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Description:Positive Choice is an individual-level, interactive computer-based intervention to improve screening and counseling about ongoing sex risk and substance use among HIV-positive patients. While waiting for the scheduled visit with a care provider, HIV patients first complete the Positive Choice risk assessment on a laptop computer. Based on the risk assessment, a video clip appears on the computer in which an actor -portrayed Video Doctor delivers interactive risk-reduction messages to the patient. The clip is matched and tailored to the patient’s gender, risk profile, and readiness to change. This risk -reduction “Video Doctor” counseling session is based on Motivational Interviewing principles, which emphasize a patient-centered approach, non-judgmental tone, empathy, and support. The Video Doctor counseling session lasts an average of 24 minutes. After this brief session, the computer prints out two documents: (1) an educational worksheet for participants with questions for self-reflection, harm reduction tips, and local resources; and (2) a cuing sheet for health care providers, which offers a summary of the patient’s risk profile and readiness to change, and suggested risk-reduction counseling statements to serve as a prompt for discussing risky behaviors with patients. A booster Video Doctor counseling session is provided 3 months later and includes feedback reflecting changes made since the initial visit, along with an updated output for the patient and provider to review and discuss during the clinic visit.
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