Open Access Indicators and Implementation Guidance to Advance Value-Based HIV Care Through People-Centered Metrics

In 2022, the U.S. President’s Emergency Plan for AIDS Relief shifted to a “person-centered” or “people-centered” orientation. Designed to align with the Joint United Nations Programme on HIV/AIDS (UNAIDS) Global AIDS Strategy’s operating principles, the language change from “client-centered” recognizes individuals’ holistic selves—not only as persons living with HIV in need of diagnosis and treatment but also as people with unique and dynamic needs, preferences, and rights who deserve an individualized service experience tailored to their life journey.

The call for a “people-centered” approach has also been expressed through advocacy in the HIV community for a fourth goal—beyond the original 95-95-95 UNAIDS fast-track targets—to achieve and sustain epidemic control. UNAIDS’ 2025 target of linking at least 90% of people living with HIV and people at risk to people-centered and context-specific integrated services demonstrates the success of this advocacy in elevating people-centered outcomes that have not been previously measured in a standardized way in HIV programs, specifically health-related quality of life. By drawing inspiration from the value-based care movement, metrics to advance progress toward this 90% goal can be an outcome and an enabler of the UNAIDS’ revised 2025 top-line targets. By defining the “numerator” of value, HIV programs can apply the metrics to measure and incentivize the outcomes that advance an individual’s quality of life and care experience.