Effective Interventions

Effective Interventions

High Impact Prevention

Project START is an individual-level, multi-session intervention for people being released from a correctional facility and returning to the community. It is based on the conceptual framework of Incremental Risk Reduction, and focuses on increasing clients' awareness of their HIV,STI, and Hepatitis risk bProject STARTehaviors after release and providing them with tools and resources to reduce their risk.

Staff Required to Attend a TOF:
Agency staff attending this skills-based training will learn how to conduct the intervention, practice intervention delivery skills, and identify agency-specific implementation strategies. Therefore, an agency may submit up to two individual applications for staff who may be directly involved in implementing Project START. 

Priority will be given to training applicants who have the agency capacity to implement Project START and two staff members who meet the requirements listed below. However, if space allows, an additional staff member from a qualified agency will be considered on a case-by-case basis. 
All program staff who will have primary responsibility for conducting the Project START individual sessions, i.e., counselors/case managers, must attend a Project START training of facilitators (TOF). In addition, program supervisors who oversee the intervention and supervise counselors/case manager are also encouraged to attend the training. 
Program managers, agency administrators, and others who are interested in learning more about the intervention are encouraged to read the Project START Starter Kit
Project START Staffing:
Staff should be familiar with HIV/STD/Hepatitis prevention activities and the specific needs of people being released from correctional settings (e.g., parole/probation, substance abuse prevention and treatment, homelessness and mental health issues). Staff must be comfortable working in a correctional facility setting and have personal characteristics that facilitate communication (e.g., nonjudgmental attitude, active listening skills, friendly, outgoing and trustworthy personality). Project START requires the following positions:

  • 1 full-time (or 2 half-time) experienced counselor(s) or case manager(s) to conduct all of the direct-service intervention activities. 
  • 1 part-time (40% time) program manager to provide program oversight, work as a liaison to the correctional facility, and oversee quality assurance and evaluation activities. 
  • 1 part-time (20% time) program assistant to provide administrative support for all staff and maintain an up-to-date facilitated referral database and community resource guides. 
A note about program staff who were formerly incarcerated: These staff members may have a difficult time obtaining a security clearance to enter the correctional facility. CBOs must first check the facility's policy on criminal backgrounds, incarceration, and clearance before posting positions.  

Research and Development

Wolitski, R.J. and the Project START Writing Group, for the Project START Study Group. Relative Efficacy of a Multisession Sexual Risk-Reduction Intervention for Young Men Released from Prisons in 4 States. American Journal of Public Health. 2006; 96(10): 1854-1861.

Program Review Panel Information

The CDC requires all CDC-funded agencies using the Project START 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 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 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

START Core Elements

  • Hold program sessions with clients transitioning back to the community from a correctional setting prior to release and continue sessions with the client after they are released into the community.
  • Use a client-focused, personalized, incremental risk reduction approach.
  • Use assessment and documentation tools to provide a structured program.
  • Staff program with people who are familiar with HIV, STI, and hepatitis prevention activities and who are familiar with the specific needs of people being released from correctional settings.
  • Staff-client relationships developed during pre release sessions must be maintained during post release sessions to promote client trust. Thus, the same staff member should conduct both pre-release and post-release sessions with his or her clients.
  • Conduct enrollment and schedule two pre-release sessions within 2 months before a client's release.
  • Schedule four post-release sessions. Hold the first session as soon as possible, ideally within 48 hours of release. The next three sessions should be spaced out over 3 months after release.
  • Provide condoms at each post-release session.
  • Actively maintain contact with clients, using individual-based outreach and program flexibility to determine the best time and place to meet with them.

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.