Parity, inclusion, and representation: Lessons from a decade of HIV prevention community planning for the movement to eliminate health disparities

Parity, inclusion, and representation are hallmarks of the process evaluation commitments that have been central to HIV prevention community planning since its inception in 1993. This groundbreaking CDC initiative built upon the lessons learned from past community-based planning experiences, particularly those of neighborhood health centers in the 1960s to address the HIV/AIDS crisis of the 1990s. HIV prevention community planning guidance required that planning groups be organized by and operated with central values of parity, inclusion, and representation (PIR). Parity refers to true equity in decision-making regardless of education, status, employment, language, or other hierarchical constructs. Inclusion requires that all process elements respect, reflect, and engage the diversity of participants and perspectives, at all times and without fail. Representation means that all relevant perspectives are present and that those representing a perspective are authentically connected to that community or experience. CDC's commitment to PIR in HIV prevention planning has stimulated and nurtured sensitive, nuanced, and powerful process observation strategies that are at play in communities across the country, contributing a wealth of community-based evaluation approaches to current efforts to eliminate health disparities and establish health equity. As the commitment to eliminating health disparities shifts from initiative to broad-based movement, the conceptual framework, tools, and courage of 15 years of HIV prevention community planning offer both hope and direction. Examples will be drawn from 10 years of process evaluation of San Francisco's HIV Prevention Planning Council.