Many NGOs/CBOs/PLWHA groups become involved in HIV/AIDS-related treatment work because they want to respond to the urgent needs of people living with HIV/AIDS. Groups working in HIV/AIDS-related treatment should consider certain issues. These include:

• Sustainability. For example, has the organization got the capacity and resources to continue responding to treatment needs for as long as help is required?

• Coverage. For example, how does the number of people living with HIV/AIDS that the organization can help compare with the total number who need treatment?

• Equity. For example, are people's health needs met in a fair and just way?

• Quality. For example, can the organization provide treatment services that are effective, both at the start of their work and over the longer term?

• Acceptability. For example, are the proposed or actual treatment services acceptable to people living with HIV/AIDS and what are the community's attitudes to the treatment?

To make good decisions about starting or increasing the scope of HIV/AIDS-related treatment work, an organization needs to begin by analysing the existing needs, resources and action in its community. This can be done through an assessment.

An assessment provides a way of understanding the context in which an organization is working and of making strategic decisions about what to do. It can involve many different people and organizations, including community members, local leaders and the organization itself. It enables people to share their 'real life' experiences, opinions and concerns, usually through a mixture of focus group discussions and participatory activities.

An assessment helps to ensure that action on HIV/AIDS-related treatment is based upon the real needs of the community, rather than on what people think those needs might be.

An assessment can help an organization to answer the following questions:

• What are the treatment priorities of people living with HIV/AIDS?
• What difficulties do people experience in using treatments?
• How could access to HIV/AIDS-related treatment be improved?
• How can our organization make the biggest difference possible?

The involvement of people living with HIV/AIDS is especially vital to any work aiming to meet their needs. If people living with HIV/AIDS are involved throughout - from the assessment, through the decision-making process to the implementation of the work - their ideas and experiences can contribute greatly. The involvement of people living with HIV/AIDS will also help to reduce HIV/AIDS-related stigma and discrimination.

Assessment is a participatory process involving three key steps:

This chapter includes sets of questions that can be used in the three parts of Step 1: to assess the needs and resources of people living with HIV/AIDS and of the community, the local environment and your organization. These questions can be used as the basis of focus group discussions and/or group activity sessions.

The chapter also provides help on how to prioritize needs and resources, and how to decide what your organization will and will not do.

To plan an assessment, an organization needs to decide the following:

• Who will be involved?

- How many and what type of participants do you want?
- Will you have separate groups of participants or mixed groups?

• How will the assessment be carried out?

- How much time is needed?
- When and where will you carry it out?
- Can you talk openly about HIV/AIDS, or should you talk generally about illness?
- How can you put people at ease about sensitive subjects?

• How will the assessment be documented?

- How will you record your results?
- How will you share your results with others?