Photo Credit: Nadiia Lapshynska

Physicians can use techniques based on motivational interviewing—an evidence-based, patient-centered, collaborative communication style—for HIV prevention.

Healthcare providers play a crucial role in preventing HIV by empowering patients to make healthier choices. Patient-provider communication can either inhibit behavior change or when done successfully, promote positive decision-making. Motivational Interviewing (MI) is an evidence-based, patient-centered, collaborative communication style that providers can adopt as part of a comprehensive HIV prevention strategy.

According to the Motivational Interviewing Network of Trainers, MI can be particularly effective with patients when:

• Ambivalence is high and people are stuck in mixed feelings about change
• Confidence is low and people doubt their abilities to change
• Desire is low and people are uncertain about whether they want to make a change
• Importance is low and the benefits of change and disadvantages of the current situation are unclear

Using Motivational Interviewing in Patient Communication

Below are prompts that healthcare providers can use when discussing HIV prevention with patients.

Building Rapport and Trust

• Create a safe space: Let patients know that this is a judgment-free zone, and they can speak openly about their behaviors and concerns.
• Offer empathy: “I understand that these topics can be sensitive. I’m here to support you.”

Exploring Ambivalence

• Ask open-ended questions: “What are your thoughts on your current sexual health practices?”
• Explore mixed feelings: “It sounds like you might be unsure about making a change. Can you tell me more about what’s on your mind?”

Using Reflective Listening

• Paraphrase to show understanding: “It sounds like you’re concerned about potential risks but also enjoy your current lifestyle. Is that right?”
• Reflect emotions: “It sounds like you’re feeling unsure about the benefits of changing your behavior. Let’s talk more about that.”

Eliciting Change Talk

• Encourage the patient’s own reasons for change: “What are some reasons you might want to consider changing your current behavior?”
• Highlight benefits: “How would your life be different if you were able to reduce your risk of HIV?”

Setting Goals and Planning

• Identify specific goals: “What specific steps can you take to protect yourself and your partners from HIV?”
• Create an action plan: “How about we work together to develop a plan that includes regular testing, safer sex practices, and possible PrEP use?”

Providing Information and Feedback

• Share relevant information: “Here are some facts about the effectiveness of PrEP and other preventive measures. How do you feel about these options?”
• Offer feedback without judgment: “From what you’ve shared, it sounds like you’re at an increased risk for HIV. Let’s discuss some strategies to reduce that risk.”

Maintaining Follow-Up and Support

• Schedule follow-up appointments: “Let’s plan a follow-up visit to check on how you’re doing with your plan and address any concerns you may have.”
• Provide resources: “Here are some resources and support groups that you might find helpful as you work towards your goals.”

By using these discussion prompts, healthcare providers and clinical staff can guide patients in exploring their own motivations for changing risky behaviors and making healthier choices. Motivational Interviewing techniques create a supportive, patient-centered approach that can have a significant impact on HIV prevention.

Need additional HIV resources for your clinic? Explore these offerings from ETR:

• Patient Education Materials on HIV
• On-Demand Webinar: Implementing Tailored Motivational Interviewing for HIV Prevention
• “Creating Status Neutral HIV Prevention and Care” blog post