A public health approach to "prevention with positives": the New York State HIV/AIDS Service Delivery System.

Prevention of new HIV infections through meeting the prevention needs of HIV-infected persons, known as "prevention with positives," is a national priority. State health departments administer complex HIV/AIDS prevention, health care, and supportive service programs and shape the context for prevention services in their states. This larger context provides opportunities for development and enhancement of HIV prevention interventions. This article presents results of an assessment conducted by the New York State Department of Health of the extent to which the New York State HIV service delivery system, conceptualized as a continuum of services, supports prevention with positives and identifies opportunities for new initiatives. The New York State service continuum offers a comprehensive yet flexible framework into which effective HIV prevention interventions and services are embedded. It is mobilized in support of meeting individuals' HIV prevention needs. The service continuum continues to evolve and requires constant attention on the part of New York State Department of Health to keep pace with the ever-changing HIV epidemic. Additional features of New York State's comprehensive approach to prevention with positives are also discussed. This simple assessment, which can be adapted for use elsewhere, was effective in pinpointing how the current service delivery system supports prevention with positives. Approaches used by state health departments to advance prevention with positives warrant support and recognition.