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. 2014;5(2):1-8.
doi: 10.7728/0502201404.

Adding to the HIV Prevention Portfolio - The Achievement of Structural Changes by 13 Connect to Protect ® Coalitions

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Adding to the HIV Prevention Portfolio - The Achievement of Structural Changes by 13 Connect to Protect ® Coalitions

Kate S Chutuape et al. Glob J Community Psychol Pract. .
Free PMC article

Abstract

Opportunities to control risk factors that contribute to HIV transmission and acquisition extend far beyond individuals and include addressing social and structural determinants of HIV risk, such as inadequate housing, poor access to healthcare and economic insecurity. The infrastructure within communities, including the policies and practices that guide institutions and organizations, should be considered crucial targets for change. This paper examines the extent to which 13 community coalitions across the U.S. and Puerto Rico were able to achieve "structural change" objectives (i.e., new or modified practices or policies) as an intermediate step toward the long-term goal of reducing HIV risk among adolescents and young adults (12-24 years old). The study resulted in the completion of 245 objectives with 70% categorized as structural in nature. Coalitions targeted social services, education and government as primary community sectors to adopt structural changes. A median of 12 key actors and six new key actors contributed to accomplishing structural changes. Structural change objectives required a median of seven months to complete. The structural changes achieved offer new ideas for community health educators and practitioners seeking to bolster their HIV prevention agenda.

Keywords: HIV prevention; adolescents; coalition; community mobilization; structural change.

Figures

Figure 1
Figure 1. Connect to Protect (C2P) Coalition Logic Model
The C2P coalition logic model depicts the steps contributing to the intermediate outcome of achieving structural changes via a community mobilization process. Over five years, the C2P coalitions completed 245 objectives, 70% of which targeted structural determinants of HIV risk within the community, such as access to health and social services.

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