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Patient Self-Administered Risk-Reduction and Screening Programs

From The Center for AIDS

Winter 2011

Intervention Aim Tools Brief Description
Positive Choice Video Doctor1 Eliminate or reduce sex risk behaviors or illicit drug use in HIV-positive people Laptop, printed educational worksheet, cuing sheet for providers Patients in HIV clinics complete in-depth computerized risk assessment and receive tailored risk-reduction counseling from a "Video Doctor" via laptop and printed educational worksheet; providers receive cuing sheet on reported risks for discussion during patient visit.
Motivational interviewing2 Enhance motivation of HIV-positive people to reduce number of HIV-negative and status-unknown sex partners Waiting room computer Ten-minute self-administered interactive program that (1) assesses personal values, (2) encourages personal responsibility and responsibility toward others, (3) provides feedback on congruence between personal values and behavior, (4) encourages self-efficacy to implement new actions.
Safe in the City3 Lower incidence of HIV and other STIs Waiting room posters directing attention to a personally viewed video Twenty-three-minute video viewed in STI clinics depicts couples overcoming barriers to safer sexual behaviors; animated segments show correct condom use.
STI self-screen4 Detect asymptomatic gonorrhea and chlamydia in HIV clinic patients Multiple self-swabs to detect rectal, urethral, and pharyngeal pathogens, followed NAAT During routine blood-test visit, nurse-led screening relying on self-swabbing by patients with no STI symptoms, followed by staff-conducted NAAT for Neisseria gonorrhoeae and Chlamydia trachomatis.

NAAT, nucleic acid amplification test; STI, sexually transmitted infection.

  1. Gilbert P, Ciccarone D, Gansky SA, et al. Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings. PLoS One. 2008;3:e1988.
  2. Lightfoot M, Rotheram-Borus MJ, Comulada WS, Reddy VS, Duan N. Efficacy of brief interventions in clinical care settings for persons living with HIV. J Acquir Immune Defic Syndr. 2010;53:348-356. Search for Lightfoot and click on PDF.
  3. Warner L, Klausner JD, Rietmeijer CA, et al; Safe in the City Study Group. Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Med. 2008;5:e135. www.safeinthecity.org to preview and access the video.
  4. Soni S, White JA. Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic -- high yields and high acceptability. Sex Transm Dis. 2011;38:1107-1109. http://links.lww.com/OLQ/A26 for self-swabbing instructions for patients.



  
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This article was provided by The Center for AIDS. It is a part of the publication Research Initiative/Treatment Action!. Visit CFA's website to find out more about their activities and publications.
 
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