HIV testing and counseling

Abstract

Fifteen years into the epidemic, AIDS remains a frightening and life-threatening disease. Knowledge about the cause, natural history, treatments, and prognosis, has significantly increased longevity, but there is still no sign of a cure. The number of newly-infected persons continues to rise, despite concerted efforts at education and prevention. Our social and legal system have attempted to put in place structures to provide humane care, treatment and protection, but much ignorance and discrimination remain. Because of the life-threatening nature of the disease, and the psychological, social and legal ramifications, strategic HIV testing and counseling are important safeguards. Pre-test counseling helps to educate those considering HIV testing about the real risks of HIV transmission, and reinforces behavior which can lead to risk reduction. For persons receiving news of a positive HIV test, post-test counseling provides a safe place to react to their diagnosis and to begin, hopefully, a healthy adjustment to their altered life. This article summarizes information psychiatrists and other clinicians need in order to provide the most effective counseling for those who seek and receive HIV testing.