Rise is a one-on-one peer counseling program to improve adherence to medications and health care engagement among Black clients. Rise can be used for people with HIV (for HIV treatment, for people without HIV (for pre-exposure prophylaxis for HIV prevention or PrEP), and for people with other chronic conditions such as hypertension and diabetes.

Rise aims to improve clients’ overall wellness through problem solving barriers to adherence and access to care; providing referrals to social services for unmet needs; and improving doctor-patient relationships and patient self-advocacy. Rise peer counselors use Motivational Interviewing strategies to educate about adherence, medications, and HIV, work with clients to problem solve adherence barriers, and link clients to services to address unmet needs (e.g., for food, housing). Rise counselors address lack of health knowledge, stigma and discrimination, medical mistrust, and poor doctor-patient relationships, among other adherence challenges. Rise counselors also highlight clients’ protective factors, such as social support networks and spirituality in facilitating adherence and care engagement.

The program includes two phases:

• Phase 1 consists of three core sessions that take place within the first month of the program. During these sessions, the counselor and client establish a plan of action and together works through the main strategies and tools for helping with adherence and engagement in care. The first session takes about 90 minutes; other sessions last about one hour.

• Phase 2 consists of maintenance (booster) sessions scheduled at months 3 and 5, in which the goal is to help clients maintain excellent adherence and health care engagement over the long term. All clients receive two booster sessions, and clients who continue to have adherence issues are offered up to four additional booster sessions.

Rise can be conducted in person, online, or by phone.

Rise is based on APLA Health’s Treatment Advocacy program for people with HIV, which showed promising effects in a process evaluation. Rise was adapted for Black clients living with and affected by HIV and other comorbidities through a community engagement process.