U.S. Human Immunodeficiency Virus (HIV)/Sexually Transmitted Disease (STD) Advocates, Researchers, and Program Directors' Prioritization of Impact and Political Feasibility to Inform Policy Agendas

Background: Policy advocacy efforts to advance STD and HIV prevention may be improved through better assessing constituencies’ interests, if based on data regarding impact on transmission, as well as on perceived likelihood of getting funded or enacted.

Objectives: To assist in prioritizing national policy agendas.

Methods: Through snowball sampling, we recruited 73 advocates, 109 STD/HIV directors, and 150 researchers who were named by others as leaders in the field.  We asked participants to complete the following statement:  "A policy at the national level (e.g., legislation or an initiative) that would have an impact on reducing HIV or STD transmission in the next two to five years is...”.  Directors and researchers then rated the 102 responses according to impact on transmission, and advocates on political feasibility.

Results: Examples of results: Directors and researchers rated as high impact for both HIV & STD, and high feasibility: mandating insurers cover all STD/HIV screening/testing per CDC recommendations; free and easy access to condoms; supporting sexual health clinics. High impact on STDs and high feasibility: allowing point of care testing for STDs and HIV by DIS and staff at CBOs; High impact and low feasibility for STDs; ensure funding for 1 DIS for every 500 reported cases of gonorrhea. Low impact on HIV & high feasibility: ending bans on GLBT in the military; providing resources for linking people to a medical home.

Conclusions: There were high levels of agreement among directors, researchers and advocates for a number of strategies. Implications for Programs, Policy, and Research: Assessing perceived impact and political feasibility of strategies will help prioritize policies and help build stronger ties among researchers, advocates, and program directors by clarifying areas where existing research may not be sufficiently well-disseminated, or where more research may be needed to help inform decisions where conflicting perceptions exist.