A comprehensive sex education approach for HIV testing and counselling

Abstract

Despite huge prevention efforts the number of HIV infections worldwide continues to increase dramatically. Among other strategies, the HIV test offers an important chance for targeted prevention, provided quality counselling is offered. Several studies have revealed that HIV testing is often performed in less than optimal conditions and is often not effective. In this paper we argue that effective counselling must be based on a comprehensive sex education approach. To understand sexual risk behaviour, and to change it, the complexity of sexual behaviour has to be taken into account. Sex is one of the most socially diverse of human activities. The meaning of sex differs profoundly among societies, cultures, subcultures, particular relationships and individuals. As a consequence, HIV counselling must be tailored to the specific risk situation of the particular individual or couple asking for the test. Rather than (or in addition to) offering universal knowledge and advice, the counsellor should discuss the specific meaning of (unsafe) sex and the obstacles for safer sex for the specific person or couple in a dialogue and focus on their empowerment in order to have safer sex in the future.

Acknowledgements

The author is grateful to her former colleagues, especially Prof. Dr Nathan Clumeck and Dr Stéphane De Wit of the Aids Reference Centre of the Free University of Brussels (ULB).