The Work Group identified a number of concerns and suggestions for updating the Plan. Some of the important themes that arose from these deliberations included:

• Develop an overarching racial/ethnic disparities goal to inform the implementation of objectives and strategies for all goals in the updated Plan.
• Distinguish between goals and objectives that relate to persons living with HIV and seronegative persons at risk of HIV infection.
• Emphasize the importance of creating greater specificity within the Plan for goals and objectives related to care, particularly for maintaining persons in care.
• Write stronger language that stresses making HIV testing routine and available in multiple settings including and beyond health care.
• Address structural and social norms that lead to HIV risk, and to target these areas for intervention.
• A resource analysis at the objective level needs to occur in order to allow goal targets and funding allocations to be adjusted and monitored
• Biomedical interventions must be explicitly included, as should appropriate focus on interventions with acute / more highly infectious individuals
• A mechanism for appropriately aligning the evaluation and capacity building activities and resources of prior Goal 4 across the new goals/objectives must be developed
• Appropriate federal partners should be identified for each objective
• Progress on goals needs to be monitored and reported annually
• There should be a strategy regarding expanded resources for care
• Improve all goals / objectives to achieve better targeting
  • Target testing efforts differentially regarding prevalence / incidence
  • Determine efficacy of improving interventions w/ most infectious people
  • Increase specificity of care linkage goal
• Success of the updated Plan will depend on taking different approaches, clearly defining a road map, and implementing a detailed mobilization strategy. § Improved models for assessing differentially efficacious/cost-effective interventions must be developed and used to describe an optimal mix of interventions
  • Expanded focus on system/structural interventions and the needed mobilization must be a part of this framework
• Improved models for assessing differentially efficacious/cost-effective interventions must be developed and used to describe an optimal mix of interventions
  • Expanded focus on system/structural interventions and the needed mobilization must be a part of this framework
• Scale up models including resources and needed federal and other partners must be established
• A review of the current models of replication package development, dissemination, fidelity, effectiveness and provider/agency burden must be undertaken
  • Uptake of cross-cutting components more important than package development / use