Emotional reactions of haemophilia health care providers.

This study investigated the prevalence and impact of job burnout and job satisfaction among health care professionals working with HIV-infected patients with haemophilia, using a survey that included the Maslach Burnout Inventory (MBI). A minority (7.4%) of the 213 respondents met the criteria for job burnout as assessed by the MBI. Nearly 90% of the respondents reported 'liking' their job, although only 46% anticipated being in the same job in 5 years. The following factors were associated with increased degrees of burnout: greater perceived colleague stress, less overall job satisfaction, greater perceived stress in the working environment, fewer team meetings and fewer years of career experience. Mental health professionals were also less likely than physicians to report burnout. A multiple logistic regression found that providers who reported stress with colleagues were 42% more likely than their peers to be classified as experiencing a high level of job burnout. This study underscores the importance of a well-functioning team in buffering the inevitable stresses of caring for haemophilia patients with HIV.

Influence of sexual abuse on HIV-related attitudes and behaviors in adolescent psychiatric inpatients.

OBJECTIVE: To investigate the associations between sexual abuse and human immunodeficiency virus (HIV)-related attitudes and behaviors of adolescents with a psychiatric disorder. METHOD: HIV-related knowledge, attitudes, and behaviors were examined by self-report assessment of adolescents admitted to a psychiatric hospital (N = 100). A subsample (n = 30) completed a role-playing exercise regarding HIV-preventive behavior that was scored for the degree of effective communication by raters blind to the subjects' abuse history. RESULTS: HIV-related risk behaviors were prevalent, including unprotected sexual intercourse (67%) and multiple partners (27%) among the sexually active (71% of the total). Also frequent were alcohol and drug use (25%) and sharing cutting instruments (22%) among those engaged in self-cutting behavior (62%). The 38% of the sample identified as having a history of sexual abuse indicated significantly poorer self-efficacy concerning condom use than their peers. Abused females scored significantly lower on the self-efficacy of condom use scale and reported significantly more frequent alcohol use than nonabused females (p = .003). A hierarchical multiple regression that controlled for consistency of condom use and tolerance of people with acquired immunodeficiency syndrome found that abuse history uniquely accounted for 16% of the variance in condom use self-efficacy. Analysis of the videotaped role-play found that abused adolescents were significantly less competent and had more difficulty in effective communication than their peers (p = .003). CONCLUSION: A history of sexual abuse is associated with impaired safe sexual decision-making and HIV-preventive communication skills, even in this already at-risk group. This study also underscores the importance of actively addressing these issues in the context of clinical care.