This report summarizes a review of scientific literature on case management, acquired immunodeficiency syndrome (AIDS) case management, and PCM. The review was undertaken to support the revision of PCM guidelines, and it highlights many important lessons learned from the case management literature that should be considered in planning, implementing, and evaluating PCM programs. This document may help CDC grantees implement the revised PCM guidelines.

PCM is a time-limited behavioral intervention designed to assist HIV-seropositive and HIV-seronegative persons. It is intended for persons having, or likely to have, difficulty initiating and sustaining practices that limit the transmission and the acquisition of HIV. PCM, a hybrid of HIV risk-reduction counseling and case management, provides intensive, individualized support and prevention counseling. PCM comprises several essential components, including the assessment of clients' HIV and STD risk behavior and medical and psychosocial needs, risk-reduction counseling, and service brokerage. PCM is based on the premise that some people may not be able to prioritize HIV prevention when they face problems perceived to be more important and immediate (Falck, Carlson, Price, & Turner, 1994). Furthermore, developing an ongoing relationship with each client provides an environment of trust and understanding within which prevention counseling can take place.

Because PCM is a relatively new type of HIV prevention activity, important questions emerged from the experiences of those implementing the first programs about the appropriate range of services for this intervention, the type and extent of counseling, staffing patterns and qualifications of staff, quality assurance measures, and evaluation methods. These questions persisted despite the existence of guide-lines (CDC, 1995). In 1996, CDC staff began a guideline revision process comprising the following activities:

• Review and synthesis of relevant scientific literatureStructured interviews with 25 CBOs that conduct PCM
• Survey of 32 health departments about PCM
• Site visits to 7 CBOs with PCM programs
• A meeting with consultants from nongovernment organizations, health departments, and academic institutions

This document complements the new programmatic guidelines for PCM that emerged from these activities (CDC, 1997) and is divided into two sections: Literature Review (Section 2.0) and Summary of PCM Practices in 1996 (Section 3.0). Section 2.1 provides a description of the theoretical underpinnings of case management. Then, AIDS case management, which is funded primarily by the Health Resources Services Administration (HRSA), is described briefly in Section 2.2. Finally, the available literature on PCM is examined in Section 2.3. In Section 3.0, a brief summary of the results of interviews and site visits with PCM projects directly funded by CDC is provided as well as a summary of survey results from various state, territorial, and city health departments. A more detailed review of the results of the surveys, interviews, and site visits is provided elsewhere (Purcell, DeGroff and Wolitski, submitted for publication). The literature review and practice data presented here and elsewhere greatly enhanced the guideline revision process. Hopefully, this document also will provide useful background information for agencies implementing PCM programs.

Go to section 2.0 Literature Review