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High Impact Prevention

CLEAR

CLEAR

Implementation Forms 

CLEAR Part 1. Forms (PDF - 4.25 MB)

In this document you will find the following forms:

 

  • The Structure of CLEAR
  • Feeling Thermometer
  • CLEAR Ground Rules
  • Goal Card
  • Guidelines for Goal Setting
  • Goal Log - Core Skill Session One
  • Possible Ideal Self Characteristics
  • Relaxation: Visualization
  • F-T-D Grid
  • Life Goals: What is Important to Me?
  • My Ideal Self
  • Goal Log - Core Skill Session Two
  • Relaxation: Releasing Tension
  • SMART Problem-Solving Guidelines (2 pages)
  • Applying SMART Problem Solving
  • Goal Log - Core Skill Session Three
  • Assertive Communication
  • Relaxation Sequence: On The Beach (2 pages)
  • Scripted Role Play: The Next Appointment
  • Goal Log - Core Skill Session Four
  • Individual Prevention Plan
  • Prevention Goals
  • Prevention Steps Taken
  • Identifying My Triggers for Unsafe Sex
  • What's My Comfort Level?
  • Substance Use Weekly Schedule
  • How to Use a Female Condom
  • How to Use a Male Condom
  • Assertive Communication
  • Getting Ready To Influence My Steady Partner To Accept Condoms
  • Persuading My Sexual Partners
  • Making It Safer

CLEAR Part 2. Forms (PDF - 2.98 MB)

In this document you will find the following forms:

 

  • Pros and Cons of Disclosure 
  • Tips for Telling Your Partner You Are HIV Positive (2 pages)
  • What are the Pros and Cons of My Substance Use?
  • My External Triggers
  • How to Clean Your Needles and Syringes
  • Needles and Your Health
  • Tips to Prevention Overdose
  • Questions to Ask My Health Care Provider About My Drug Use
  • How's My Adherence?
  • Using CLEAR Thinking to Help with My Medication Adherence (2 pages)
  • What Are My Current Medications?
  • HIV Medications Information Sheet (2 pages)
  • Guidelines on Discussion Your Medications with Your Health Care Provider (2 pages)
  • Applying CLEAR Thinking in My Communication with My Health Care Provider (2 pages)
  • My Pride Worksheet
  • Stigma Cards (2 pages)

CLEAR Part 3. Forms (PDF - 3.64 MB)

In this document you will find the following forms:

 

  • Stigma Cards (1 page - continued from Part 2)
  • The Denver Principles (2 pages)
  • My Rights as a Person Living with HIV or AIDS: Frequently Asked Questions (FAQs) - 3 pages
  • CLEAR Thinking Scenarios (3 pages)
  • Scripted Role Play: Patient and Receptionist
  • Advantages and Disadvantages of Disclosure
  • Disclosure Comfort/Importance Grid
  • Disclosure Target: Advantages and Disadvantages
  • Guidelines for Disclosing That You are HIV Positive (2 pages)
  • Relaxation Sequence: On the Beach (2 pages)
  • My Contribution to Others
  • Using CLEAR Thinking to Help with Staying Healthy (2 pages)
  • Using CLEAR Thinking to Help Break Down Barriers to Medical Appointments (2 pages)
  • Guidelines for Being a Partner in Your Medical Care (2 pages)
  • Rights and Responsibilities of People Living with HIV
  • Characteristics of Communication
  • Role Play: Assertive Communication
  • How Do I Maintain My New Behavior?

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.

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