Personalized Cognitive Counseling

Personalized Cognitive Counseling (PCC) is an intervention to reduce unprotected anal sex among men who have sex with men (MSM) who are repeat testers for HIV. It encourages clients to identify their thoughts and feelings during a recent episode of unprotected anal sex in order to reduce risk in future situations. In this course, unprotected anal sex means sex without a condom, without PrEP use, and without knowledge of the sexual partner’s HIV status or viral suppression.

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 unprotected anal sex reduce to the risk behavior in future situations.

Intervention Goal

To reduce unprotected anal sex among repeat HIV testing, HIV negative MSM.

Intervention Core Elements

  • Provide one-on-one counseling focusing on a recent, memorable episode of unprotected anal sex.
  • Provide the service within the context of HIV testing and counseling, prevention case management, primary medical care, or mental health services.
  • Direct the client to review the PCC Checklist of Thoughts.
  • Explore the circumstances and context of the episode of unprotected anal sex in detail before, during, and after the event.
  • Identify specific self-justifications used by the client in making the decision to engage in the specific event and then, in relation to each self-justification heard, clarify how they are linked to the decision to have unprotected sex.
  • Guide the clients to reexamine their thoughts and identify ways they might think differently in the future.

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;
  • does not have a chronic substance use;
  • have had unprotected anal sex since their last HIV test with a non-primary partner who was HIV-positive or whose status was unknown;
  • be able to recall the unprotected anal sex event; and
  • know about HIV risk behavior.

Personalized Cognitive Counseling Training

This training has one prerequisite and two components:

Fundamentals of Motivational Interviewing for HIV virtual instructor-led training is a prerequisite for this training.

  1. 3-day virtual instructor-led 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.
  2. A 1-day virtual instructor-led mini-training intended for frontline staff who will conduct PCC may be offered only if the 3-day training is not available. This mini-training is also available in Spanish.

To view and register for scheduled virtual instructor-led trainings:

  1. Access the National HIV Classroom Learning Center training calendar hosted on Cicatelli Associates, Inc.’s (CAI’s) website.
  2. Pre-register for your selected course via the link provided in the training calendar.

Complete your registration on CDC TRAIN as directed when you receive an email from the National HIV Classroom Learning Center. You must join the HIV CBA Learning Group and locate the HIV CBA Training Plan in order to complete your CDC TRAIN registration for a specific classroom session (step-by-step instructions are available).

To access eLearning modules, including training prerequisite courses:

  1. Log-in to CDC TRAIN and access the HIV CBA Training Plan (step-by-step instructions 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 or that a training session be scheduled:

  1. CDC’s directly funded health department and CBO partners may request technical assistance or a training session 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 training or technical assistance request.

If you have questions or need additional assistance, please contact

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.


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.