LIFE-STEPS for PrEP
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LIFE-STEPS for PrEP

  • 07/06/2020

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    Life-Steps for PrEP is a nurse-delivered, individual-level, cognitive-behavioral intervention that focuses on PrEP adherence, sexual behavior, and barriers to adherence. Life-Steps for PrEP is adapted from Life-Steps, a brief intervention to increase ART adherence for persons with HIV. The intervention consists of four counseling sessions and two booster sessions, and participants are provided with a six-month supply of PrEP* over the course of the study. At the initial session, participants are given a 30-day supply of PrEP and are introduced to the program. The first session includes rapport building, discussing the psychosocial context in which PrEP use would occur, a brief motivational interviewing exercise, and exploring the establishment of a regular dosing schedule. The second session focuses on understanding participants’ experiences taking PrEP and engaging in a problem - solving activity to address any reported barriers to adherence. The third session introduces sexual risk behavior education, identifies high-risk activities, and factors that could increase and decrease personal risk for HIV as well as other sexually transmitted infections. The session also involves a discussion about biological factors associated with HIV transmission (e.g., partners’ level of infectiousness, measured by plasma HIV RNA) and discusses ways to reduce their risk in the context of taking PrEP. The final session involves setting PrEP adherence goals and discussing prior session content, as well as the participant’s plans for continued PrEP use upon intervention completion. The session context is designed to be flexible, allowing participants to identify their adherence support needs; optional modules provide a framework to help interventionists work with participants who are experiencing substance abuse or mental health concerns that are adversely impacting PrEP adherence. The two booster sessions include electronic real-time adherence monitoring.
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