, Volume 13, Issue 3, pp 420-423,
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Evidence Based Family Wellness Interventions, Still Not HIV Prevention: Reply to Collins

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Dr. Collins’s outline of the challenges for advocates of a Family Wellness perspective highlight the many similarities in our suggestions, as well as some intractable challenges that have faced public health providers and policy makers for the last century. We were unclear on several points and would like to clarify our intentions below in repsonse to the problems Dr. Collins has outlined.

Horizontally integrate prevention services into one site locally, with priorities tailored to local health challenges and managed by local community leaders

Collins points out the lack of capacity at local levels in almost all of the developing world and the United States to implement prevention services. We were unclear in our presentation. While we argue that services need to be delivered locally in one site, we endorse the need for service packages, training systems, and infrastructure to be designed centrally, where the capacity is the greatest. Diagonal integration (Frenk 2006; Ooms et al. 2008; U