Together Learning Choices (TLC)

TLC (Together Learning Choices) is an HIV prevention and health promotion intervention developed for HIV-positive teens and youth (ages 13 to 29). TLC is delivered in small groups using cognitive-behavioral strategies to change behavior. It provides young people living with HIV the tools and skills necessary to live their best lives and to be able to make healthy choices. The goal of the intervention is to help these young people maintain health, reduce transmission of HIV and infectious diseases, and improve their quality of life. TLC is a product of extensive collaboration among researchers, staff from public and private agencies serving the population, and members of the intended population, representing diverse backgrounds and perspectives.

TLC consists of two sequential modules that totaled 16 sessions. Each module has eight sessions and is designed to be delivered by two Facilitators in a group setting.

  •  The Staying Healthy module encourages healthy living by focusing on health maintenance and forging effective partnerships with health care providers.
  • The Acting Safe module is dedicated to primary and secondary HIV prevention by addressing sex- and substance use-related risk behaviors and reducing new infections and reinfections.

– The goal of this study was to design, pilot test, and evaluate an intervention for service providers to address HIV-related stigma and its impact on health service delivery and adequate care.
TLC is a science-based behavioral intervention that has demonstrated evidence of effectiveness in reducing risky behaviors, such as unprotected sex, or in encouraging safer ones, such as using condoms and other methods of practicing safer sex. It is offered by the Centers for Disease Control and Prevention (CDC) through the Replicating Effective Programs (REP) and Dissemination of Effective Behavioral Interventions (DEBI) at

Targeted Risk Group:
Young People Living with HIV (YPLH) aged 13 to 24 in original efficacy trial and aged 13-29 in . The majority of participants were African-American and Latino.

Intervention model:
Small group intervention.
Original intervention manuals available here:

Module 1 – Staying Healthy

Module 2 – Act Safe: Sexual Decisions of HIV-Positive Youth and Reducing Drug and Alcohol Use

  1. TLC- Mod 2, Sess 1: Should I Protect Myself and My Partner? (93 downloads)
  2. TLC- Mod 2, Sess 2: Which Protection Methods and Sex Acts Are Best for Me? (92 downloads)
  3. TLC- Mod 2, Sess 3: Should I Tell My Partner I Am HIV-Positive? (97 downloads)
  4. TLC- Mod 2, Sess 4: Should I Try To Get My Partner to Accept Our Using Condoms? (95 downloads)
  5. TLC- Mod 2, Sess 5: Should I Refuse Unprotected Sex? (100 downloads)
  6. TLC- Mod 2, Sess 6: Establishing the Commitment (87 downloads)
  7. TLC- Mod 2, Sess 7: How Can I Stop Drug and Alcohol Thoughts? (83 downloads)
  8. TLC- Mod 2, Sess 8: How Can I Avoid External Triggers? (95 downloads)
  9. TLC- Mod 2, Sess 9: How Can I Avoid Internal Triggers? (94 downloads)
  10. TLC- Mod 2, Sess 10: How Can I Handle Anxiety and Anger? (99 downloads)
  11. TLC- Mod 2, Sess 11: How Can I Handle Drugs, Alcohol, and Sex? (92 downloads)

CDC funded replication manual: TLC Implementation Manual (117 downloads)
TLC Broadsheet (109 downloads)

Research Methods:
Group randomized trial with immediate intervention and delayed (waitlisted) control conditions. Assessment interviews conducted every three months over 24 months.

Local Significance:
The intervention reduced sexual risk behaviors, substance use, and emotional distress, and increased social support and other positive coping styles.