Transitions: Community Participation
Volume 14, No. 3, April 2002
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Kayla Jackson, MPA, Director, HIV/STD Prevention Programs
Across the United States in 1994, the Centers for Disease Control and Prevention implemented HIV prevention community planning to deal with the changing HIV epidemic and the increasingly diverse communities affected by the epidemic. Community planning enables community members to come together to design local plans that best represent the needs of local populations at risk for or affected by HIV. HIV prevention community planning is mandatory in the 65 state, territorial, and local health departments that receive funds from the federal government for HIV interventions.
Community planning is based on a set of core principles—parity, inclusion, and representation. These principles ensure that all community planning group (CPG) members have an equal voice in voting and making decisions, that the views and needs of all affected groups are involved in the process, and that representatives truly reflect communities' values, norms, and behaviors. Members of CPGs are "persons who reflect the characteristics of the current and projected epidemic in that jurisdiction."1 HIV prevention community planning has the following core objectives:
- Fostering openness and participation in the community planning process
- Ensuring that the CPG reflects the diversity of the epidemic in the jurisdiction and that the process includes expertise in epidemiology, behavioral science, health planning, and evaluation
- Determining priority HIV prevention needs, based on each jurisdiction's unique, epidemiological profile and on an HIV prevention needs assessment
- Prioritizing interventions, based on explicit considerations of needs, outcome effectiveness, cost effectiveness, theory (from social and behavioral science), and community norms and values
- Fostering strong, logical links between the community planning process and its plans applications for funding and allocation of CDC HIV prevention resources.2
HIV prevention community planning has achieved some real successes since 1994, including:
- Developing planning groups at the local, regional, and state levels
- Opening up the planning process to more people
- Recruiting diverse members that reflect the epidemic
- Improving relationships between health departments and those at risk
- Changing the direction of prevention spending
- Affecting prevention activities (e.g., targeting programs geographically and in recognition of different behaviors and cultures within at-risk populations).2
Despite these successes, youth's representation on CPGs is low. Only about five percent of CPG members are under the age of 24,2 even though young people under the age of 25 comprise half of the new HIV infections in the United States.3 Youth, especially youth of color and gay, lesbian, bisexual and transgender youth, are disproportionately affected by HIV.
There are many potential barriers to including youth meaningfully in the community planning process. Many of the attitudes and assumptions of both youth and adults make it difficult for them to work together in partnership. Institutional barriers, such as time constraints, meeting times, financial resources, and transportation, make it difficult for young people to become involved in an adult-oriented process. Commitment to forming effective youth-adult partnerships and willingness to compromise in order to create a more youth-friendly environment are requirements for facilitating true youth involvement.
In order to achieve parity, inclusion, and representation, youth must be actively and meaningfully involved in the community planning process. Bringing youth—especially those at highest risk—to the table is also necessary as an invaluable component of the entire community planning process. Young people provide fresh perspectives and relevant information about the needs of youth. Youth provide energy and enthusiasm as well as appropriate and pertinent ideas for planning. The most logical way to strengthen and promote HIV prevention among youth in a community is by having young people from that community engaged in the planning of prevention activities.
- Centers for Disease Control & Prevention. Guidance: HIV Prevention Community Planning for HIV Prevention Cooperative Agreement Recipients. Atlanta, GA: The Centers, National Center for HIV, STD & TB Prevention, Division of HIV/AIDS Prevention, [n.d.].
- Centers for Disease Control & Prevention. HIV Prevention Community Planning: Successes and Challenges. Atlanta, GA: The Centers, National Center for HIV, STD, & TB Prevention, Division of HIV/AIDS Prevention, 1998.
- Office of National AIDS Policy. Youth and HIV/AIDS 2000: A New American Agenda. Washington, DC: White House, 2000.
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Transitions (ISSN 1097-1254) © 2002, is a quarterly publication of Advocates for Youth—Helping young people make safe and responsible decisions about sex. For permission to reprint, contact Transitions' editor at 202.419.3420.
Editor: Sue Alford