Policy Adoption and Networked Governance: How Power Arrangements Explain Local Approaches to HIV Testing in County Jails
Type of DegreePhD Dissertation
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Human Immunodeficiency Virus (HIV) continues to be a pernicious problem in the United States’ correctional facilities, despite national prevention efforts for decades. The Center for Disease Control (CDC) has been working to improve HIV screening methods on the local level. A minority of jails in the U.S. follow the CDC’s recommendations for HIV testing. The CDC has recommended opt-out HIV testing policies and to use the rapid method. Despite rapid HIV testing has become widely available and affordable to correctional facilities, most jails do not have opt-out testing policies nor do they use the rapid method for screening. This study explores why localities have not adopted an opt-out policy and rapid HIV testing methods in county jails using a power arrangements framework. The findings highlight some organizational arrangements in which power dynamics matter, and point to directions for future research to further explore how power in local networks can encourage or stymie the adoption of new policies. Further, this dissertation presents implications of small administrative arrangements within a larger policy network system, an idea which has not been fully discussed in the networked governance literature.