Five Year HIV Prevention Plan

A recent HIV incidence study in a major US city provided evidence that not only was the HIV prevalence the highest in the country, but an alarming number of new cases was also occurring. The need for effective HIV preventive interventions was critical.

Both federal and local funding cycles ended simultaneously and the entire HIV prevention portfolio needed to be awarded in a competitive Request for Proposals (RFP). The Health Department lacked a strategic, measurable agenda and was in search of innovative HIV prevention approaches.

Based on a review of best HIV prevention practices garnered nationally and internationally, a five year strategic agenda was created and an RFP was developed. Community involvement was sought at every stage of the agenda and RFP development. The RFP included both biological and behavioral interventions, as well as novel interventions targeting the context of people’s lives that place them at increased risk of either acquiring or transmitting HIV infection, (e.g., substance use problems, undetected sexually transmitted infections, and unaddressed mental health needs).

In addition to providing detailed information with regard to prevention approaches, an emphasis was placed on evaluation strategies with a limited number of outcome indicators. The change from collecting numerous process indicators, which had been the standard of monitoring and evaluation in previous funding cycles, to collecting a reduced number of outcome indicators had the effect of making the new agenda more relevant and intervention programming easier to evaluate at the population level.

The Health Department was able to institute HIV prevention priorities that established a clear and measurable agenda for a five year funding cycle. The involvement of community was essential to the development and introduction of a dramatically different HIV prevention approach that requires greater accountability. Ultimately, the practical and common sense interventions appealed to community members who were genuinely interested in decreasing HIV transmission.