we serve.
Additional Resources
- Learn more about ETR’s Health Equity Framework
- Request free downloads of HIV Patient Education Materials
- Sign up for free HIV e-learning courses from ETR and the CDC. How to access the courses:
About ETR
ETR | Education, Training, and Research is a non-profit organization that envisions a world where all people and communities achieve their best health. Through our work, we improve the health and well-being of youth and communities by championing science. To learn more, visit www.etr.org.
