HIV counselling in developing countries: the link from individual to community counselling for support and change.

Abstract

Community involvement in counseling and communities' capacity for confidential sharing can be important elements of a participatory response to AIDS and HIV, linking inclusive care to prevention by community-determined change in attitudes, behaviors, and environment. Community counseling fosters a sense of mutual accountability which helps support and prevention to become realities. Such counseling has not, however, been promoted anywhere as the main strategic approach for HIV/AIDS support and prevention. Family and community structures seem to be better developed in developing countries than in developed countries. Counseling in developing countries can extend from individual to family and community, implemented as a means of facilitating changes or support, and in the community context can be used to measure as well as sustain behavioral change. Community hope exists through the recognition of loss, inclusion of suffering people, and capacity and action for change. Programs in Brazil, Sri Lanka, Northeastern India, Zambia, and Zimbabwe are examples of the potential for a positive link between individuals and the community through confidential sharing, and that such a link can give rise to prevention through counseling.