This document is to help the CARE Act1 community conduct needs assessments so that they can better plan on how to use CARE Act resources to fill gaps in care. It describes the process of needs assessment and provides "how-to" information about tasks ranging from developing an epidemiologic profile to estimating the need for services. The Guide provides: Legislative requirements and HIV/AIDS Bureau (HAB) expectations for each CARE Act title; Types of needs assessment information; Steps in conducting a comprehensive needs assessment; Practical guidance on how to: Prepare an epidemiologic profile; Collect and use surrogate markers for HIV/AIDS, such as co-morbidity data; Collect information from people living with HIV disease (PLWH) and other community representatives through focus groups, surveys, interviews, and community forums; Prepare a resource inventory; Conduct an assessment of provider capacity/capability, and Assess service needs. Ways to use needs assessment results in decision making; The experiences of CARE Act Titles I, II, III, and IV grantees nationwide, and; Information on special HAB needs assessment initiatives (i.e., preparing a joint epidemiologic profile with an HIV prevention community planning body, developing a framework for estimating unmet need). The Needs Assessment Guide was designed for use by all CARE Act titles and can provide a common approach to needs assessment that facilitates cross-title collaboration. Input on its content was provided by HAB staff and a Field Review Group. Title I and Title II needs assessments typically involve planning bodies-Title I HIV services planning councils and Title II regional consortia or Statewide planning entities. Therefore, the roles of planning bodies are described throughout. For Title III or Title IV, the planning body may be an agency's planning committee or executive committee. Many programs also establish advisory bodies that include community and PLWH participation-or there may be no planning body involvement.