Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

498 Abstracts 24299-24304

12th World AIDS Conference

24299 The impact of multiple AIDS related deaths on Perth's
health care professionals
Anthony M.J. Cichello, M.A. Tilley, J. Thornton. Curtin University of Technology,
Ward 4K, Royal Perth Hospital Box X2213 GPO Perth W.A. 6001, Australia
Issue: As the AIDS pandemic continues, there is growing evidence that a new
group of people are experiencing its impact. The focus of this study is the impact
on Health Care Professionals experiencing multiple AIDS related patient deaths.
Design: Psychosocial impact, coping strategies and coping supports were
assessed in 14 core Health Care Professionals working with Perth's HIV/AIDS
population. Data consisted of responses on the General Health Questionnaire
(GHQ) and qualitative data.
Results: GHQ data suggest that there was a 50 percent prevalence of psychological distress amongst this sample. The main themes of its impact were
regarding "a better appreciation of life" and "increased levels of depression,
anxiety and stress". The most commonly utilised coping strategies were "solicit
support from colleagues", "utilise private counselling", "talk to a friend, lover or
family member", "teach others about HIV/AIDS" and "remain objective". The two
most frequently reported coping supports were "formal supervision" and "attend
individual counselling".
Conclusions: This small sample of Health Care Professionals report high
levels of psychological distress, reliance on debriefing, peer support, formal supervision and individual counselling as coping techniques. They report that more
inservice training, stress management workshops, stress leave and alike would
assist further in coping with multiple AIDS related deaths.
24300 Work-related stress and occupational burnout in AIDS
caregivers: Test of a coping support model
Violaine Chalvin', S.C. Kalichman2, A. Demi1, J. Peterson'. 1Georgia State
University, 1956 Hitching Post Lane Marietta GA 30068; 2Center for AIDS
Intervention Research, Milwaukee, WI, USA
Objectives: To test the relative effects of work load, emotion focused and problem
focused coping strategies, and perceived locus of control on occupational burnout
in nurses who provide care to people living with HIV.
Design: Anonymous postal survey methodology.
Methods: In October 1997, 1500 nurses randomly sampled from a US national
organization of nurses in AIDS care were sent an anonymous survey containing
the Maslach Burnout Inventory as a measure of occupational stress-burnout, the
Ways of Coping Inventory, Rotter's Locus of Control Scale, and demographicwork history information. Surveys were returned anonymously using postage-paid
envelopes. A total of 494 nurses returned completed surveys; providing a 33%
response rate.
Results: We tested a model of psychological factors related to occupational
burnout adapted from Bennett et al. (1992). As shown in the figure, we hypothesized that both perceived external control over stress and emotion focused
coping would predict occupational burnout, over and above work load and work
environment. In contrast, problem focused coping strategies were expected to
provide protective functions and predict lower levels of burnout. Results of path
analyses provide support for these hypotheses.

cator, I have more experience and knowledge about HIV/AIDS infection problems
and as such I am able to help many people who are worried and infected to
help themselves cope with their problems. My greatest challenge is many clients
are not coming back because they are frustrated that they cannot afford to know
their serostatus as testing is not available in our districts. Finally my wife also
found strength to seek her own serostatus and discuss it with other women in the
community.
Lessons learnt: Being both counsellor and educator with the knowledge of
my serotatus contributes to strengthening AIDS information dissemination in an
area with no testing facility. Yet, counselling without testing is frustrating and
leaves most clients in a dilemma to make positive choices. Voluntary HIV testing
and counselling should be available for all including the rural setting to promote
behaviour change among sexual active groups.
24302 Secondary traumatic stress syndrome: Understandings
and coping mechanisms learned during HIV prevention
research at the University of Illinois at Chicago
Carrol A.M. Smith, R.M. Novak, D. Pollins, B.-A. Jacob, G. Davis-Miller,
P. Newman, F. Freeman. The University of Illinois at Chicago, Chicago, IL, USA
Issue: Frequent exposure to the traumatic events 'in research participants' lives
left staff vulnerable to Secondary Traumatic Stress Syndrome (STS).
Project: Finding methods to reduce the effects of STS among a research staff
of seven was important and necessary so that our work could be accomplished.
STS produces feelings of sadness, anger, despair and helplessness in those
who continually listen to the stories of trauma from others. The goal was to
enable team members to continue to work effectively with at-risk women who
live in an everyday milieu where rape, domestic violence, street violence and
death are endemic. Scheduled meetings where staff could discuss their feelings
were useful. Staff also learned a specific questioning technique, Critical Incident
Debriefing, which allows the "debriefer" to assist the affected staff member to
describe in detail the event causing the STS and thus relieve her/himself of their
overwhelming feelings. Staff practiced other methods of self-care recommended
by trauma therapists: designated stress-relief times at work where staff can eat,
laugh, and tell funny stories together as well as careful attention to setting limits
on length of work hours and intensity of the work.
Results: Staff have profited from the techniques described to enable them to
support one another, diffuse overwhelming feelings and return to a better level of
efficiency in their work.
Lessons Learned: Our trauma is not unlike that experienced by many public or
protective service workers. However, training should be initiated for all staff at the
outset. They will then be less disoriented by the disruptive psychological effects
of STS. We have also learned that if we are able to make meaningful referrals
when we hear the traumatic stories, partcipants have a way of dealing directly
with their trauma. This also helps reduce staff feelings of anger and helplessness,
and makes the work even more rewarding and meaningful.
24303 HIV and AIDS: Identification, stigmatisation (personal
and social) awareness of minor girl children who are
sexually abused for commercial purposes
Anindit Roy Chowdhury. c/o Sanlaap 21 B Pratapaditya Road, Calcutta, India
Issue: In India, 40% of the estimated 30,000 children trafficked and forced into
prostitution are HIV positive and need stigma-free medical & social attention and
care. Innovative approaches and modifications in law are prerequisites to combat
the problem.
Project: While working with the vulnerable children of prostitutes & resqued
children who were forced into prostitution, it has been found by the project that
more than 40% are HIV positive & some have full blown AIDS. The State & its law
does not have any legislation that protects the right of these unfortunate children.
Moreover there is forced testing, stigmatisation after identification & total lack of
innovative approaches of the state while helping these children. The strategy is
not only to help the child but make major interventions to make the society aware
& react through its Social Welfare, Police, Border SEcurity Force, Judiciary, Local
Self Government (Panchayat) & the family, all who are the stakeholders of this
activity.
Results: There is a total lack of information and also intention ofthe state to
better the situation of these vulnerable & unfortunate children. The project has
also lobbied and joined hands with all the stakeholders to bring change and
address child right.
Lessons Learned: Awareness of the mass is necessary on a continuous basis
NGOs have to lobby on a prolonged basis with the policy makers and develop
innovative approaches to bring about the desired change.
24304 Double lives: Current problems faced by HIV-infected
physicians
Robert Klitzman. HIV Cntr/Columbia Univ/NYS Psych Inst 722 West 168th

Street/#10 New York, New York, USA
Background: Objectives: to understand current problems faced by HIV+ physicians, and implications for treatment of HIV+ and other patients.
Methods: In-depth semi-structured interviews (2 interviews of 2 hours each)
are being conducted with 40 HIV+ physicians, examining their experiences as
patients and as providers. Interviews are being audiotaped, transcribed, and

Problem
'Focused,.14"
co in_
Work Load &.27*
Work Environment E
SEmotion /.30*
Focused
CopingJ

Burnout.22**
External
I Control i

Conclusion: Interventions focused on increasing organizational and personal
support, perceived internal control over stressors, and active-problem focused
coping skills may reduce the risk for occupational burnout in AIDS caregivers.

1243011

My experience as an HIV/AIDS educator and counsellor
living with HIV in a remote rural district of northern
Uganda

Alli Arkangel', J.W. Idro2. 'Moyo AIDS Control Initiative, Adjumani; 2MACI,
Adjamani, Uganda
Issue: Discussing my own HIV positive status as an HIV/AIDS educator and
counsellor.
Project: I tested HIV positive some 130 kilometers away from my home area
in May 1996. After going through despair and depression, I sought proper counselling among my fellow workmates and decided to open up. I made my first
declaration of being HIV positive in a seminar organised for district authority leaders in mid 1996. Since then, I have continued to discuss my status in trainings
and workshops reaching over 12,000 people including young men and women,
women leaders, opinion leaders, beer brewers, health workers and NGO staff, as
recorded in my diary.
Results: Initially, people from my rural area could not believe that one could
be infected but look healthy like me. However, my presence now attracts many
people to our educational activities. Another result of my openness is that I was
trained as a counsellor and now receive clients seeking counselling and more
information about HIV/AIDS including HIV testing. Being both counsellor and edu