Motivate your colleagues to embrace BEST PRACTICES for service delivery

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Evidence you can use to educate and persuade

Click on the topics below to read a summary of the research and strategies to incorporate these findings to your practice.

  • WE KNOW THAT…

    • The risk-based screening tools and algorithms that are often used to determine PrEP eligibility don’t work and stigmatize patients.

    • Anticipating stigma — and being labeled “high-risk” — can deter patients from seeking sexual health care, HIV testing, and PrEP.

    • Emphasizing benefits and self-efficacy — rather than risk and threat — is more successful in motivating patients toward prevention and care behavior.

    HIV prevention should be presented as empowering actions that patients can CHOOSE to keep themselves healthy and provide peace of mind.

    The BLUPrInt PrEP Options Counseling Checklist provides sample language promoting this “strengths-based” (rather than risk-based) approach, as does the GOALS framework for sexual history. You can also check out this Gain-Framed MessagingCounseling Guide.

  • WE KNOW THAT…

    • Universal HIV/STI screening is more beneficial and cost-effective than risk-based screening

    • Opt-out HIV testing (provided to every patient unless they refuse) increases testing rates, identifies new cases, and facilitates conversations about HIV prevention and PrEP.

    • Talking about sexual health as part of overall health (and primary care!) increases patients’ willingness and interest in HIV testing.

    • Framing HIV testing as something that is provided to every patient (not just “high-risk” patients) increases acceptability.

    Instituting universal or opt-out HIV testing can significantly increase rates and access — it can also increase the number of HIV prevention conversations you have with patients!

    You can learn more about these strategies on our Real World Strategies page, or in PrEP Awareness and Education Guide.

  • WE KNOW THAT…

    • Universal (rather than targeted) screening is more cost effective in a setting with higher prevalence.

    • STI rates are on the rise in almost every population in the United States.

    • Universally offered screening is associated with detecting and successfully treating a higher proportion of STIs among adolescents and young adults.

    • Patient preference data indicate that benefits of screening outweigh the possible harms.

    Increasing the number of patients tested for STIs and increasing accessibility to low-threshold STI testing and sexual health care is critical to any successful HIV prevention program.

  • WE KNOW THAT:

    • Decreasing patient discomfort — both physical and emotional —can improve adherence and retention in care.

    • Taking time to explain why patients should follow care plans significantly increases the likelihood that they will do so.

    • Patients need information, tools, and strategies for integrating HIV prevention into their everyday lives.

    • Self-efficacy is a critical predictor of PrEP adherence and persistence.

    • Logistical and structural barriers can hinder adherence and persistence on PrEP.

    Increasing patient adherence means:

    1. Explaining to patients how PrEP works and why adherence to pills and visits really matters;

    2. Giving patients proactive strategies and support to manage side effects;

    3. Considering context — including the physical environment and logistical context of PrEP visits;

    4. Embracing positive messaging that builds patients’ confidence in their own ability to manage PrEP.

    See BLUPrInt’s Motivating, Retaining, and Engaging Patients’ Checklist and check out Real World Strategies from other clinics for more inspiration.

  • WE KNOW THAT:

    • Patients process new information in the context of their pre-existing knowledge and attitudes.

    • Patients want providers to acknowledge the wealth of knowledge and lived experience that they bring to conversations about their health.

    • Using inclusive language with patients can be motivating and empowering.

    • Patients trust providers who they feel “get it” (meaning they have valuable information about the healthcare topic) and “get me” (meaning they understand the patients’ perspective and constraints).

    Shared decision-making is a collaborative communication strategy that is particularly well suited to HIV prevention conversations. Shared decision-making helps patients choose an HIV prevention method based on their preferences, needs, and values.

    See BLUPrInt’s PrEP Options Counseling Checklist for more information, or check out this Guide to Choice Counseling for PrEP.

  • WHAT WE KNOW:

    • The availability of more methods for contraception increased overall uptake, as well as patient satisfaction with their chosen contraceptive option.

    • Expanding the number of options available does not necessarily ensure choice for users: patients need options and access.

    • Increasing feelings of autonomy and the ability to choose decreases reactance and makes patients more open to considering prevention options.

    Increasing the availability of different PrEP options at your clinics (2-1-1 PrEP, injectable PrEP) can increase acceptability and interest.

    Learn more about creating an injectable PrEP program on our Program Builder page, and check-out our injectable-PrEP resources here.