title: Reframing "prevention with positives": incorporating counseling techniques that improve the health of HIV-positive patients.
abstract: Federal HIV prevention strategy seeks to increase efforts by health care providers to identify and reduce their HIV-positive patients' transmission-related behaviors. Implementation of these recommendations will be hindered if providers perceive these efforts have the potential to harm their relationships with patients. Because transmission-related behaviors (unsafe sex and sharing needles) and the related issues of drug and alcohol use also jeopardize the health of HIV-positive patients, providers can use patient-centered counseling when addressing those behaviors. We suggest efforts to increase provider-delivered transmission-prevention counseling be reframed so that "prevention with positives" includes the goal of protecting HIV-positive patients' health. We review the specific consequences of these risky behaviors on HIV-positive patients' health and review brief counseling strategies appropriate for HIV care providers.
authors.affiliation: Division of Behavioral Sciences, University of California San Francisco, 94117, USA. Barbara.gerbert@ucsf.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Gerbert
authors.forename: Dale W
authors.initials: DW
authors.lastname: Danley
authors.forename: Karen
authors.initials: K
authors.lastname: Herzig
authors.forename: Kathleen
authors.initials: K
authors.lastname: Clanon
authors.forename: Daniel
authors.initials: D
authors.lastname: Ciccarone
authors.forename: Paul
authors.initials: P
authors.lastname: Gilbert
authors.forename: Michael
authors.initials: M
authors.lastname: Allerton
mesh_terms: D003376:Counseling / Q000379:methods*; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity; D006282:Health Personnel; D006293:Health Promotion; D006801:Humans; D010353:Patient Education as Topic; D040242:Risk Reduction Behavior; D012309:Risk-Taking