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Patient Self-Administered Risk-Reduction and Screening Programs

Winter 2011

InterventionAimToolsBrief Description
Positive Choice Video Doctor1Eliminate or reduce sex risk behaviors or illicit drug use in HIV-positive peopleLaptop, printed educational worksheet, cuing sheet for providersPatients 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 interviewing2Enhance motivation of HIV-positive people to reduce number of HIV-negative and status-unknown sex partnersWaiting room computerTen-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 City3Lower incidence of HIV and other STIsWaiting room posters directing attention to a personally viewed videoTwenty-three-minute video viewed in STI clinics depicts couples overcoming barriers to safer sexual behaviors; animated segments show correct condom use.
STI self-screen4Detect asymptomatic gonorrhea and chlamydia in HIV clinic patientsMultiple self-swabs to detect rectal, urethral, and pharyngeal pathogens, followed NAATDuring 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. 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. for self-swabbing instructions for patients.

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