High Impact Prevention

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

CLEAR logoThe intervention provides clients with the skills necessary to be able to make healthy choices for their lives. The Centers for Disease Control and Prevention's (CDC's) guidelines on Comprehensive Risk Counseling and Services (CRCS), formerly known as Prevention Case Management (PCM), identify CLEAR as a structured intervention that may be integrated into CRCS programs.

Available Now! CLEAR e-Course for Program Manager

If you are a Program Manager who is:
  • Considering implementing CLEAR
  • Getting ready to implement CLEAR
Take a look at the new, interactive, user-friendly online course offered by EDC's e-Learning & CBA Center. 

 You'll learn:
  • What is CLEAR?
  • How Does CLEAR Work?
  • Is CLEAR Right for Your Agency
  • What's Involved in Implementing CLEAR?
To register and for more information, visit - http://course.cba.edc.org

Research and Development

Comulada, W. S., Swendeman, D.T., Rotheram-Borus, M. J., Mattes, K.M., & Weiss, R. E. (2003). Use of HAART among young people living with HIV. American Journal of Health Behavior, 27 (4), 389-400.

Rotheram-Borus, M.J., Swendeman, D., Comulada, S. Weiss, R., & Lightfoot, M. (2004). Prevention for substance using HIV + young people: telephone and in person delivery. JAIDS, 37(Supp2), S68-S77.

Lightfoot, M. Swendeman, D., Rotheram-Borus, M.J., Comulada, S., & Weiss, R. (2005). Risk behaviors of youth living with HIV: Pre- and post-HAART. American Journal of Health Behavior, 29(2), 162-171.

Swendeman, D., Rotheram-Borus, M.J., Comulada, S., Weiss, R., & Ramos, M.E.(2006). HIV-related stigma among young people living with HIV. Health Psychology, 25(4), 501-509.

Lightfoot, M., Rotheram-Borus, M.J., & Tevendale, H. (2007). An HIV -preventive intervention for youth living with HIV. Behavior Modification, 31(3), 345-363.

Program Review Panel Information

The CDC requires all CDC-funded agencies using the CLEAR intervention to identify, or establish, and utilize a Program Review Panel and complete Form 0.1113 to document this activity. The intervention researchers and developers are not involved in this activity. This is a CDC requirement for their grantees, and all questions in this regard should be directed to your agency's CDC Project Officer or to the health department funding your agency's implementation of the intervention.

The Program Review Panel guidelines, instructions for completion of Form 0.113, and the form itself are available under the Related Links section of the this website.

CDC Policy on Youth Peer Outreach Workers

CDC funded (directly or indirectly) agencies using youth (either paid or volunteer) in program outreach activities need to use caution and judgement in the venues/situations where youth workers are placed. Agencies should give careful consideration to the "age appropriateness" of the activity or venue. Additionally, agencies should comply with all relevant laws and regulations regarding entrance into adult establishments/environments. Laws and curfews should be clearly outlined in required safety protocols developed and implemented by agencies directly and indirectly funded by CDC.

If you have specific questions, please contact your CDC project officer.

More Info

CLEAR 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 one's 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.

The materials on this site are designed for HIV/AIDS prevention with persons at risk for acquiring or transmitting HIV. They are meant to be resources used by HIV prevention providers such as health departments and community-based organizations so as to provide the best evidence-based HIV prevention services. These materials are not meant for the general public. They are not meant for children. They are not school-based HIV prevention strategies.

Centers for Disease Control and Prevention
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