Clinical Review ABC of AIDS

HIV counselling and the psychosocial management of patients with HIV or AIDS

BMJ 2001; 322 doi: (Published 23 June 2001) Cite this as: BMJ 2001;322:1533
  1. Sarah Chippindale,
  2. Lesley French

    What is HIV counselling?

    Counselling in HIV and AIDS has become a core element in a holistic model of health care, in which psychological issues are recognised as integral to patient management. HIV and AIDS counselling has two general aims: (1) the prevention of HIV transmission and (2) the support of those affected directly and indirectly by HIV. It is vital that HIV counselling should have these dual aims because the spread of HIV can be prevented by changes in behaviour. One to one prevention counselling has a particular contribution in that it enables frank discussion of sensitive aspects of a patient's life—such discussion may be hampered in other settings by the patient's concern for confidentiality or anxiety about a judgmental response. Also, when patients know that they have HIV infection or disease, they may suffer great psychosocial and psychological stresses through a fear of rejection, social stigma, disease progression, and the uncertainties associated with future management of HIV. Good clinical management requires that such issues be managed with consistency and professionalism, and counselling can both minimise morbidity and reduce its occurrence. All counsellors in this field should have formal counselling training and receive regular clinical supervision as part of adherence to good standards of clinical practice.

    This article has been adapted from the forthcoming 5th edition of ABC of AIDS. The book will be available from the BMJ bookshop and at

    Aims of counselling in HIV infection


    Determining whether the lifestyle of an individual places him or her at risk

    Working with an individual so that he or she understands the risks

    Helping to identify the meanings of high risk behaviour

    Helping to define the true potential for behaviour change

    Working with the individual to achieve and sustain behaviour change


    Individual, relationship, and family counselling to prevent and reduce psychological morbidity associated with HIV infection …

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