This program is for adults who have HIV.

Healthy Living Project (HLP), a community-based program, is designed to encourage participants to make healthy behavioral choices, including the reduction of substance use, to decrease the risk of HIV transmission.

HLP was implemented in a multi-site randomized controlled trial.  Participants consisted of HIV-infected men and women who were randomized into a treatment or wait-list control group.  Groups completed follow-up assessments at 5-, 10-, 15-, 20- and 25-months post-randomization.  One outcome measure was transmission risk, as assessed by the number of unprotected sex acts with persons of HIV-negative or unknown status.  Results showed a significant reduction in the number of transmission risk acts for both the treatment and wait-list control groups from baseline to 25 months.  The treatment group experienced a greater reduction than the control group at 10, 15, and 20 months. At 25 months, the treatment and control groups did not differ in the reduction amount. A second outcome measure was substance use. Results showed significantly greater reductions in substance use among the treatment group for alcohol and/or marijuana use, any substance use, hard drug use, and a weighted index adjusting for severity of the drug, with differences noted by gender and sexual orientation.  Sexual behavior and drug use outcomes were analyzed for participants who were homeless at some time during the past 37 months, and results showed significantly greater reductions in unprotected risky sex acts, number of sex partners of HIV-negative or unknown status, alcohol or marijuana use, and hard drug use among the intervention group compared to the control group.

HLP uses a cognitive-behavioral approach to help improve participant's well-being and health care practices.  Facilitators, acting as life coaches, work with individuals and encourage participants to change their health behaviors, engage in ongoing medical care, and set and achieve personal goals.  The program consists of 3 modules:

• Stress, Coping, and Adjustment - Identify personal strengths, challenges, and stressors; set attainable goals; develop problem-solving and coping skills; increase social support;
• Safer Behaviors - Identify personal risks and triggers to risky behaviors, understand proper use of condoms, strengthen communication and negotiation skills, enhance self-efficacy related to disclosure; and
• Health Behaviors - Access health services, practice adherence, maintain behavior changes and social support, and actively participate in medical care decision making.

During sessions, clients are encouraged to identify and pursue a long-term, life goal; discover ways to address challenges in their lives; and build self-confidence, self-esteem, and motivation to practice protective healthy behaviors, such as decreasing personal risky sexual or drug use activities.  Several strategies are implemented to help achieve goals and include psychosocial education, skill-building to improve coping, and problem-solving training using role-play activities.

HLP was developed by Craig Ewart in the early 1990's and was updated in 2009. The program has been implemented in the United States and in China.

Facilitators should have a bachelor's degree. A required, 2-week, on-site training is available for $1,300 per person plus travel expenses.  Please use details in the Contact section for additional information.

Considerations for implementing this program include recruiting facilitators and ensuring they receive training, obtaining funds for training expenses, acquiring participant buy-in and commitment as this program requires self-motivation and self-monitoring, locating meeting space, and understanding some material may be of a sensitive nature.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing HLP, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

This program is delivered in three modules that consist of five 90-minute sessions each. Sessions are delivered about once per week and there is a three-month break between each module.

The intervention manual and other program materials are free.  The estimated cost for delivering the program to one client is $412.

To move HLP to the Effective category on the Clearinghouse Continuum of Evidence, at least one external evaluation must be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185     Email: Clearinghouse@psu.edu

You may also contact Dr. Steven Morin by mail Center for AIDS Prevention Studies, University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA, 94105, phone 1-415-597-9228, or email steve.morin@ucsf.edu  

https://www.cdc.gov/hiv/pdf/research/interventionresearch/compendium/ma/hlp_best_rr_good_ma.pdf, https://cdc.thehcn.net/index.php?controller=index&module=PromisePractice&action=view&pid=3534, https://www.theathenaforum.org/healthy_living_project_for_people_living_with_hiv and Parker et al. (2013)