Our Standards

1.1 Board Composition

• At least 50% of board members are:
  • People living with HIV (PLHIV), and
  • People from communities most impacted in the service area (e.g., Black and Brown communities, LGBTQ+ people, trans and nonbinary people, people who use drugs, sex workers, migrants, rural residents, poor and working-class communities).
• Board composition reflects or exceeds the race, gender, and class demographics of the communities served.
• At least one PLHIV board member holds a leadership position on the board (Chair, Vice-Chair, or equivalent).

1.2 Executive and Senior Leadership

• At least one C-level or top officer (ED/CEO, COO, or equivalent) is a PLHIV.
• At least 50% of directors/department heads (prevention, care, housing, behavioral health, etc.) are:
  • PLHIV and/or
  • From the communities most impacted in the service area.
• Senior leaders are geographically grounded:
  • Live in, or in close proximity to, the service area, or
  • Have a written requirement to spend a minimum number of days per month on-site and in community settings (not just offices).

1.3 Conflict of Interest & Power Concentration

• Written, enforced conflict-of-interest policies for board and leadership, including:
  • Vendor relationships
  • Family ties
  • Personal financial gain from contracts and partnerships.
• No single individual or small clique controls:
  • Hiring
  • Major contracts
  • Strategic decisions
  without oversight from a representative board and PLHIV community structures.

2.1 PLHIV Involvement

• PLHIV are involved at all levels: governance, management, frontline staff, evaluation, and advisory roles.
• “Meaningful involvement” means:
  • PLHIV help make decisions, not just “give feedback.”
  • PLHIV have formal authority to approve, reject, or amend major programmatic changes.

2.2 Community Advisory Structures

• Standing Community & PLHIV Councils with:
  • A written charter and defined powers
  • Direct reporting lines to the board, not only to staff
  • Ability to issue formal recommendations that must be addressed in writing by leadership.
• Advisory members are paid for their labor; no unpaid “volunteer advisory” bodies doing what should be funded work.

3.1 Explicit Anti-Oppression Commitments

• Written policies and practices to actively confront:
  • Racism and white supremacy
  • Serophobia and HIV criminalization
  • Homophobia and transphobia
  • Ableism and classism
• These are integrated into:
  • Hiring and promotion
  • Program design
  • Partnerships
  • Public policy positions.

3.2 Decriminalization and Policy Stance

• Organization opposes HIV criminalization and supports:
  • HIV law modernization
  • Decriminalization of HIV exposure, sex work, and drug use within a harm reduction and human rights framework.
• Staff are trained on:
  • Clients’ legal rights
  • Risks of involving law enforcement
  • How not to collaborate with policing in ways that harm PLHIV and impacted communities.

4.1 Person-Centered and Healing-Centered Care

• Care and prevention services are:
  • Person-centered
  • Trauma-informed
  • Healing-centered
• Clients are treated as partners, not “cases to manage.”
• Evidence of:
  • Flexible scheduling and telehealth options
  • Respect for client autonomy and decision-making
  • No shaming, coercion, or punitive treatment tied to adherence or engagement.

4.2 Accessibility

• Services are physically and economically accessible:
  • Locations reachable by public or realistic transportation
  • Hours that work for people with jobs, caregiving, or unstable housing
  • Clear policies to serve uninsured and underinsured clients.
  • Interpretation and language access provided where needed.

4.3 Comprehensive Prevention

• Prevention programs include:
  • HIV and STI testing
  • PrEP and PEP access
  • Harm reduction (syringe services, safer use supplies where legal, overdose prevention)
  • Condom and safer sex distribution
• Programs are co-designed with PLHIV and high-risk communities, not just built to satisfy grant language.

5.1 Financial Transparency

• Annual public disclosure of:
  • Budget categories (programs, admin, fundraising)
  • Executive compensation ranges
  • Major vendors and related-party transactions.
• Easy-to-understand summaries available to clients and community, not just buried in 990s.

5.2 Program Transparency

• Public reporting at least annually on:
  • Retention in care
  • Viral suppression rates (in aggregate)
  • Demographic breakdowns of who is being served vs who is most impacted in the region
  • Changes made in response to community feedback.

5.3 Independent Oversight

• Mechanisms for independent review of:
  • Complaints
  • Major incidents
  • Allegations of discrimination, harassment, or retaliation.
• Oversight includes PLHIV and external community members, not just internal leadership.

6.1 Hiring and Promotion

• Written policies and active recruitment strategies to:
  • Hire PLHIV and impacted community members at all levels
  • Promote peer workers and frontline staff into supervisory and leadership roles with support and training.
• Job postings do not quietly exclude PLHIV or marginalized people via:
  • Inflated degree requirements
  • Unnecessary “professionalism” standards rooted in white, middle-class norms.

6.2 Training and Supervision

• Mandatory, recurring training on:
  • HIV science, U=U, PrEP/PEP
  • Stigma and serophobia
  • Anti-racism, anti-transphobia, anti-oppressive practice
  • Person-centered and healing-centered care.
• Supervisors are evaluated on:
  • Staff support and retention
  • Ability to foster safe, non-punitive environments for PLHIV and marginalized staff.

6.3 Workplace Safety for PLHIV Staff

• Clear policies protecting PLHIV staff from:
  • Discrimination and microaggressions
  • Forced disclosure
  • Retaliation for speaking up about inequity or harm.
• Access to reasonable accommodations without penalty.

7.1 Data Use

• Data is used to reduce disparities and improve care, not to punish clients or staff.
• Disaggregated data (race, gender identity, orientation, geography, income) is analyzed and shared with community advisory structures.

7.2 Evaluation

• Evaluation includes:
  • Quantitative outcomes (retention, suppression, prevention uptake)
  • Qualitative feedback from PLHIV and impacted communities.
• PLHIV participate in:
  • Evaluation design
  • Interpretation of findings
  • Setting priorities for change.

7.3 Continuous Improvement

• Organizations demonstrate specific changes made in response to:
  • Client complaints
  • Community advisory council recommendations
  • Staff input and exit interviews.

8.1 Ethical Use of Funds

• Funds are used primarily to:
  • Expand access
  • Improve quality of care and prevention
  • Reduce disparities and structural barriers.
• No excessive spending on:
  • Executive perks
  • Image-only marketing and branding detached from actual services
  • Vanity projects that do not benefit clients.

8.2 340B and Revenue Transparency

• If 340B or similar programs are used, the organization discloses:
  • How much revenue is generated
  • How it is reinvested into direct services, PLHIV support, and community benefit.
• Communities have a say in prioritizing how surplus revenue is used.

9.1 Grievance Processes

• Clear, accessible processes for clients and staff to:
  • File complaints
  • Receive timely responses
  • Appeal outcomes.
• Information on how to complain is publicly posted and included in intake.

9.2 Whistleblower Protections

• Written, enforced protection for staff, volunteers, and clients who:
  • Report discrimination, misuse of funds, abusive practices, or data manipulation
  • Speak with regulators, funders, or external watchdogs.
• Explicit ban on retaliation, including:
  • Firing, demotion, schedule cuts
  • Denial of service
  • Harassment or blacklisting.

9.3 Documentation

• All grievances and investigations are:
  • Documented
  • Tracked
  • Reviewed by leadership and relevant community bodies to identify patterns.

• PCM considers an HIV service organization non-compliant with community-rooted and PLHIV-centered standards if any of the following are true:
  • Board has less than 25% PLHIV or impacted community members.
  • No PLHIV in any C-level or director-level roles.
  • Leadership resides far from the service area and has no defined on-site engagement requirements.
  • No paid PLHIV advisory structure with real power.
  • Documented retaliation against PLHIV staff, clients, or whistleblowers.
  • No public, accessible financial summary or meaningful transparency about executive pay and major vendors.
• Organizations that meet some but not all standards are considered “in transition” and should have a written, time-bound plan, developed with PLHIV and impacted communities, to reach full compliance.

• Positive Change Movement will use these standards to:
  • Assess HIV service organizations for:
    • Advocacy and watchdog reporting
    • Public statements and scorecards
    • Partnership decisions.
  • Inform letters to:
    • Funders
    • Regulators
    • Legislators
    • Community partners.
  • Develop tools (e.g., EvalU, Fiscal Watchdog) that measure:
    • Governance and leadership
    • Equity and MIPA
    • Financial and programmatic accountability.
• Organizations are free to adopt these standards in whole or in part. If they choose not to, they should be prepared to explain to PLHIV and impacted communities why they believe we deserve less.