Counselling for HIV-positive haemophiliacs in Japan

This paper describes the current status of counselling for HIV-positive haemophiliacs at a haemophilia centre in Japan. Clinical experience with 23 HIV-infected haemophiliacs (all male, age range 16-56, mean 29.9 years), 22 family members (eight couples of parents, one grandmother, five siblings) and nine sexual partners (five wives and four girlfriends) between April 1990 and February 1994 is detailed. Methods of counselling consisted of individual counselling in 32, couple counselling in eight and family counselling in three cases. Indications for counselling consisted of fear of or shame of HIV infection in 37, concern for the family in 21, risk of transmitting HIV to sexual partners in 12, fear of death and dying in 12, future career and family life in seven, interest in treatment options in five, daily life style in 10, parents' feeling of guilt over the infection in five cases, lack of knowledge of haemophilia, HIV infection and AIDS in seven, and bereavement in two cases. A total of 200 counselling hours were provided. Consequently, pending disclosure of HIV infection was successfully completed in five, disclosure of HIV infection to the sexual partner by the patient was facilitated in two, the patient-family relationship improved in nine, and smooth transition of care to the adult in-hospital unit was achieved in two patients. Our experience in Japan clearly verifies the importance of psychoeducational counselling for HIV-positive haemophiliacs and their family as well as sexual partners.