Choosing Life: Empowerment! Action! Results! (CLEAR) is an evidence-based, health promotion intervention for males and females ages 16 and older with HIV. CLEAR is a client-centered program delivered one-on-one using cognitive-behavioral techniques to change behavior.


CLEAR: Choosing Life: Empowerment! Action! Results! (CLEAR) enables prevention counselors to individually tailor the intervention to address the unique needs of each client and provides clients with the skills necessary to be able to make healthy choices for their lives. CLEAR consists of five core skill sessions, 21 menu sessions, and a wrap-up session. The core skill sessions teach the essential cognitive and behavioral skills of the program. Within these core skill sessions, clients develop a personal life goal and an individual prevention plan which directs the focus and selection of subsequent menu sessions. The final wrap-up session addresses the maintenance of behavior changes made in the program.

Intervention Goal

  • To help clients maintain health, reduce transmission of HIV and other STDs, and improve their quality of life.

Intervention Core Elements

  • Development of emotional awareness through use of a Feeling Thermometer and identification of the link between feelings, thoughts, and actions (F-T-D Framework).
  • Identification of Ideal Self to help motivate and personalize behavior change.
  • Teaching, modeling, and practicing Short- and Long-term Goal Setting.
  • Teaching, modeling, and practicing SMART Problem-solving.
  • Teaching, modeling, and practicing Assertive Behavior and Communication.

CLEAR Training

This training has one component:

  1. 1-hour eLearning module (Available in both English and Español)

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 CLEAR 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

Implementation and Marketing Materials

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

  • Comulada WS, Swendeman DT, Rotheram-Borus MJ, Mattes KM, Weiss RE. Use of HAART among young people living with HIV. Am J Health Behav 2003;27(4):389-400.
  • Rotheram-Borus MJ, Swendeman D, Comulada S, Weiss R, Lightfoot M. Prevention for substance using HIV-positive young people: Telephone and in-person delivery. J Acquir Immune Defic Syndr 2004;37(supp 2):S68-S77.
  • Lightfoot M, Swendeman D, Rotheram-Borus MJ, Comulada S, Weiss R. Prevention for HIV-Seropositive Persons: Successive Approximation Toward a New Identity. Behav Modif 2005;29(2):227-255.
  • Swendeman D, Rotheram-Borus MJ, Comulada S, Weiss R, Ramos ME. Risk behaviors of youth living with HIV: Pre- and post-HAART. Am J Health Behav 2006;29(2):162-171.
  • Swendeman D, Rotheram-Borus MJ, Comulada S, Weiss R, Ramos ME. HIV-related stigma among young people living with HIV. Health Psychol 2006;25(4):501-509.
  • Lightfoot M, Rotheram-Borus MJ, Tevendale H. An HIV-preventive intervention for youth living with HIV. Behav Modif 2007;31(3):345-363.