ABSTRACT
Th e threat of HIV/AIDS has become a familiar aspect of our national and international social and health care milieu. Th e familiarity for many people manifests in a daunting daily grind of interaction with health care providers as they and their fellow patients, signifi cant others, friends, and family attempt to attend to the devastating eff ects of a disease that still results in certain, although increasingly prolonged, death. For others, HIV/AIDS is a common phrase but is perceived as a distant threat even though statistics suggest a resurgence of HIV/AIDS in the United States since 2001. People of color, women, and young people have been especially hard hit by the HIV/ AIDS epidemic in recent years (Centers for Disease Control and Prevention [CDC], 2005b). New cases are highest among both heterosexual and homosexual young people aged 15 to 29 (CDC, 2005a) who either do not consider their sexual behavior risky or acknowledge their risky behavior but may maintain a fatalistic attitude. In addition, as part of a major HIV prevention policy shift the CDC has begun focusing on “positive prevention” out of concern for reaching those who test positive for HIV/AIDS so they do not infect others (CDC, 2003a; Kalichman, 2005; see also chap. 11, this volume). It is with these diverse at-risk populations that HIV test counseling may hold the most promise. And it is through a philosophy known as
harm reduction theory (HRT), already used in successful intervention programs targeting injection drug users (IDUs) and to frame HIV test counseling in other countries ravaged by HIV/AIDS, that these prevention education opportunities can be best realized to promote safer sex and other harm-reducing behaviors.
