Individuals trained in communication processes can make a special contribution in situations that require extraordinary interventions. Such situations include dealing with intravenous drug users, working with hard-to-reach teenagers, counseling gay and bisexual men who are at risk but do not perceive themselves to be, addressing intercultural issues that complicate AIDS education efforts, and creating political agendas for legislators who must be sensitized to the complexity of the AIDS crisis. Many of the political and ideological issues surrounding the AIDS crisis manifest themselves in HIV testing. Ambiguity surrounds the reproducibility, specificity, and sensitivity of AIDS tests. Nonetheless, HIV testing should be part but not the center of a comprehensive AIDS prevention policy. Teaching individuals not to discriminate is another difficult problem associated with AIDS. An additional problem is that individuals and communities are unwilling to talk about AIDS in an open and frank manner. Populations at risk should be carefully targeted for education and prevention programs, and communication specialists should play a crucial role in interactive caregiving. Future challenges are to increase understanding of the disease, expedite the development of effective drugs and vaccines, identify global strategies to deal with AIDS caseloads, improve global access to quality health care, eliminate political and socioeconomic barriers to prevention strategies, and eliminate discrimination against those affected by the epidemic. 16 references