This paper describes the evolution of a counselling service in the context of an HIV/AIDS research programme in rural Uganda. The background to AIDS counselling both in Europe/America and in Africa is outlined first, and the cultural context of the programme explained. The evolution of the counselling procedure is then described and village case studies are used to illustrate the development and the difficulties that have been faced in finding an appropriate counselling model. It is noted that the Euro-American model of person-to-person counselling needs to be adapted to the rural African setting, by placing the emphasis on support for the family. It is emphasized that the approach to counselling needs to remain flexible and sensitive to the sociocultural context in which it is developed.