Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Oct;17(5):422-430.
doi: 10.1007/s11904-020-00516-z.

Implementing a Status-Neutral Approach to HIV in the Asia-Pacific

Nittaya Phanuphak  1 , Reshmie Ramautarsing  2 , Tanat Chinbunchorn  2 , Rena Janamnuaysook  2 , Supabhorn Pengnonyang  2 , Krittaporn Termvanich  2 , Pongthorn Chanlearn  3 , Danai Linjongrat  4 , Surang Janyam  5 , Praphan Phanuphak  6
Affiliations
Review

Implementing a Status-Neutral Approach to HIV in the Asia-Pacific

Nittaya Phanuphak et al. Curr HIV/AIDS Rep. 2020 Oct.

Abstract

Purpose of review: Globally, "undetectable equals untransmittable (U=U)" and "pre-exposure prophylaxis (PrEP)" have become crucial elements in HIV treatment and prevention programs. We reviewed the implementation of U=U and PrEP among countries in the Asia-Pacific region.

Recent findings: U=U and PrEP uptakes were limited and slow in the Asia-Pacific. Inadequate knowledge among health care practitioners and pervasive stigma towards individuals living with HIV and their sexual lives are key barriers for the integration of U=U into clinical practice. Paternalistic and hierarchical health care systems are major obstacles in PrEP implementation and scale-up. Countries with the most advanced PrEP implementation all use community-based, nurse-led, and key population-led service delivery models. To advance U=U and PrEP in the Asia-Pacific, strategies targeting changes to practice norm through wide-scale stakeholders' training and education, making use of online health care professional influencers, and utilizing financial mechanism should be further explored through implementation research.

Keywords: Asia-Pacific; HIV; Key population-led health services; Lay providers; Status-neutral; Task shifting.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
“Status-neutral” approach to HIV as a way to shift the messaging and programming paradigms of HIV treatment and prevention
See this image and copyright information in PMC

References

    1. Myers JE, Braunstein SL, Xia Q, Scanlin K, Edelstein Z, Harriman G, et al. Redefining prevention and care: a status-neutral approach to HIV. Open Forum Infect Dis. 2018;5(6):ofy097. doi: 10.1093/ofid/ofy097. - DOI - PMC - PubMed
    1. Quinn TC, Wawer MJ, Sewankambo N, Serwadda D, Li C, Wabwire-Mangen F, Meehan MO, Lutalo T, Gray RH. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342(13):921–929. doi: 10.1056/NEJM200003303421303. - DOI - PubMed
    1. Vernazza P, Hirschel B, Bernasconi E, Flepp M. Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitment antirétroviral efficace ne transmettent pas le VIH par voie sexuelle. Bull Med Suisses. 2008;89:165–169. doi: 10.4414/bms.2008.13252. - DOI
    1. Boerner H. HIV undetectable does equal uninfecious: the Swiss Statement and the vindication of Pietro Vernazza. Available at: https://www.thebodypro.com/article/hiv-undetectable-does-equal-uninfecti.... Accessed on 25 February 2020.
    1. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, Hakim JG, Kumwenda J, Grinsztejn B, Pilotto JH, Godbole SV, Mehendale S, Chariyalertsak S, Santos BR, Mayer KH, Hoffman IF, Eshleman SH, Piwowar-Manning E, Wang L, Makhema J, Mills LA, de Bruyn G, Sanne I, Eron J, Gallant J, Havlir D, Swindells S, Ribaudo H, Elharrar V, Burns D, Taha TE, Nielsen-Saines K, Celentano D, Essex M, Fleming TR, HPTN 052 Study Team Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. doi: 10.1056/NEJMoa1105243. - DOI - PMC - PubMed

Substances