Abuse negatively affects women living with HIV and AIDS. It can be a hindrance to living positively with the disease. Little is known about the essence of living with HIV, AIDS and abuse among women. The purpose of this study was to develop and refine guidelines for assessment of abuse in women living with HIV and AIDS. The objectives were to explore and describe the experiences of the women in Lilongwe, Malawi and to develop and refine guidelines for assessment of abuse in the women. In phase 1 of the study, descriptive phenomenology as espoused in life world research was used. Data were gathered using unstructured interviews from a purposefully selected sample of 12 women living with HIV and AIDS who had encountered abuse. The data were analysed using qualitative methods. The women’s experiences were characterized by humiliation from partners, families, neighbours and friends; hopelessness and blame. Harm emanated from being beaten, stress suffered from the abuse, interrupted antiretroviral drugs and possible re-infection with HIV due to unprotected sex. Abandonment of the women by their husbands and families was a common occurrence. Phase 2 of the study was the development of guidelines that can be used with women who experience abuse while living with HIV and AIDS. The guidelines were based on discussion of the findings of phase 1 in the context of an extensive literature review on the constituents. Modified Delphi technique was utilized to refine the draft guidelines. Two rounds were used to finalize the guidelines by a panel of ten experts who were purposefully selected based on their involvement in issues of gender-based violence, HIV and AIDS. The study findings though applicable to the context of the study, can be transferable to similar contexts. Recommendations made include validating the assessment guidelines and testing them in practice to evaluate the applicability and feasibility of using the guidelines.