A research-based tool for identifying and strengthening culturally competent and evaluation-ready HIV/AIDS prevention programs.

Recent literature on racial disparities in HIV/AIDS and effective HIV/AIDS health service delivery efforts has underscored the importance of cultural sensitivity, relevance and competence in reducing such disparities and providing effective health service delivery. Less work has been done on the role of cultural competence in the delivery of effective HIV/AIDS prevention programs, perhaps because few such prevention programs aimed at minority populations have to date been demonstrated as effective. This article surveys the various ways that the concept of cultural competence has been studied, extends the concept to the field of HIV/AIDS prevention, and presents a simple-to-use instrument that operationalizes the concept for use with HIV/AIDS prevention programs. The article also explores the idea of evaluation readiness among HIV/AIDS prevention programs in the hope of eventually enlarging the pool of minority-focused HIV/AIDS programs demonstrated as effective. The resultant tool can serve as a research-based framework that: (a) serves as a cost-effective way to select promising programs--especially promising minority-focused programs-for rigorous outcome evaluation; (b) advances the field of HIV/AIDS prevention research by providing a conceptual framework for studying the relationship between cultural competence and program effectiveness; and (c) serves as a framework for building capacity in HIV/AIDS prevention programs, pointing to ways in which such programs can be strengthened.