HIV Prevention Community Planning is one of nine required essential components of a comprehensive HIV prevention program. The CDC state/local health department grantee is responsible for carrying out the comprehensive HIV prevention program. As outlined in
Program Announcement #04012 (2004-2008), HIV Prevention Projects, Notice of Availability of Funds, the nine components are:
- HIV prevention community planning;
- HIV prevention activities;
- HIV prevention counseling, testing, and referral services (CTR);
- Partner counseling and referral services (PCRS) with strong linkages to prevention and care services;
- Prevention for HIV-infected persons;
- Health education and risk reduction (HE/RR) activities;
- Public information programs;
- Perinatal Transmission Prevention;
- Quality assurance;
- Evaluation of major program activities, interventions, and services, as well as collection of data on interventions and clients served;
- Capacity-building activities;
- STD prevention activities;
- Collaboration and coordination with other related programs;
- Laboratory support; and,
- HIV/AIDS epidemiologic and behavioral surveillance.
A. The Comprehensive HIV Prevention Plan and Key Products
The primary task of the CPG is to develop a comprehensive HIV prevention plan that includes prioritized target populations and a set of prevention activities/interventions for each target population. Target populations should be prioritized and prevention activities/interventions chosen based on their ability to prevent as many new infections as possible. Key information necessary to develop the comprehensive HIV prevention plan will be found in the epidemiologic profile and the community services assessment. After developing and/or reviewing these products, CPGs will then move to the task of setting priorities for target populations. Once target populations have been prioritized, the CPG must determine what intervention or mix of interventions will best meet the needs of the prioritized target population. The CPG's comprehensive HIV prevention plan should include details of these key products:
- Epidemiologic Profile: describes the impact of the HIV epidemic in the jurisdiction, provides the foundation for prioritizing target populations;
- Community Services Assessment: describes the prevention needs of populations at risk for HIV infection, the prevention activities/interventions implemented to address these needs, and service gaps;
- Prioritized Target Populations: focuses on a set of target populations (identified through the epidemiologic profile and community services assessment) that require prevention efforts due to high rates of HIV infection and high incidence of risky behaviors;
- Appropriate Science-based Prevention Activities/Interventions: a set of prevention activities/interventions (based on intervention effectiveness and cultural/ethnic appropriateness) necessary to reduce transmission in prioritized target populations; and
- Letter of Concurrence/Concurrence with Reservations/Non-concurrence: describes via a written response from the CPG whether the health department application does or does not, and to what degree, agree with the priorities set forth in the Comprehensive HIV Prevention Plan.
The Comprehensive HIV Prevention Plan — The CPG is required to develop at least one Comprehensive HIV Prevention Plan every five years. This jurisdiction-wide plan should address all HIV prevention activities and inform decisions about how all HIV prevention funds are to be used, including federal, state, local, and, when possible, private resources. If a jurisdiction implements more than one CPG, the comprehensive plan should summarize any multiple or regional plans into one document. The plan, whether designed to be a one- or multi-year document, must be updated annually. As the health department's federal funding for HIV prevention is on a five-year cycle, the CPG's final plan for the 2004-2008 project period should guide the development of the next five-year funding cycle (January 2009-December 2013).
The CPG should be aware of contracting and funding cycles, and funding sources. Health departments typically implement HIV prevention priorities through a variety of funding mechanisms. Because of multiple-year contracts, shifts in priorities may not affect a program for several years. To understand how resources are being allocated, the CPG should review the health department's most current HIV prevention budget and other sources of prevention funding, and ask the following questions:
- How does it reflect the current priorities?
- What proportion of health department resources have been allocated to these priorities?
- How does the health department distribute resources among prioritized target populations and appropriate science-based prevention activities for each target population?
- What other funding sources — including state, local, and private — were used to address the current priorities?
The Comprehensive HIV Prevention Plan should describe the jurisdiction's entire HIV prevention program. The objective of the plan is to guide how HIV prevention programs in the jurisdiction should respond to the HIV epidemic in implementing HIV prevention community planning, partner counseling and referral services (PCRS), health education/risk reduction (HE/RR), capacity building, evaluation, and other health department activities conducted under Program Announcement #04012 (2004-2008), HIV Prevention Projects, Notice of Availability of Funds. The plan must consider all HIV prevention activities regardless of funding. Thus, it is important for the CPG(s) to know and understand the extent and array of prevention funds that will be allocated as a result of both the health department's and other funders' implementation of the CPG's target population priorities and set of prevention activities/intervention, as described in the Comprehensive HIV Prevention Plan.
B. Planning Cycle
The community planning process should be flexible. There is no “one way” to accomplish community planning, however, a process that is based on shared decision making between the health department and the CPG is more likely to accomplish the goals and objectives of community planning. It is important for health departments and CPGs to jointly determine the approach for the community planning cycle (i.e., reasonable time frame and the step-wise process to accomplish the various products of the process that lead to a comprehensive HIV prevention plan and health department application submission requirements).
CPGs should be routinely informed by the health department of other relevant planning efforts. CPGs and health departments should consider merging the HIV prevention community planning process with other planning bodies or processes already in place. In addition to HIV prevention community planning, states and Eligible Metropolitan Areas (EMAs) carry out care planning under the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. However, if such mergers are undertaken, grantees must adhere to the goals, objectives, principles, and indicators of HIV prevention community planning as described in this Guidance.
The health department and CPG are jointly responsible for determining the planning process and cycle and documenting progress made in accomplishing the Goals and Objectives of HIV Prevention Community Planning. To develop a comprehensive HIV prevention plan, a CPG will need access to specific information and products — e.g., epidemiologic profile and community services assessment. Before choosing a timeline for developing a comprehensive plan, it may be important to determine the scope and amount of time that will be necessary to develop and/or review these products, and then to set priorities among target populations and prevention interventions/activities. In determining the planning cycle, health departments and CPGs may choose either one- or multi-year planning processes (from one to five years), and submit a Comprehensive HIV Prevention Plan depending on their planning timeframe. For example:
- One-Year Process — if the health department and the CPG decide to complete the planning process in one year, then all of the products of community planning and the comprehensive HIV prevention plan must be completed in time for the annual health department application process.
- Two-Year Process — if the health department and the CPG decide to complete the planning process in two years, then all of the products of community planning and the comprehensive HIV prevention plan must be completed within two years. In year one, the CPG is required to update the most recent comprehensive HIV prevention plan and carry-out a concurrence process. In the second year, the CPG is required to develop a new comprehensive HIV prevention plan and carry out a concurrence process.
- Multiple-Year Process (three to five years) — if the health department and the CPG decide to complete the planning process over multiple years, then all of the products of community planning and the comprehensive HIV prevention plan must be completed within either three, four, or five years. Each year, the CPG is required, depending on the time frame chosen, to either update the most recent comprehensive HIV prevention plan and carry-out a concurrence process or to develop a new comprehensive HIV prevention plan and carry out a concurrence process.
Note: Regardless of the planning timeframe, due to potential changes in funding, each year the CPG is required to either update the most recent comprehensive HIV prevention plan and carry-out a concurrence process or to develop a new comprehensive HIV prevention plan and carry out a concurrence process.