Personalized Cognitive Counseling

Personalized Cognitive Counseling (PCC) is an intervention to reduce condomless anal intercourse among men who have sex with men (MSM) who are repeat testers for HIV.

About Personalized Cognitive Counseling

Personalized Cognitive Counseling (PCC) is a 30- to 50-minute individual-level, single-session intervention. PCC encourages HIV test clients to identify thoughts and feelings from a recent episode of condomless anal intercourse reduce to the risk behavior in future situations.

Intervention Goal

To reduce condomless anal intercourse among repeat HIV testing, HIV negative MSM.

Intervention Core Elements

  • Provide one-on-one counseling focusing on a recent, memorable high-risk sexual encounter.
  • Provide alongside HIV testing.
  • Using the Checklist of Thoughts, identify specific self-justifications used to make the decision to have risky sex.
  • Reflect on how these self-justifications are linked to the decision to engage in high-risk behavior.
  • Guide the clients to re-examine the thinking that led to their decision to have condomless anal intercourse including their use of substances and to identify ways they might think differently in future situations.

Intervention Population

To be eligible for PCC, the client must:

  • be a man who has sex with men;
  • have previously tested HIV-negative and not on PrEP;
  • have had condomless anal intercourse since their last HIV test with a non-primary partner who was HIV-positive or whose status was unknown;
  • be able to recall the condomless anal intercourse event; and
  • know about HIV risk behavior.

Personalized Cognitive Counseling Training

This training has two components:

  1. 1.5-hour eLearning online course overview of PCC for managers, program administrators, supervisors, and health department monitors.
  2. 2.5-day eLearning training intended for frontline staff who will conduct PCC with the following experience:
    • Training as an HIV antibody test counselor.
    • At least one year of experience as an HIV test counselor.
    • Training and experience in a helping field (psychology, social work, counseling).
    • Cultural competence and knowledge about MSM.
    • Comfort with using everyday language to discuss sex.
    • Familiarity with issues pertaining to substance use.
    • Knowledge of community resources to make referrals.

To access eLearning modules, including training prerequisite courses:

  1. Log-in to CDC TRAINexternal icon and access the HIV CBA Training Plan (step-by-step instructionsexternal icon are available).
  2. Select the module you wish to take.
  3. Launch the module or save the module for later.

Technical assistance for the implementation of PCC is available.

To request technical assistance:

  1. CDC’s directly funded health department and CBO partners may request technical assistance by submitting a request in the CBA Tracking System.
  2. Organizations not directly funded by CDC may contact their local health department for assistance in submitting a request.

If you have questions or need additional assistance, please contact HIVCBA@cdc.gov.

Implementation and Marketing Materials

The materials and resources listed below support the implementation and/or marketing of Personalized Cognitive Counseling by health departments, community-based organizations, and health care or other organizations. The resources are evidence-based and designed for cost-effective, scalable implementation.

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PCC is an evidence-based public health intervention. It has recently been adapted to address rationalizations for episodic substance use based on the findings of Project Echo.

  • Coffin PO, Santos GM, Colfax G, Das M, Matheson T, DeMicco E, Herbst JH. Adapted personalized cognitive counseling for episodic substance-using men who have sex with men: A randomized controlled trial. AIDS Behav 2014 Jul;18(7): 1390-1400.
  • Dilley JW, Woods WJ, Sabatino J, Lihatsh T, Adler B, Casey S, McFarland W. Changing sexual behavior among gay male repeat testers for HIV: A randomized, controlled trial of a single-session intervention. J Acquir Immune Defic Syndr 2002;30(2):177-186.
  • Dilley JW, Woods WJ, Loeb L, Nelson K, Sheon N, Mullen J, McFarland W. Brief cognitive counseling with HIV testing to reduce sexual risk among men who have sex with men: Results from a randomized controlled trial using paraprofessional counselors. Acquir Immune Defic Syndr 2007;44(5):569-577.