Note: The definitions used here are specific to how the terms are used
in CDC Program Announcement 04-012 and the HIV Prevention Community
Planning Guidance
Accountability:
An obligation or willingness to
accept responsibility.
Application:
A health department’s formal
request to CDC for HIV prevention funding. The
application contains a written narrative and budget
reflecting the priorities described in the
jurisdiction’s comprehensive HIV prevention plan.
Behavioral data:
Information collected from
studies that examine human behavior relevant to
disease risk. For instance, relevant behavioral data
for HIV risk may include sexual activity, substance
use, condom use, etc.
Behavioral intervention:
See “Intervention.”
Capacity building:
Activities that strengthen the
core competencies of an organization and
contribute to its ability to develop and implement an
effective HIV prevention intervention and sustain
the infrastructure and resource base necessary to
support and maintain the intervention.
CARE Act:
The Ryan White Comprehensive
AIDS Resources Emergency (CARE) Act, the
primary federal legislation created to address the
health and support service needs of persons in the
United States living with HIV/AIDS, and their
families. Enacted in 1990, the CARE Act was reauthorized
in 1996.
Centers for Disease Control and Prevention
(CDC):
The lead federal agency for protecting the
health and safety of people, providing credible
information to enhance health decisions, and
promoting health through strong partnerships.
Based in Atlanta, Georgia., this agency of the U.S.Department of
Health and Human Services serves as the national focus for developing
and applying
disease prevention and control, environmental
health, and health promotion and education
activities designed to improve the health of the
people of the United States.
Collaboration:
Working with another person,
organization, or group for mutual benefit by
exchanging information, sharing resources, or
enhancing the other’s capacity, often to achieve a
common goal or purpose.
Community-level intervention (CLI):
An
intervention that seeks to improve the risk
conditions and behaviors in a community through a
focus on the community as a whole, rather than by
intervening only with individuals or small groups.
This is often done by attempting to alter social
norms, policies, or characteristics of the
environment. Examples of CLI include community
mobilizations, social marketing campaigns,
community-wide events, policy interventions, and
structural interventions.
Community planning group (CPG):
The official
HIV prevention planning body that follows the HIV
Prevention Community Planning Guidance to
develop a comprehensive HIV prevention plan for
a project area.
Community services assessment:
A description
of the prevention needs of populations at risk for
HIV infection, the prevention
interventions/activities implemented to address
these needs (regardless of funding source), and
service gaps. The community services assessment
is comprised of: - Resource inventory — Current HIV
prevention and related resources and activities
in the project area, regardless of the funding
source. A comprehensive resource inventory
includes information regarding HIV prevention
activities within the project area and other
education and prevention activities that are
likely to contribute to HIV risk reduction.
- Needs assessment — A process for obtaining
and analyzing information to determine the
current status and service needs of a defined
population or geographic area.
- Gap analysis — a description of the unmet
HIV prevention needs within the high-risk
populations defined in the epidemiologic profile.
The unmet needs are identified by a comparison
of the needs assessment and resource
inventory.
Comprehensive HIV prevention plan:
A plan
that identifies prioritized target populations and
describes what interventions will best meet the
needs of each prioritized target population. The
primary task of the community planning process is
developing a comprehensive HIV prevention plan
through a participatory, science-based planning
process. The contents of the plan are described in
the HIV Prevention Community Planning
Guidance, and key information necessary to
develop the comprehensive HIV prevention plan is
found in the epidemiologic profile and the
community services assessment.
Concurrence:
The community planning group’s
(CPG’s) agreement that the health department’s
application for HIV prevention funds reflects the
CPG’s target populations and intervention priorities
(see “nonconcurrence”). As part of its application
to the CDC for federal HIV prevention funds,
every health department must include a letter of
concurrence, concurrence with reservations or
nonconcurrence from each CPG officially
convened and recognized in the jurisdiction.
Conflict of interest:
Conflict between the private
interests and public obligations of a person in an
official position.
Cooperative agreement:
A financial assistance
mechanism that may be used instead of a grant
when the awarding office anticipates substantial
federal programmatic involvement with the
recipient.
Coordination:
Aligning processes, services, or
systems, to achieve increased efficiencies, benefits
or improved outcomes. Examples of coordination
may include sharing information, such as progress
reports, with state and local health departments, or
structuring prevention delivery systems to reduce
duplication of effort.
Cost-effectiveness:
The relative costs and
effectiveness of proposed strategies and
interventions, either demonstrated or probable.
Culturally appropriate:
Conforming to a culture’s
acceptable expressions and standards of behavior
and thoughts. Interventions and educational
materials are more likely to be culturally
appropriate when representatives of the intended
target audience are involved in planning,
developing, and pilot testing them.
Demographics:
The statistical characteristics of
human populations such as age, race, ethnicity, sex,
and size.
Diversity:
Individual differences along the
dimensions of race, ethnicity, gender, sexual
orientation, socio-economic status, age, physical
abilities, religious beliefs, political beliefs, health or
disease status, or other ideologies. The concept of
diversity encompasses acceptance, respect, and
understanding that each individual is unique.
Epidemic:
The rapid spread, growth, or
occurrence of cases of an illness, specific
health-related behavior, or other health-related
events in a community or region in excess of
normal expectancy.
Epidemiologic profile:
A document that
describes the HIV/AIDS epidemic within various
populations and identifies characteristics of both
HIV-infected and HIV-negative persons in defined
geographic areas. It is composed of information
gathered to describe the effect of HIV/AIDS on
an area in terms of sociodemographic, geographic,
behavioral, and clinical characteristics. The
epidemiologic profile serves as the scientific basis
for the identification and prioritization of HIV
prevention and care needs in any given jurisdiction.
Epidemiology:
The study of the causes, spread,
control and prevention of disease in human beings.
Evidenced-based:
Behavioral, social, and
structural interventions that are relevant to HIV
risk reduction, have been tested using a
methodologically rigorous design, and have been
shown to be effective in a research setting. These
evidence- or science-based interventions have
been evaluated using behavioral or health
outcomes; have been compared to a
control/comparison group(s) (or pre-post data
without a comparison group if a policy study); had
no apparent bias when assigning persons to
intervention or control groups or were adjusted for
any apparent assignment bias; and, produced
significantly greater positive results when
compared to the control/comparison group(s), while
not producing negative results.
CDC expects its grantees to deliver interventions
based on a range of evidence. These interventions
may include: -
Evidenced-based interventions
(that meet the
criteria described above and can be found in
CDC’s Compendium of HIV Prevention
Interventions with Evidence of Effectiveness (1999). These interventions can either be
implemented exactly as intended and within a
context similar to the original intervention or
adapted and tailored to a different target
population if the core elements of the
intervention are maintained.
-
Interventions with insufficient evidence of
effectiveness based on prior outcome
monitoring data suggesting positive effects,
but that cannot be rigorously proven.
These
interventions must be based on sound science
and theory; a logic model that matches the
science and theory to the intended outcomes of
interest; and a logic model that matches
relevant behavioral-epi data from their
community and target population.
Group-level interventions (GLIs):
Health
education and risk-reduction counseling that shifts
the delivery of service from the individual to groups
of varying sizes. Group-level interventions use
peer and non-peer models involving a range of
skills, information, education, and support.
Health communications/public information
(HC/PI):
The delivery of planned HIV/AIDS
prevention messages through one or more channels
to target audiences. The messages are designed to
build general support for safe behavior, support
personal risk-reduction efforts, and inform people
at risk for infection about how to get specific
services. Channels of delivery include electronic
media, print media, hotlines, clearinghouses, and
presentations/lectures.
Health education/risk reduction (HE/RR):
Organized efforts to reach people at increased risk
of becoming HIV-infected or, if already infected,
of transmitting the virus to others. The goal is to
reduce the spread of infection. Activities range
from individual HIV prevention counseling to
broad, community-based interventions.
High-risk behavior:
A behavior in a high
prevalence setting that places an individual at risk
for HIV or STDs or in any setting in which either
partner is infected.
HIV prevention community planning:
The
cyclical, evidence-based planning process in which
authority for identifying priorities for funding HIV
prevention programs is vested in one or more
planning groups in a state or local health
department that receives HIV prevention funds
from CDC.
HIV prevention counseling:
An interactive
process between client and counselor aimed at
identifying concrete, acceptable, and appropriate
ways to reduce risky sex and needle-sharing
behaviors related to HIV acquisition (for
HIV-uninfected clients) or transmission (for
HIV-infected clients).
Incidence:
The number of new cases in a defined
population within a certain time period, often a
year, that can be used to measure disease
frequency. It is important to understand the
difference between HIV incidence, which refers to
new cases, and new HIV diagnosis, which does
not reflect when a person was infected.
Incidence rate:
The number of new cases in a
specific area during a specific time period among
those at risk of becoming cases in the same area
and time period. The incidence rate provides a
measure of the impact of illness relative to the size
of the population. Incidence rate is calculated by
dividing incidence in the specified period by the
population in which cases occurred. A multiplier is
used to convert the resulting fraction to a number
over a common denominator, often 100,000.
Inclusion:
Meaningful involvement of members in
the process with an active voice in decisionmaking.
An inclusive process assures that the
views, perspectives, and needs of all affected
communities are actively included.
Individual-level interventions (ILIs):
Health
education and risk-reduction counseling provided
for one individual at a time. ILIs help clients make
plans for behavior change and ongoing appraisals
of their own behavior and include skills-building
activities. These interventions also facilitate
linkages to services in both clinic and community
settings (for example, substance abuse treatment
settings) in support of behaviors and practices that
prevent transmission of HIV, and help clients make
plans to obtain these services.
Injection drug user (IDU):
Someone who uses a
needle to inject drugs into his or her body.
Intervention:
A specific activity (or set of related
activities) intended to change the knowledge,
attitudes, beliefs, behaviors, or practices of
individuals and populations to reduce their health
risk. An intervention has distinct process and
outcome objectives and a protocol outlining the
steps for implementation.
Intervention plan:
A plan setting forth the goals,
expectations, and implementation procedures for an
intervention. It should describe the evidence or
theory basis for the intervention, justification for
application to the target population and setting, and
the service delivery plan.
Jurisdiction:
An area or region that is the
responsibility of a particular governmental agency.
This term usually refers to an area where a state
or local health department monitors HIV
prevention activities (e.g., Jonestown is within the
jurisdiction of the Jones County Health
Department).
Logic model:
A systematic and visual way to
present and share understanding of the
relationships among the resources available to
operate a program, planned activities, and
anticipated changes or results. The most basic
logic model is a picture of how a program will
work. It uses words and/or pictures to describe
the sequence of activities thought to bring about
change and how these activities are linked to the
results the program is expected to achieve.
Management and staffing plan:
A plan
describing the roles, responsibilities, and
relationships of all staff in the program, regardless
of funding source. An organization chart provides
a visual description of these relationships.
Men who have sex with men (MSM):
Men
who report sexual contact with other men (that is,
homosexual contact) and men who report sexual
contact with both men and women (that is, bisexual
contact), whether or not they identify as “gay.”
Met need:
A need within a specific target
population for HIV prevention services that is
currently being addressed through existing HIV
prevention resources. These resources are
available to, appropriate for, and accessible to that
population (as determined through the community
services assessment of prevention needs). For
example, a project area with an organization for
African American gay, bisexual, lesbian, and
transgender individuals may meet the HIV/AIDS
education needs of African American men who
have sex with men through its outreach, public
information, and group counseling efforts. An
unmet need is a requirement for HIV prevention
services within a specific target population that is
not currently being addressed through existing HIV
prevention services and activities, either because
no services are available or because available
services are either inappropriate for or inaccessible
to the target population. For example, a project
area lacking Spanish-language HIV counseling and
testing services will not meet the needs of Latinos
with limited-English proficiency.
MSM/IDU:
Men who report both sexual contact
with other men and injection drug use as risk
factors for HIV infection.
Nonconcurrence:
A Community Planning
Group’s disagreement with the program priorities
identified in the health department’s application for
CDC funding. Nonconcurrence also may mean
that a CPG has determined that the health
department has not fully collaborated in developing
the comprehensive plan.
Outcome evaluation:
Evaluation employing
rigorous methods to determine whether the
prevention program has an effect on the
predetermined set of goals. The use of such
methods allows ruling out factors that might
otherwise appear responsible for the changes seen.
These measurements assess the effects of
interventions on client outcomes such as
knowledge, attitudes, beliefs, and behavior.
Outcome monitoring:
Efforts to track the
progress of clients or a program based upon
outcome measures set forth in program goals.
These measurements assess the effects of
interventions on client outcomes such as
knowledge, attitudes, beliefs, and behavior.
Monitoring allows the identification of changes that
occurred, but the intervention may not have been
responsible for the change. This would take a
more rigorous approach (see Outcome evaluation).
Outreach:
HIV/AIDS interventions generally
conducted by peer or paraprofessional educators
face-to-face with high-risk individuals in
neighborhoods or other areas where they typically
congregate. Outreach may include distribution of
condoms and educational materials as well as HIV
testing. A major purpose of outreach activities is
to encourage those at high risk to learn their HIV
status.
Parity:
The ability of community planning group
members to equally participate and carry-out
planning tasks or duties in the community planning
process. To achieve parity, representatives should
be provided with opportunities for orientation and
skills-building to participate in the planning process,
and have equal voice in voting and other
decision-making activities.
Partner counseling and referral services
(PCRS):
A systematic approach to notifying sex
and needle-sharing partners of HIV-infected
persons of their possible exposure to HIV so they
can avoid infection or, if already infected, prevent
transmission to others. PCRS helps partners gain
earlier access to individualized counseling, HIV
testing, medical evaluation, treatment, and other
prevention services.
PLWHA:
A person or persons living with HIV or
AIDS.
Prevalence:
The total number of cases of a
disease in a given population at a particular point in
time. For HIV/AIDS surveillance, prevalence
refers to living persons with HIV disease,
regardless of time of infection or diagnosis date.
Prevalence does not give an indication of how long
a person has had a disease and cannot be used to
calculate rates of disease. It can provide an
estimate of risk that an individual will have a
disease at a point in time.
Prevention activity:
Activity that focuses on
behavioral interventions, structural interventions,
capacity building, or information gathering.
Prevention case management (PCM):
Client-centered HIV prevention activity with the
fundamental goal of promoting the adoption of HIV
risk-reduction behaviors by clients with multiple,
complex problems and risk-reduction needs. PCM
is a hybrid of HIV risk-reduction counseling and
traditional case management, which provide
intensive, ongoing, and individualized prevention
counseling, support, and service brokerage.
Prevalence rate:
The number of people living
with a disease or condition in a defined population
on a specified date, divided by that population. It is
often expressed per 100,000 persons.
Prevention need:
A documented necessity for
HIV prevention services within a specific target
population. The documentation is based on
numbers, proportions, or other estimates of the
impact of HIV or AIDS among this population
from the epidemiologic profile. Prevention need
also is based on information from the epidemiologic
profile and community services assessment.
Prevention program:
An organized effort to
design and implement one or more interventions to
achieve a set of predetermined goals, for example,
to increase condom use with non-steady partners.
Prevention services:
Interventions, strategies,
programs, and structures designed to change
behavior that may lead to HIV infection or other
diseases. Examples of HIV prevention services
include street outreach, educational sessions,
condom distribution, and mentoring and counseling
programs.
Priority set of prevention
interventions/activities:
A set of
interventions/activities identified in the
Comprehensive HIV Prevention Plan, which, if
implemented, can have a major effect on the HIV
epidemic in a target population.
Priority population:
A population identified
through the epidemiologic profile and community
services assessment that requires prevention
efforts due to high rates of HIV infection and the
presence of risky behavior.
Program announcement:
A CDC announcement
in the Federal Register describing the amount of
funding available for a particular public health goal
and soliciting applications for funding. The
program announcement describes required
activities and asks the applicants to describe how
they will carry out the required activities.
Program indicator:
A quantitative measure of
program performance.
Public information program:
Activities funded
through the cooperative agreement to build general
support for safe behavior, dispel myths about
HIV/AIDS, address barriers to effective risk
reduction programs, and support efforts for
personal risk reduction. In addition to addressing
general audiences, public information programs
should inform persons at risk of infection about
how to obtain specific prevention and treatment
services such as counseling, testing, referral,
partner counseling and referral services, and STD
screening and treatment.
Project area:
Same as “Jurisdiction.”
Qualitative data:
Non-numeric data, including
information from sources such as narrative
behavior studies, focus group interviews,
open-ended interviews, direct observations,
ethnographic studies, and documents. Findings
from these sources are usually described in terms
of underlying meanings, common themes, and
patterns of relationships rather than numeric or
statistical analysis. Qualitative data often
complement and help explain quantitative data.
Quantitative data:
Numeric information -- such
as numbers, rates, and percentages -- representing
counts or measurements suitable for statistical
analysis.
Referral:
A process by which immediate client
needs for prevention, care, and supportive services
are assessed and prioritized and clients are
provided with assistance in identifying and
accessing services (such as, setting up
appointments and providing transportation).
Referral does not include ongoing support or case
management. There should be a strong working
relationship with other providers and agencies that
might be able to provide needed services.
Relevance:
The extent to which an intervention
plan addresses the needs of affected populations in
the jurisdiction and other community stakeholders.
As described in the Guidance, relevance is the
extent to which the populations targeted in the
intervention plan are consistent with the target
populations in the comprehensive HIV prevention
plan.
Representation:
The act of serving as an official
member reflecting the perspective of a specific
community. A representative should reflect that
community’s values, norms, and behaviors, and
have expertise in understanding and addressing the
specific HIV prevention needs of the population.
Representatives also must be able to participate in
the group and objectively weigh the overall priority
prevention needs of the jurisdiction.
Representative:
A sample having the same
distribution of characteristics as the population
from which it is drawn. Thus the sample can be
used to draw conclusions about the population.
Risk factor or risk behavior:
Behavior or other
factor that places a person at risk for disease. For
example, drug use is a factor that increases risk of
acquiring HIV infection; and factors such as
sharing injection drug use equipment, unprotected
anal or vaginal sexual contact, and commercial
unprotected sex increase the risk of acquiring and
transmitting HIV.
Seroprevalence:
The number of people in a
population who test HIV-positive based on
serology (blood serum) specimens. Seroprevalence is often presented as a percent of
the total specimens tested or as a rate per 1,000
persons tested.
Science-based:
See “Evidence-based.”
Sociodemographic factors:
Important
background information about the population of
interest, such as age, sex, race, educational status,
income, and geographic location. These factors
are often thought of as explanatory, because they
help make sense of the results of analyses.
Socioeconomic status (SES):
A description of a
person’s societal status using factors or
measurements such as income levels, relationship
to the national poverty line, educational
achievement, neighborhood of residence, or home
ownership.
Structural intervention:
An intervention
designed to implement or change laws, policies,
physical structures, social or organizational
structures, or standard operating procedures to
affect environmental or societal change. (An
example might be changing the operating hours of
a testing site or providing bus tokens for access.)
Surveillance:
The ongoing and systematic
collection, analysis, and interpretation of data about
occurrences of a disease or health condition.
Target populations:
Populations that are the
focus of HIV prevention efforts because they have
high rates of HIV infection and high levels of risky
behavior. Groups are often identified using a
combination of behavioral risk factors and
demographic characteristics.
Technical assistance (TA):
The
delivery of expert programmatic, scientific, and technical
support to organizations and communities in the
design, implementation, evaluation of HIV
prevention interventions and programs. CDC
funds a National Technical Assistance Providers’ Network to assist
HIV prevention community planning groups in all phases of the community
planning process.
Transmission categories:
Classification of
infected individuals based on how the individual
may have been exposed to HIV, such as injection
drug use.
Unmet need:
See “Met need.”
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