Group counseling to prevent AIDS.

Abstract

A review of evaluation studies of drug counseling approaches in AIDS prevention in drug treatment outpatient and inpatient programs is provided after a short description of drug counseling approaches. The general conclusion is that small groups can affect patients knowledge and attitudes toward AIDS and HIV risk but not behavior although group approaches show some promise. Detailed information is provided on how to conduct group work in general and with reference to residential treatment programs outpatient detoxification integration into clinic operations and multiethnicity but there is not enough information to run an effective group. Reference is made to the Heitsmann training manual. The goals of the intervention are to increase drug clients understanding of AIDS transmission and prevention to develop skills in helping themselves avoid or spread AIDS and to help make lifestyle changes that are self-protective. The elements of importance in a counseling group are didactic presentations groups discussion structured exercises social interactions and process review and planning. Preparation involves a months time in orienting staff with among other items a demonstration workshop and recruiting a clinic staff member to colead a group. Paraprofessionals in advanced stages of recovery contribute to developing trust and group cohesion. Professionals with advanced behavioral science training can provide therapeutic skills and adhere to protocol. Clients are recruited by written invitation and telephone reminders and posted fliers. Personal and individual contact is always appreciated. Educational tools and supplies include a videocassette recorder and TV monitor and flip chart or blackboard. Condom use and needle cleaning checklists are also required. Checklist should be adapted to the population served. There is discussion of what changes may improve the use of the lists provided. In the 3 sessions over a 6-hour period the topics cover the introduction of concepts sexual behavior and HIV testing and review. Seropositive members are asked not to identify themselves. Leaders open discussion with personal questions about whether any one has had direct contact with someone with AIDS or someone who has died of AIDS. Clients are asked what they think is risky in terms of drug use and the results are posted. Leaders then ask how one decreases each high risk activity. The sexual behavior discussion continues to explore ways to reduce risk and the HIV testing session focuses on encouraging thinking about the impact of HIV on their lives.