Warning:

This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:

• STD Treatment Guidelines   at http://www.cdc.gov/STD/treatment

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1993 Sexually Transmitted Diseases Treatment Guidelines

09/24/1993

SUGGESTED CITATION
Centers for Disease Control and Prevention. 1993 Sexually
transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14):
{inclusive page numbers}.

CIO Responsible for this publication:
National Center for Prevention Services,
Division of Sexually Transmitted Diseases and HIV Prevention

Counseling for Patients with HIV Infection
     
     Behavioral and psychosocial services are an integral part of
HIV early intervention. Patients usually experience emotional
distress when first being informed of a positive HIV test result,
and also later when notified of changes in immunologic markers,
when antiviral or prophylactic therapy is initiated, and when
symptoms develop. Patients face several major adaptive challenges:
a) accepting the possibility of a curtailed life span, b) coping
with others' reactions to a stigmatizing illness, c) developing
strategies for maintaining physical and emotional health, and d)
initiating changes in behavior to prevent HIV transmission. Many
patients also require assistance with making reproductive choices,
gaining access to health services and health insurance, and
confronting employment discrimination.

     Interrupting HIV transmission depends upon changes in behavior
by those persons at risk for transmitting or acquiring infection.
Though some viral culture studies suggest that antiviral treatment
reduces viral burden, clinical data are insufficient to determine
whether therapy might reduce the probability of transmission.
Infected persons, as potential sources of new infections, must
receive extra attention and support to help break chains of
transmission and to prevent infection of others. Targeting behavior
change programs toward HIV-infected persons and their sex partners,
or those with whom they share needles, is an important adjunct to
current AIDS prevention efforts.

     Specific recommendations for counseling patients with HIV
infection are listed below:

--   Persons who test positive for HIV antibody should be counseled
     by a person who is able to discuss the medical, psychological, and
     social implications of HIV infection.

--   Appropriate social support and psychological resources should
     be available, either on site or through referral, to assist
     patients in coping with emotional distress.

--   Persons who continue to be at risk for transmitting HIV should
     receive assistance in changing or avoiding behaviors that can
     transmit infection to others.

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