Separate or combined? Finding points of integration in HIV prevention and health services community planning

Issues: Over the past ten years, HIV community planning has significantly changed prevention and health services in communities across the United States. Recently, many jurisdictions have responded to changing policy, political, or economic pressures by combining their prevention and health services groups in an effort to maximize resources, increase local political influence, or streamline the cumbersome community planning process. Others have resisted the pressure to merge.

Description: This case study presents results of the evaluation of a large and influential jurisdiction which has consciously resisted merging prevention and care. Instead, the two planning groups have engaged a careful and deliberative process of seeking “points of integration” – those places in which prevention and care together create new insights, better leverage, and more effective strategies and interventions.

Lessons learned: Finding points of integration must begin with identifying core principles from prevention and services planning; cultures of even very similar planning bodies can be markedly different; gains and losses of merging prevention and care can have significant impact on the place, position, and effectiveness of local approaches to HIV/AIDS and indirect, even unanticipated influence on broader public health issues in the local jurisdiction and beyond.

Recommendations: A cautious, intentional, inclusive process is necessary to deciding whether or not to integrate community planning for HIV prevention and health services. Common principles and points of integration provide a critical foundation for effective action that retains the edge of each while enhancing the community's vision and capacity for addressing HIV/AIDS in the 21st century.