Acquired immune deficiency syndrome (AIDS) poses a health threat unparalleled in modem times. Identified just a few years ago, AIDS and the human inunlmodeficiency virus (IDV) responsible for it affect millions of persons worldwide. AIDS has already become the leading cause of death among persons under 40 in some large American cities. From the beginning. it has been evident that AIDS carries unique psychological and social ramifications. In spite of its lethality, new cases of HIV infection are preventable if individuals can be assisted to make behavior changes to lessen or eliminate viral transmission. To the extent that we can develop effective primary prevention interventions, it will be possible to keep larger numbers of people from becoming infected with the mv virus. Psychological and social risk­ behavior change interventions, whether at the level of individual clients, groups, or entire communities, can playa key role-in fact, the only available role-in disease prevention. Patients with any life-threatening illness have psychological, social, and support needs. However, these needs are more pronounced and, often, less easily addressed for persons affected by AIDS. People in good clinical health but with HIV infection face years of worry concerning whether they will develop AIDS. Nearly 2 million Americans are currently in this precarious position; by 1991, 50 to 100 million persons worldwide are expected to share the same uncertainty.

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1: Medical Aspects of AIDS.- 1.1. Medical Characteristics of AIDS.- 1.1.1. HIV and Its Relation to AIDS.- 1.2. Diseases Related to HIV Infection.- 1.2.1. Diseases Associated with AIDS.- 1.2.2. AIDS-Related Complex.- 1.3. Incidence and Demography.- 1.3.1. AIDS Incidence and Prevalence.- 1.3.2. Risk Groups.- 2: Transmission and Risk Factors for AIDS.- 2.1. AIDS Risk Behavior among Homosexual or Bisexual Males.- 2.1.1. Number of Sexual Partners.- 2.1.2. High-Risk Sexual Practices.- 2.1.3. History of Sexually Transmitted Diseases.- 2.1.4. Substance Use History.- 2.2. AIDS Risk Behavior among Heterosexuals.- 2.3. Reduced-Risk Conduct.- 2.3.1. Misconceptions Concerning Risk Practices.- 2.4. The Case against Casual Transmission.- 3: Risk-Reduction Counseling for Individuals and Groups.- 3.1. For Whom Are Individual and Group Prevention Efforts Needed?.- 3.2. Providing Risk-Reduction Information.- 3.2.1. Providing Risk-Reduction Information to Gay Male and At-Risk Heterosexual Clients.- 3.2.2. Providing Risk-Reduction Information to Clients Who Are Intravenous Drug Users.- 3.2.3. Limitations of Information Provision in Promoting Risk-Behavior Change.- 3.3. Behavior-Change Counseling.- 3.3.1. Self-Management Training.- 3.3.2. Assertion Training.- 3.3.3. Life-Style Issues.- 3.3.4. Program Effectiveness.- 3.3.5. Implications for Individuals and Group Counseling.- 4: Behavioral Interventions at a Community Level.- 4.1. Informational and Educational Messages.- 4.1.1. Limitations of Written Materials for AIDS Prevention.- 4.1.2. Additional Means of Public Education.- 4.1.3. AIDS Risk Education for Adolescents.- 4.2. Provision of Cues to Adopt Lower-Risk Behavior.- 4.2.1. Prompts.- 4.2.2. Increasing the Perceived Salience of the AIDS Health Threat.- 4.2.3. Modeling Influences.- 4.3. Supports for Maintenance of Risk-Behavior Change.- 5: Psychosocial Consequences of HIV Seropositivity.- 5.1. Learning of HIV Seropositivity.- 5.2. Risk-Behavior Changes Prompted by Seropositivity.- 5.3. Emotional Consequences That Follow Knowledge of Seropositivity.- 5.3.1. Anxiety.- 5.3.2. Anger.- 5.3.3. Depression.- 5.3.4. Somatization.- 5.3.5. Denial.- 5.4. Neurological Consequences of HIV Exposure.- 5.5. Social Consequences of HIV Infection.- 5.6. Implications for Future Health and Adjustment.- 6: Psychosocial Interventions for HIV-Seropositive Persons.- 6.1. Counseling at the Time of HIV Testing.- 6.1.1. Pretest Counseling and Education.- 6.1.2. Posttest Counseling.- 6.2. Psychosocial Interventions to Promote Behavior Change and Coping Skills.- 6.2.1. Interventions to Alter Continued Risk Behavior.- 6.2.2. Psychological Interventions to Reduce Stress Associated with Seropositivity.- 6.2.3. Interventions to Improve Cognitive Coping Skills.- 6.2.4. Interventions to Improve Social Functioning.- 6.3. Other Considerations.- 7: Psychological Consequences of AIDS and AIDS-Related Complex.- 7.1. Factors Influencing Psychological Reactions to an ARC or AIDS Diagnosis.- 7.1.1. Health Status.- 7.1.2. Attributions Regarding Illness.- 7.1.3. Reactions to the Diagnosis.- 7.1.4. Self-Disclosure of Health Problems.- 7.1.5. Availability of Environmental Support Systems.- 7.2. Psychological Consequences of ARC and AIDS.- 7.2.1. Anxiety.- 7.2.2 Depression.- 7.2.3. Anger.- 7.3. Neuropsychological Consequences of ARC and AIDS.- 7.4. Psychological Consequences of ARC and AIDS to Others.- 7.4.1. Effects on Spouses and Lovers.- 7.4.2. Families.- 7.4.3. Caregivers.- 8: Psychosocial Care Needs of Persons with AIDS.- 8.1. Psychological Interventions.- 8.2. Other Care Needs following AIDS Diagnosis.- 8.3. Assistance with Housing and Health Care Resources.- 8.3.1. Transitional Apartments.- 8.3.2. Ambulatory Day Care.- 8.3.3. Home-Based Support Programs.- 8.3.4. Hospice Care.- 8.4. Interventions for Family Members and Significant Others.- 8.5. Interventions for Caregivers.- 9: Effective Help-Providing: Knowledge, Sensitivities, and Ethics.- 9.1. Knowledgeable Caregiving.- 9.1.1. Knowledge of Sexual Behavior.- 9.1.2. Knowledge about AIDS and HIV Infection.- 9.1.3. Knowledge of Life-Style Issues.- 9.2. Ethical Issues.- 9.2.1. Other Ethical Considerations.- 9.3. Special Sensitivities Required of AIDS Caregivers.- Epilogue: The Societal Challenge of AIDS.- Appendix: Selected AIDS Resources in the United States.- References.