Psycho-social care for AIDS patients in developing countries.

Psychosocial care of acquired immunodeficiency syndrome (AIDS) patients has emerged as an essential service even in resource-poor developing countries. Salient counseling issues include decisions about notifying sexual partners prevention of human immunodeficiency virus (HIV) transmission future reproductive behavior concern for surviving children coping with the reactions of family members and friends and the range of complex psychological responses to an HIV diagnosis. A study conducted in Uganda confirmed that counseling of persons with HIV/AIDS had a beneficial effect on personal coping family and community acceptance and condom use. Western-based models of AIDS counseling based on a behavioral and psychotherapeutic client-centered approach are now being modified in Africa and Asia to take cultural norms and socioeconomic factors into consideration. Since 1988 the World Health Organization and other international agencies have supported HIV counseling workshops in many developing countries. In addition national AIDS programs local institutions and nongovernmental organizations have developed their own counseling training manuals and videos. Problematic however remains the provision of private space for counseling sessions in overcrowded hospitals and outpatient clinics in developing countries. A promising strategy for ensuring the sustainability of psychosocial care has been the integration of counseling into the ongoing duties of nurses and social workers.