Mental Health problems are associated with life‐threatening illnesses generally and Acquired Immune Deficiency Syndrome (AIDS) specifically. This report describes the range and extent of psychological problems and therapeutic input for all patients (n = 258) referred to an HIV clinical psychology service over a one‐year period at a teaching hospital in the area of highest HIV prevalence in the UK. The majority (79%) were HIV positive; of these 92% were gay males, 6.5% heterosexual women and 1.5% heterosexual men. The age range was 15 to 72 years. Referrals were received for patients at all stages of HIV disease and for partners and relatives who were HIV negative but affected by HIV infection in another. The highest rate of referral was for HIV positive patients who were asymptomatic and the greatest intensity of need was for those with AIDS. Suicide (ideation or behaviour) was an issue in referral for 43 patients.
Assessment revealed the major problems to include anxiety (48%), relationship problems (31.7%), depression (26.5%), adjustment to HIV status (16.9%), bereavement (12%), employment (11%), sexual issues (10%), isolation and suicide (9% each). Psychological therapy for the majority took the form of short‐term or crisis intervention. Group intervention did not substitute for individual therapy. The needs of patients were examined. They ranged from general interventions addressing adjustment to infection with HIV or an AIDS diagnosis, to specific input for issues such as sexual difficulties or coping with physical illness and bereavement. The data are discussed in terms of the growing demand for psychological services.