Economic Evaluation and HIV Prevention Community Planning

Abstract

In 1994, a new approach to implementing publicly funded HIV prevention programs was introduced. Roughly $190 million in federal funds in fiscal year 1994 allocated to the Centers for Disease Control were in turn reallocated to 65 different planning areas (the 50 states, eight territories, and seven of the U.S. cities hardest hit by AIDS).¹ Each of these jurisdictions undertook a community planning process to establish priorities for HIV prevention. The planning groups formed were intended to reflect the local communities affected by the HIV/AIDS epidemic, providers of HIV prevention programs and services, and local health officials (and in some cases local AIDS experts). Thus the role of the community planning group was envisioned as one of providing guidance to local health departments with respect to HIV prevention activities. The actual allocation of HIV prevention funds to specific programs and tasks remained within the jurisdiction of the local health department.^1–3 The overriding goal of this process is stated clearly: “The purpose of the HIV Prevention Cooperative Agreement Program is to assist State and local health departments in preventing the transmission of HIV...”⁴ The 1997 budget further underlines this focus: “At the historic White House Conference on HIV and AIDS, the President made his commitment to HIV prevention clear: “We have to reduce the number of new infections each and every year until there are no more infections.’”⁵