HIV and
Sexually Transmitted Diseases

• The Framework "wheel" is much improved from last year's fan. However, it depicts a lot of emphasis on reducing diseases and disorders and not a lot on health promotion and primary prevention.

• The related objectives page is helpful, but perhaps it should be located toward the front of the chapter so that readers see right away that there are other related focus areas they may also want to review if they don't find what they are looking for in one focus area.

• There is an objective in the education chapter that deals with cultural competence and strategies to deliver services in a sensitive manner, but this should be more prevalent throughout the document. Again, moving related objectives to the front of each chapter might be helpful.

• As a program planning tool, Healthy People is not being utilized to it's full potential. Perhaps it should be included in program grant announcements and applications.

• Smaller components (companion documents) on specific areas might be more useful to community and state partners.

• Technical Assistance is needed on how to best utilize this document as a "tool."

• Accountability related to HP objectives should be incorporated into HIV prevention community planning group processes.

• This document is too data driven.

Comments related to objectives:

• Objectives should be targeted at "eliminating" health disparities as opposed to only "reducing" health disparities.

• There needs to be more prevention objectives which focus on awareness and education to reduce risky behaviors.

• It is difficult on a state level to measure and track objectives where and objective reads, "no data available." This statement conveys a message that perhaps this is optional data or it is not a priority to collect this data because the federal government is not collecting this data.

• We need to at least attempt to eliminate disparities. Showing "no data available" or incomplete data shows where data is missing and this could be used to advocate for collecting new data.

• In the STD focus area, there is an objective related to HPV, but what about an objective related to cervical cancer? Specifically, cervical cancer should be monitored in STD clinics.

• Goals and objectives for adolescents need to targeted toward those aged 14 and under, as opposed to aged 15 - 19, to maximize early intervention.

• There are currently no objectives, in HIV, related to college aged adults. Will the College Risk Behavior Survey be administered again and could this be used as a data source?

• Where data is available, it should be broken out by Hispanic sub-population (Mexican, Puerto Rican, Guatemalan, etc.).

• Where there is a better than the best standard to strive for, that should be the target. The target should not just be based on the number of "white" cases. If the Asians have the lowest rate of heart disease, then that should be used to set the better than the best target.

• There should be some objectives in both HIV and STD on older Americans. If there is no way to measure this, than perhaps an objective on provider education would be able to get at whether or not the older population was receiving the kind of education and support needed.

• There should be a general objective on HIV counseling and testing that can be used on a national level. The current counseling and testing objectives are too focused on specific populations.

• There needs to be better HIV objectives related to treatment. Why are we only focusing on people already in care? What about those not accessing care?

• There needs to be more focus on communities of color and men who have sex with men, especially in the HIV chapter. This document should reflect the priorities put forth in the President's Initiative on Race.

• Gay men of color and heterosexual women should be specifically targeted, as this is where we are seeing the largest increases in HIV and AIDS cases.

Jack Spencer, CDC, National Center for HIV, STD, and TB Prevention (STD Coordinator)
Carmen Villar, CDC, National Center for HIV, STD, and TB Prevention (HIV Coordinator)
Eliana T. Loveluck, National Coalition of Hispanic Health and Human Services
John Moore, CDC, Division of Adolescent and School Health
Lorento Olivas, USPHS, Region VIII
Lisbeth Stark, Center for Clinical Quality Evaluation
Mychelle Farmer, John Hopkins, Society for Adolescent Medicine
Colleen Ryan, CDC, National Center for Health Statistics
Jeff Crowley, National Association of People with AIDS
Darlene R. Saunders, The College Fund/UNCF
Gloria Webster-French, Indiana State Department of Health, Office of Minority Health
Lori Valencia Greene, American Psychological Association
Millicent Gorham, National Black Nurses Association