Health Education/Risk Reduction (HE/RR)

Service Standard

HE/RR Service Standard print version

Subcategories Service Units
HE/RR - Prevention Case Management for HIV positives – Individual Intervention Per 15 minutes
HE/RR – Group-level Intervention Per 15 minutes

 

Health Resources and Services Administration (HRSA) Description:

Health Education/Risk Reduction (HE/RR) is the provision of education to clients living with HIV about HIV transmission and how to reduce the risk of HIV transmission. It includes sharing information about medical and psychosocial support services and counseling with clients to improve their health status. Topics covered may include:

  • Education on risk reduction strategies to reduce transmission such as pre-exposure prophylaxis (PrEP) for clients’ partners and treatment as prevention
  • Education on health care coverage options (e.g., qualified health plans through the Marketplace, Medicaid coverage, Medicare)
  • Health literacy
  • Treatment adherence education
     

Limitations:

Health education/risk reduction services cannot be delivered anonymously.
 

Services:

Activities of HE/RR include, but are not limited to:

  • Assessments of health literacy, HIV-related knowledge, educational needs, and unmet service needs.
  • Education on health promotion, risk reduction, and available services that may improve the client’s health status.
  • Administering pre- and post-tests to gauge effectiveness of interventions
     

Universal Standards:

Services providers for Health Education/Risk Reduction must follow HRSA/DSHS Universal Standards 1-46 and 151-152.
 

Service Standards and Measures:

The following standards and measures are guides to improving healthcare outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.

Standard Measure

Educational Assessment and Service Plan: Staff will complete a health/HIV education evaluation and a service plan that specifies how the client’s educational needs will be met. The plan must address:

  • Methods of HIV transmission
  • How to reduce the risk of HIV transmission
  • Medication adherence
  • Resources for recently incarcerated clients, as applicable
  • Health care coverage options, as applicable
  • Other available resources to meet client needs
  • Health literacy
  1. Percentage of clients with a completed health/HIV education evaluation and plan.
     
  2. Percentage of clients with a completed education plan addressing routes of HIV transmission, healthy behavior promotion, and resources available to meet the client’s needs.

Health Education/Risk Reduction: HE/RR staff will provide a health education/risk reduction curriculum that addresses the following:

  • Routes of HIV transmission and how to reduce the risk of transmission
  • Strategies to improve health status, including medication adherence
  • Information on maintaining a plasma HIV RNA (viral load) of <200 copies/mL with antiretroviral therapy to prevent sexual transmission of HIV (known as Undetectable = Untransmittable or U=U)
  1. Percentage of clients with documentation of counseling regarding routes of HIV transmission and how to reduce the risk of transmission.
     
  2. Percentage of clients with documentation of counseling regarding how to improve health status and the principles of Undetectable = Untransmittable (U=U).

Resources: HE/RR staff will provide information about available medical and psychosocial support services to reduce barriers to care. Education regarding medical coverage options should be provided as applicable.

  1. Percentage of clients with documentation of education provided on available medical and support services in the community.

Evaluation of Health Education/Risk Reduction Counseling: HE/RR staff will administer pre- and post-tests to each client to assess changes in knowledge and attitudes after receiving HE/RR counseling.

  1. Percentage of clients who received a pre-test to assess the client’s understanding of HIV before receiving HE/RR counseling.
     
  2. Percentage of clients who received a post-test to assess the client’s understanding of HIV after receiving HE/RR counseling.

 

References

Division of Metropolitan HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part A Recipients. Health Resources and Services Administration, June 2022.

Division of State HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part B Recipients. Health Resources and Services Administration, June 2022.

Ryan White HIV/AIDS Program. Policy Notice 16-02: Eligible Individuals & Allowable Uses of Funds. Health Resources & Services Administration, 22 Oct. 2018.

Texas Department of State Health Services HIV/STD Program. Interim Guidance for the Use of Telemedicine, Teledentistry, and Telehealth for HIV Core and Support Services. Texas Department of State Health Services. Accessed 12 Jan. 2023.