Burnout in HIV/AIDS Volunteers: A Socio-Cultural Analysis among Latino Gay, Bisexual Men, and Transgender People

Supporting the helpers: what do peer deliverers of HIV interventions need to sustain their implementation efforts?

Peer-led HIV interventions are an increasingly common and low-cost strategy to address shortages of professionally trained health workers for implementing evidence-based HIV prevention and treatment interventions to populations who experience health disparities. There is a need to understand the experiences and unmet needs of this essential workforce responsible for implementing and delivering HIV interventions to ensure their implementation efforts are sustainable. This commentary provides a brief overview of barriers to peer deliverers' sustained engagement in the HIV workforce and potential implementation strategies to promote the sustainment of peer deliverers' implementation efforts.

Burnout Among Service Providers for People Living with HIV: Factors Related to Coping and Resilience

Individuals who provide services for people living with HIV (PLWH) face numerous work-related challenges, including psychosocial and structural factors affecting the quality of care that they provide. Little is known about the factors that relate to burnout among service providers for PLWH. The current study seeks to examine the factors associated with burnout and the role of resilience and coping in the context of burnout. Via convenience sampling, data was collected from 28 professionals (e.g., peer counselors, HIV testers, case managers/case workers, group facilitators, or social workers) serving PLWH in the USA. Participants completed quantitative measures on sociodemographics, organizational factors, discrimination, trauma, depression, and burnout. A sub-sample of 19 participants provided in-depth qualitative data via semi-structured interviews on burnout, coping, and resilience as a buffer against the effects of burnout. Thematic content analysis revealed themes on the factors related to burnout (e.g., discrimination, limited financial and housing resources, and COVID-19), rejuvenating factors, coping with burnout, and intervention strategies. Additionally, Pearson's product moment correlations revealed significant associations between mental health variables such as depressive and posttraumatic stress disorder symptomology with (a) discrimination and microaggressions and (b) burnout. The current study highlights challenges to providing HIV care, including structural barriers and discrimination that are doubly impactful to the professionals in this sample who share identities with the PLWH whom they serve. These findings may inform the development of an intervention targeting burnout among individuals providing services to PLWH and motivate change to remove structural barriers and improve quality of care for PLWH.

Volunteering in prisons: a systematic review and narrative synthesis

BACKGROUND

Individuals from the community who volunteer within prisons are an understudied population, despite previous research indicating the increase in involvement of the penal voluntary sector and benefits to both prisons and prisoners from effective implementation of volunteer programmes.

OBJECTIVES

This study aimed to identify the characteristics, motivations and experiences of individuals who volunteer in prisons.

STUDY DESIGN

This was a systematic review conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

METHODS

Peer-reviewed publications were identified through searchers of five electronic databases (MEDLINE, PsycINFO, Scopus, Applied Social Sciences Index & Abstracts and Social Sciences Database) without date restrictions, supplemented by hand searching and reference checking of retrieved articles. Explicit inclusion and exclusion criteria determined study eligibility. Study quality was appraised using standard tools. A narrative synthesis was conducted, and motivations were organised according to the Volunteer Function Inventory.

RESULTS

Eight studies (five qualitative and three quantitative) reported a total of 764 volunteers across five countries. More than half of the included studies investigated individuals providing primarily religious volunteer support; volunteers in these studies were typically middle aged, White and female. Prison volunteers frequently described motivations related to altruistic or humanitarian values, as well as social reasons. Positive experiences of volunteering were related to personal benefits to volunteers. Negative experiences were related to a lack of support and challenges in volunteers' relationships with prison staff.

CONCLUSIONS

Prison volunteer programmes have the ability to improve the psychological health of prisoners and provide a range of potential benefits to penal systems and volunteers themselves, but research on individuals who volunteer in prisons is limited. Difficulties in the volunteer role could be mitigated by developing formal induction and training packages, promoting closer integration with paid prison staff and providing ongoing supervision. Interventions to improve the volunteer experience should be developed and evaluated.

Passion, commitment, and burnout: Experiences of Black gay men working in HIV/AIDS treatment and prevention in Atlanta, GA

Background

HIV-focused organizations, care providers and research programs often hire Black gay, bisexual and other men who have sex with men (GBMSM) in their efforts to reach highly affected communities. Due to their unique social position within and outside of organizations, Black GBMSM are ideally situated to contribute to HIV care and prevention programming targeting their own communities, but may also be at risk for stress and burnout in these settings. Despite this critical role for Black GBMSM in efforts to end the epidemic, little is known about subjective experiences of Black GBMSM who work in the HIV field.

Methods

We conducted qualitative interviews with 19 Black GBMSM who were identified as key informants. All were working in community-based organizations, clinical or academic settings in the area of HIV prevention and treatment in Atlanta, Georgia. We used a thematic analysis approach to identify salient themes with respect to the workplace experiences of Black GBMSM as well as the role of their identities in their work in the field.

Results

Participants discussed: (1) Shared experiences and growth; (2) Work-related stressors; (3) Worker burnout; and (4) Commitment to continue working in the HIV field. On the whole, Black GBMSM derived meaning from their work, and found their intersectional identities to be a strength in fulfilling job duties. At the same time, Black GBMSM described multiple stresses faced as they balanced their personal and professional connections to this work, while also dealing with their own challenges related to discrimination, socioeconomic status, and health. Participants repeatedly described sacrificing their own well-being for the greater good of their communities, highlighting contributors to burnout within and outside of the workplace.

Conclusions

Our participants derived meaning from their work in the HIV field and were affirmed by professional interactions with other Black GBMSM. At the same time, they also faced work-related and other psychosocial stressors that predisposed them to frustration and burnout. To promote workplace equity and wellness for Black GBMSM, we share recommendations for HIV-focused organizations that employ and serve men in this demographic.

Validation of the Brief Sense of Community Scale in a lesbian, gay, and bisexual sample

Sense of community can buffer against negative mental health outcomes in lesbian, gay, and bisexual (LGB) individuals. Valid measurement of this construct can better inform research, assessment, and intervention designed to promote well-being in this population. The present study aims to evaluate the validity of the Brief Sense of Community Scale (BSCS) among sexual minority individuals. The scale was administered to 219 LGB participants within a larger assessment of health needs in a southern lesbian, gay, bisexual, and transgender (LGBT) population. Validity evidence was evaluated using the Downing model. Confirmatory factor analyses revealed good fit for a second-order model, supporting internal structure validity. Acceptable to excellent internal validity was demonstrated. Correlational analyses revealed negative relations with loneliness, internalized homophobia, and poor mental health. This study provides evidence for the use of the BSCS in an LGB population and demonstrates the utility in measuring the sense of community in sexual minority individuals.

Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study

Burnout syndrome (BOS) is a work-related constellation of symptoms characterized by emotional exhaustion, depersonalization, and personal accomplishment. A cross-sectional survey was performed to study the prevalence of BOS among a randomly selected sample of 280 Italian Red Cross volunteers. A socio-demographic questionnaire and the Maslach Burnout Inventory (MBI)-HSS were used to collect data. 241 volunteers participated (response rate: 86.1%). A significant proportion of the workers had BOS subscale scores in the highest tertile: emotional exhaustion 8.0%, depersonalization 35.9% and perceived lack of accomplishment 23.5%, respectively. Volunteers in emergency care reported higher levels of emotional exhaustion (p=0.004) and depersonalization (p=0.001), and lower level of personal accomplishment (p=0.042) than volunteers engaged in non-healthcare social and administrative duties. These findings support the opportunity of a set of administrative, organizational and individual preventive interventions for emergency volunteers' mental health.

Experienced HIV-Related Stigma and Psychological Distress in Peruvian Sexual and Gender Minorities: A Longitudinal Study to Explore Mediating Roles of Internalized HIV-Related Stigma and Coping Styles

Experiencing HIV-related stigma has important impacts on the mental health of people living with HIV, which has implications for treatment adherence, disease progression, and health outcomes. The impacts of stigma are particularly important to consider among sexual and gender minorities, who often face a disproportionate burden of HIV. To address the implications of stigma in these key populations, we leveraged a longitudinal study conducted among Peruvian sexual and gender minorities to compare the relative effects of multiple mediators affecting the relationship between experienced HIV-related stigma and psychological distress: internalized HIV-related stigma, adaptive coping, and maladaptive coping. HIV-related stigma, coping, and distress were measured, respectively, at 24 weeks, 36 weeks, and 48 weeks post-diagnosis for 145 participants from the Sabes Study. HIV-related maladaptive coping largely mediated the relationship between experienced HIV-related stigma and distress. Our findings suggest interventions targeting maladaptive coping may alleviate the mental health consequences of experiencing HIV-related stigma.