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Risk Screening and Reduction

People with HIV should receive risk screening and individualized counseling to reduce risks and maintain health.  Providers can help protect patients and their uninfected partners by matching patients with and referring them to appropriate risk reduction interventions and services.

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What is risk screening and reduction?

Risk screening involves collecting information about HIV patients’ STD history and symptoms, as well as their risk factors for transmission or acquisition of HIV and other sexually transmitted diseases (STDs), such as sexual and substance abuse behaviors.  Providers use risk screening to guide them in delivering or making referrals to risk reduction interventions and services, including treatments, designed to reduce the risks identified through screening.  (For information on CDC guidance and recommendations for risk screening and risk reduction, refer to: http://www.cdc.gov/hiv/pwp/riskreduction.html)

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Why do it?  What are the benefits?

  • Allows risk reduction activities to be tailored to an individual’s specific risk behavior(s), which has been proven through research to be effective among HIV-positive individuals
  • Helps patients and their partners to stay healthier
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What are some of the barriers to implementing risk screening and reduction?

  • Lack of training, time, or staff with appropriate skills and experience
  • Unfamiliarity with risk reduction resources
  • Patients’ need for interventions that lies beyond a provider’s capacity
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What are some strategies to improve risk screening and reduction?

Risk Screening

  • Establish trust and creating a supportive, nonjudgmental atmosphere for patients
  • Create infrastructure for routine screening, including specific sexually transmitted diseases (STDs) that can be asymptomatic
  • Assess specific sexual risk behaviors, STD symptoms, STD history, and substance abuse

Risk Reduction

  • Create infrastructure for risk reduction activities
  • Talk about risk reduction and explore possible risk-reduction methods
  • Emphasize the importance of protecting one’s own health as well as the health of one’s partner
  • Tailor risk reduction interventions and strategies to each individual
  • Refer patients to risk reduction interventions and services, as appropriate
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Who is involved to make it work?

Well-trained providers, including physicians, nurses, social workers, and case managers, are positioned to assess risks, provide treatments, recommend risk reduction methods, and provide some strategies and interventions.  More intensive risk-reduction interventions may need to be delivered by community-based organizations that specialize in such programs.  Collaborative relationships between these agencies are important.

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Gregg’s Story

I took my HIV test last year, and, boy, was I nervous!  If Bev, my counselor, hadn’t been so cool and caring, I might never have come back for my results.  I’d had a lot of unsafe sex, so I shouldn’t have been surprised when it came back positive, but I was.  I swore off sex for a few months, but then I met Ricky.  I knew from day one he was someone special, and I got a little crazy even thinking about telling him I was living... 

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