Effective Interventions

Effective Interventions

High Impact Prevention

Personalized Cognitive Counseling (PCC) is an individual-level, single session counseling intervention designed to reduce unprotected anal intercourse (UAI) among men who have sex with men (MSM) who are repeat testers for HIV. PCC focuses on the person's self-justifications (thoughts, attitudes and beliefs) he uses when deciding whether or not to engage in high risk sexual behavior. PCC is a 30 to 50 minutes intervention conducted as a component of Counseling, Testing, and Referral Service (CTRS) for MSM who meet the screening criteria. 

PCC logoPCC targets MSM who previously tested for HIV, are HIV-negative, and had UAI since their last test with a male who was not their primary partner, and that partner's serostatus was positive or unknown. 

Using PCC to reduce sexual and substance use risk behaviors among episodic substance-using MSM. (Click here for more info.)

Training Information for PCC Overview
(e-Learning) and 2-day Classroom Course 

PCC: An Overview for Managers 

This online course, PCC: An Overview for Managers, was specifically designed to give managers, including program administrators, supervisors and health department monitors, an overview of Personalized Cognitive Counseling (PCC). PCC is an individual-level, single session counseling intervention designed to reduce unprotected anal intercourse (UAI) among men who have sex with men (MSM) who are repeat testers for HIV. PCC targets MSM who previously tested for HIV, are HIV-negative, and had UAI since their last test with a male who was not their primary partner, and that partner’s serostatus was positive or unknown. This course will inform both managers of agencies already implementing PCC and those who are interested in, but not yet implementing, PCC. This online course is organized into 5 modules and takes about 90 minutes to complete. 

This course will:
  • Explain the history and development of PCC
  • Summarize the PCC five-step process
  • Explain key terms and concepts
  • Describe the PCC questionnaire used by counselors
  • Illustrate techniques used by counselors
  • Explore your program readiness
  • Assist you in developing an implementation plan, timeline, budget, and staffing plan
Complete PCC: An Overview for Managers - Online Module.
HIP eLearning Logo 
HIV counselors who are interested in implementing PCC with their clients should consider registering for the PCC 2-day classroom course on the HIP Training Calendar by entering PCC in the search field. See below for more info on the 2-day classroom course. 

Classroom Training for PCC 

The PCC Training of Counselors (TOC) is 2 days. The TOC is intended for frontline staff who will conduct PCC with clients, and have the following experience:

  • Trained as an HIV antibody test counselor
  • At least one year experience as an HIV test counselor
  • Training and experience in a helping field (psychology, social work, counseling)
  • Experience with and dedication to pursuing cultural competence with the populations of clients to be served
  • Comfort with and knowledgeable about men who have sex with men
  • Comfort with discussing sex frankly using everyday language
To apply for training, visit the HIP Training Calendar and select PCC.

Personalized Cognitive Counseling (PCC): An Adaptation for Working with Trans Women

PCC: An Adaptation for Working with Trans Women provides a sex-positive framework to reduce unprotected anal intercourse (UAI) among trans women. You may download the PCC: Adaptation for Working with Trans Women Guide. Additional resources on PCC adaptation can also be found under the PCC Resources & Tools section. The guide includes the following:

  • Requirements for implementation of PCC with trans women;
  • Eligibility criteria for participation in PCC;
  • PCC questionnaire adapted for transgender clients;
PCC Guide CoverThe PCC trans adaptation guide was based on expertise from the Center of Excellence for Transgender Health (www.transhealth.ucsf.edu) and the Center for AIDS Preventions Studies (www.caps.ucsf.edu), at the University of California, San Francisco. The adapted questionnaire was field tested by four CDC-funded CBOs with local trans women. This adaptation is specifically for use with trans women who have sex with men. Implementation with any other trans population will require additional adaptation and/or technical assistance.

The Center of Excellence for Transgender Health and the Center for AIDS Prevention Studies are funded by the Centers for Disease Control and Prevention (CDC) to provide capacity-building assistance for community-based organizations and transgender community mobilization.

Research and Development

Dilley, J.W., Woods, W.J., Sabatino, J., Lihatsh, T., Adler, B., Casey, S.,...McFarland, W. (2002). Changing Sexual Behavior Among Gay Male Repeat Testers for HIV: A Randomized, Controlled Trial of a Single-Session Intervention.Journal of Acquired Immune Deficiency Syndrome, 30(2): 177-186.

Dilley, J.W., Woods, W.J., Loeb, L., Nelson, K., Sheon, N., Mullen, J.,...McFarland, W. (2007). 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. Journal of Acquired Immune Deficiency Syndrome,44(5): 569-577.

Program Review Panel Information

The CDC requires all CDC-funded agencies using the PCC 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 judgment 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

PCC Core Elements

  • Provide one-on-one counseling focusing on a recent, memorable high risk sexual encounter.
  • Provide the service with counselors trained in HIV counseling and testing and in the PCC intervention.
  • Use the PCC questionnaire specifically tailored to identify key self-justifications used by clients in the target population. 
  • Using the questionnaire and discussion, identify specific self-justifications (thoughts, attitudes, and beliefs) used by clients in making the decision to engage in specific high-risk behavior.
  • Explore the circumstances and context for the risk episode in detail (before, during and after).
  • Clarify how the circumstances and self-justifications are linked to the decision to engage in high-risk behavior.
  • Guide the clients to re-examine the thinking that led to their decision to have high-risk sex and identify ways they might think differently, and therefore have protected sex in future potentially risky situations.  

Technical Assistance

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.