The Health Resources and Services Administration (HRSA) allocated $940 million in 2002, through Title II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, to help states improve the quality and availability of health related services for people living with HIV/AIDS . These resources are allocated based upon recommendations made by community planning committees, which in turn base their recommendations on HIV/AIDS needs assessments. A methodologically sound, comprehensive needs assessment is a critical component of effective resource allocation decisions. Poor needs assessments might lead to poor resource allocation decisions, which might have life-threatening consequences for people living with HIV/AIDS. Little is known about the quality of Ryan White Title II (RWTII) needs assessments. This dissertation identifies seven elements of a high quality needs assessment, which might serve as an assessment tool for funding agencies and as a guidance tool for grantees. The author uses the seven elements in a review of RWTII needs assessments to provide evidence pertaining to the current level of quality of RWTII needs assessments. The seven elements are then applied in a case study of improved practice to demonstrate how to adequately apply the key elements of a high quality needs assessment