Hear from Your Peers: Status Neutral Approaches in Action

Navigate to the bottom of this page to download the companion guide which includes the slide deck, transcript and view the session's recording. 

On October 23, 2023, panelists from the Oregon Health Authority and the City of San Antonio, Metropolitan Health District described how they have implemented status neutral approaches in their respective jurisdictions. During the session, participants asked questions and shared reflections. Here are some high-level takeaways from the conversation:

• Prioritize relationship building among many groups, ranging from planning groups to providers. These connections facilitate collective buy-in to the status neutral approach and are essential for spreading awareness and building a comprehensive care network. Jurisdictions highlighted how a status neutral approach moves service provision away from a medical model and toward a community-focused model, emphasizing the collective perspective required for successful implementation. 
  • Evaluate planning group membership to ensure its makeup reflects priority populations, and supports and aligns with any local health equity strategy. The planning group is your sounding board and requires intentional recruitment. One jurisdiction encouraged planning group members to “bring a plus one” to planning meetings as a way to expand their reach.
  • Look beyond traditional partnerships or connection points. Status neutral is a whole person approach that goes beyond the HIV care continuum and emphasizes social determinants of health. Connecting individuals to resources that meet their most pressing needs is crucial and may serve as an entry point to HIV testing or other health care. One jurisdiction shared an example of a disability agency that also provides HIV prevention and care services.
  • Identify organizations that already serve and have established trust with your priority populations. Explore opportunities to collaborate with these agencies that are mutually beneficial. For example, these might include providing funding (if available) to youth serving organizations, establishing bidirectional referral channels with multi-service agencies, and/or delivering HIV-related trainings to build awareness of resources and services. 
• Identify staff training and professional development needs to strengthen internal capacity related to HIV prevention and care service delivery. Staff likely operate within one part of the system (prevention or care) and may require training to ensure they understand programmatic language, policies and procedures, and reporting requirements specific to different funders. Similarly, staff may struggle with identifying how they fit into a status neutral system; training and continuing education provide opportunities for staff to see how their role aligns with others toward ending the HIV epidemic. 
• Examine communications and messaging related to HIV prevention and care. Consider how adjustments may be made to language to decrease stigma. Some suggestions included talking about sexual health instead of diseases; avoiding language related to serosorting or that might divide people; and being careful not to imply that there is a right or wrong outcome of an HIV test.
• Jurisdictions implementing status neutral frameworks noted several successes. Examples included increased PrEP uptake and adherence; improved linkage to care rates; and increased positivity rates, indicating they were reaching populations who needed to be reached.