What Are the Points of Methodological Collaboration? Using the Non-Profit Industrial Complex, Implementation Science and Policy Implementation Frameworks to Understand the HIV Service Nexus

Nearly 1.2 million people in the United States (US) have been diagnosed with HIV (Center for Disease Control and Prevention [CDC], 2021). This growing epidemic is particularly prevalent in the U.S. South where people living with HIV/AIDS (PLWHA) have a higher death rate than other U.S. regions (CDC, 2019). The US's current de-centralized health and mental health care infrastructure outsources many life-saving support services and programs for PLWHA. The result is that nonprofits are funding and implementing these programs and services through an unsustainable patchwork of government grants, private donors, and foundation funds. Ultimately, leaving individuals in the US South vulnerable to the region's history of racist policies and further privatization of healthcare.

Given this backdrop, there is a need to apply critical frameworks to understand the ways in which the public-private mix has shaped in(access) for PLWHA. Taking an anti-racist lens, along with paying attention to more macro- policy dynamics coupled with mezzo-level implementation factors could help reveal the ways in which inequities are re(produced). Furthermore, a better understanding could also lead to points of collaboration rooted in racial justice.

For example, the non-profit industrial complex (NPIC), popularized by Incite! in 2004, refers to the systemic relationships of power, money and influence between state, local and federal government, private foundations, and elite donors and non-profit organizations. To date, NPIC has been primarily discussed in literature anecdotally, discussing how adhering to funding requirements can compromise a nonprofit's mission, and advocacy work (Incite!, 2007; Spade, 2020). No work has been found that focuses on the NPIC's impact on health equity, specifically within the realm of disease-specific non-profits such as HIV.

Thus, this roundtable aims to: 1) Discuss the gaps in services shaped by power and policy implementation; 2) Introduce concepts related to the Nonprofit Industrial Complex (NPIC), Equity Centered Implementation Science Framework (Stanton, et al.,2022) and Policy Implementation and their relation to HIV health inequities; 3) Propose a methodological framework that overlays the three aforementioned frameworks to better understand the role power plays in decision-making and analysis tracing the impact of a program from direct service upwards. The roundtable will be co-facilitated by scholars who have experience in non-profit research, HIV, and organizational change. Co-facilitators will discuss foundational concepts, pose critical questions, and workshop a critical framework. Small breakout groups will be used to generate discussion. 98.247.178.113 on 4-16-2024-->