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Description:The Personalized Cognitive Risk-Reduction Counseling intervention (previously referred to as Self-Justifications Counseling) involves a single counseling session delivered to clients during the 1- to 2-week period between standard “pre-test” (risk-assessment) and “posttest” (results disclosure) HIV counseling. During the session, counselors ask the client to recall a recent encounter of unprotected anal sex with another man of unknown or serodiscordant HIV status. The client describes the encounter with as much detail as possible. The client is then encouraged to identify and express the thoughts, feelings, or attitudes that might have led to the high-risk behavior. Together, the client and the counselor examine the encounter to identify any thoughts that may have led the client to make a decision to engage in high transmission risk sex. Finally, the client and the counselor agree on strategies that can be used to deal with similar situations in the future. An optional sex diary can be used to supplement the single counseling session. The diary asks clients to keep track of and describe all sex encounters for 90–days. The sex encounters include type of sex act (e.g., anal sex or oral sex), whether a condom was used, relationship to sex partners, and HIV serostatus of sex partners.
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