Remember ‘engagement’! It is through continuing to engage clients that they will continue to attend sessions and work on difficult issues. If you are non-judgmental, your clients will grow to trust the CRCS intervention because of their own skills development and empowerment.

To retain CRCS clients, who face numerous challenges to overcoming risk for HIV infection or transmission, you will need to help them develop strategies to manage their complex lives. For example, for HIV-positive clients who are not sure how to go about managing their relationships with HIV-negative partners, you might consider including partners in counseling sessions.

In addition to working with other service providers to support clients and keep them engaged, you may need to be creative in your attempt to help clients achieve risk reduction and related objectives. The following Lessons from the Field insert is a good case example of this kind of creativity.

Lessons from the field

A CRCS counselor indicates that a client has kept many of his CRCS appointments, in part due to the assistance she is providing the client to get a job. The counselor has helped the client develop his resume and, working through another agency, directed the client to employment placement programs in the city. She allows a little time during CRCS sessions for the client to talk about his experiences finding work, because not having work is related to the client’s risk for HIV transmission. The client is getting discouraged continually being rejected by potential employers, and this tends to increase his use of alcohol, sometimes drugs, and these are associated with his risky sexual behavior. For this client, sex and self-esteem are closely related. The counselor has begun to provide feedback to the client on how to better prepare for job interviews, encouraging him not to give up. During these discussions, the client and counselor also talk about the specific risk issues the client is facing, and safer ways to deal with increasing his self-esteem.

Go to section 2 part 4D