Catalyzing system changes to make HIV care more accessible.

Although a comprehensive evaluation of the Care System Assessment Project is still several years off, the project quickly catalyzed changes in each of the communities in which it was piloted. All the sites found the system assessment model useful in identifying gaps in services. The project also clarified ways to engage underserved minorities in both care and planning for HIV care, and it helped to create community consensus in shaping initiatives to bring these populations into care. At all three sites, immigrant and refugee populations had to change beliefs that tended to delay their entry into care, and HIV-related stigma remained a significant barrier to entering care. However, all three communities also faced financial constraints that were likely to impede their ability to implement needed changes quickly. All of the sites identified needs for expanded public information campaigns and support services.