This article assesses how programmatic capacity affects coalitions' ability to achieve structural HIV prevention interventions. The focus of the analysis was on the structural changes developed (n = 304) at all coalitions involved in Connect to Protect® between early 2006 through the end of 2008. Data included records of coalitions' structural change objectives and the progress made toward their accomplishment. For the current study, we divided objectives into two periods: those created before 2008 (n = 201) and those created from January 2008 through December 2008 (n = 103). In addition to becoming more structurally focused, C2P coalitions are becoming more efficient and most individual coalitions are becoming more successful. Findings highlight the benefit of creating high quality, strategic structural change objectives. Future research should investigate other influences that impede or facilitate the implementation of structural change HIV prevention interventions.