Behavioral Interventions at a Community Level

Abstract

Individual and small group counseling efforts are appropriate and necessary when assisting help-seeking clients who are at risk for AIDS. However, in spite of the media attention that AIDS receives and the fear that AIDS can engender, it is not likely that most persons at risk for the syndrome will seek out individual risk-behavior-change assistance even from care-providers who are trusted. The stigma associated with acknowledging that one is at risk for AIDS and concerns regarding potential breaches in confidentiality make it unlikely that large numbers of persons will initiate requests for assistance in reducing their personal AIDS risk. Many investigators in the primary prevention area have also noted that traditional mental health service provision systems that require persons to “come to” therapy may be useful for a small number of help-seeking individuals but are generally ineffective in promoting behavior change on the wide-scale level needed for community prevention (Fredericksen, Solomon, & Brehony, 1984; Rosen & Solomon, 1985). Even if all persons at risk for AIDS were willing to seek out assistance to reduce their exposure risk, traditional mental health and therapy-based counseling systems could not possibly accommodate them (Solomon, 1986).