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Health Education/Risk Reduction

HIV/STD Program

HIV/STD Program

HIV Medical and Support Service Categories

Health Education/Risk Reduction

Service Standard

HE/RR Service Standard print version

Texas Department of State Health Services, HIV Care Services Group – HIV/STD Program

Subcategories Service Units
Group-Level Intervention Per 15 minutes
Health Education/Risk Reduction Per 15 minutes
Prevention Case Management – Individual 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 coverage)
  • Health literacy
  • Treatment adherence education

Limitations

Agencies cannot deliver HE/RR services 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 HE/RR must follow HRSA and DSHS Universal Standards 1-63 and 168-169.

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: HE/RR staff will complete a health and HIV education evaluation and a service plan that specifies how they will meet the client’s educational needs. 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 and HIV education evaluation and service 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 and 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 per 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 should include medical coverage options 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. If a client elects to discontinue this service before they have completed the post-test, staff should document this in the client chart.
  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, March 2025.

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, March 2025.

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