How often do you think about HIV/AIDS?



Do you ever worry about getting something from your partner? What do you worry



about? Why do you worry?

Do you ever worry about giving something to your partner? What do you worry about?



Why do you worry?

Environmental reevaluation can be facilitated with questions such as the following:

How does your partner (partners) feel about using condoms?



How would your partner (partners) feel if condoms were used?



Do people close to you ever talk about your addiction? What do they say?



Do people close to you ever talk about HIV/AIDS? What do they say?



How does your addiction affect people who are close to you?



Group therapy in inpatient settings can be very helpful in setting the stage for actual behavior

change. It is challenging for clients who have started to change behavior within a structured

setting to continue the change when they return to the less structured environment from which

they came. This environment may not necessarily support newly acquired lifestyle changes.

Stage of HIV infection

Segregating groups by stage of HIV infection presents difficulties, but not doing so can also be

problematic. Clients who are HIV positive but asymptomatic and attending a support group for

the first time may be uncomfortable when encountering clients in the late stages of AIDS. Such a

meeting may force them to confront fears about their own mortality before they are ready to do

so.

Because treatment programs have limited resources, separating groups by stage of HIV infection

may be impractical. Programs able to support separate groups may wish to use the three-group

model, with groups consisting of

Clients newly aware of their positive HIV status



Those who are asymptomatic or mildly symptomatic



Those with more advanced disease



The interplay between substance abuse disorders and HIV infection in groups can be

complicated. As clients move further into substance abuse recovery, they may be getting

progressively more ill from HIV disease. In a mixed group, healthier clients may provide support

to sicker ones.

In a group consisting solely of clients symptomatic with AIDS, members are vulnerable to

becoming involved in a process of continual grieving. Sometimes groups have to discontinue for

a period of time when too many members become sick or die. For this reason, it may be helpful

to establish support groups for time-limited periods.

Outpatient treatment