2.2 Differentiating PCM from Other HIV Risk-Reduction Activities

PCM is conceptualized as a highly individualized and intensive HIV risk-reduction strategy. PCM is intended for persons at greatest risk of transmitting or acquiring HIV whose needs are not being effectively served and whose behavior is not influenced by less intensive HIV prevention interventions, such as street outreach, group-level strategies, or HIV counseling and testing. PCM is considered an individual-level HIV prevention activity and does not typically include group or community-level strategies. Characteristics of PCM differentiate it from these other prevention activities. PCM characteristics include the following:

• The formal enrollment of "clients" into an on-going service guided by professional standards.
• The development of a formal relationship between a prevention case manager and a client, a relationship that is characterized by active, cooperative prevention planning, problem solving, counseling, and referral provision.
• In-depth, on-going, risk-reduction counseling that addresses specified behavioral objectives.
• The need for professional staff skills to conduct most functions of PCM, including assessment, prevention planning, and risk-reduction counseling.

These characteristics of PCM are in contrast to other prevention activities such as street and community outreach and risk-reduction groups in which staff or volunteers, often peers or paraprofessionals, may interact on a brief or limited basis with high-risk individuals. The relationship of PCM to other individual-level HIV prevention activities is illustrated in Figure 1.

Finally, PCM is likely to be more costly than most other HIV prevention activities that employ peers or paraprofessionals to reach larger numbers of people with less time-intensive, staff-intensive risk-reduction strategies (See Section 4.3 for more detail about staff qualifications). However, PCM is likely to be cost beneficial because it emphasizes serving persons with particular difficulty changing behavior and most likely to transmit or acquire HIV.

Figure 1. Relationship of PCM to other Individual-level HIV prevention activities.

Go to 2.3 Differentiating PCM from Other Forms of Case Management