Recommendations to Reduce HIV Counselor Stress and Burnout

People who work in AIDS service organizations (ASOs) are at increased risk for stress from several factors, including heavy caseload, fear of contamination, poor working conditions and stress associated with delivering a life-threatening diagnosis. “Recommended guidelines exist to help medical practitioners prepare for and communicate bad news, yet many individuals have still expressed stress,” said Zachary Y. Kerr, M.P.H., M.A., of the Department of Epidemiology, Gillings School of Global Public Health at The University of North Carolina-Chapel Hill. “In addition, at many ASOs, an HIV test counselor is usually a volunteer or staff person who holds other responsibilities. These individuals, although trained to HIV test counsel, may not have the advantage of a related educational background or hold a higher degree in clinical psychology/ therapy as those in previous samples exploring burnout.”

Kerr led a study examining the coping strategies that ASO employees used to manage the stress associated with HIV test results. The 42 participants were all ASO employees with at least six months of experience. Kerr found that the result of the HIV test was just one stressor among many that the ASO employees faced on a daily basis. “Stressors, such as incorrectly anticipating HIV test results, helping clients interpret HIV test results, and dealing with one’s own emotions were common,” he said. “Other stressors, such as difficult clients and self-doubt, could occur before HIV test results were given.”

The participants cited various coping strategies including respite, maintaining a healthy perspective, and social support. “The HIV test counselors relied on coworkers to provide social support that helped to minimize stress.” Kerr added, “They also noted structural support from ASOs, such as having open communication with supervisors. HIV test counselors need opportunities to formally speak with co-workers and supervisors as a form of decompressing.” Kerr believes that ASOs should provide an open environment between staff and administration to reduce the feelings of anxiety during the testing process. “In addition, we recommend having established guidelines that supervisors can utilize to help HIV test counselors during an HIV test counseling session.” He added, “Increasing an HIV test counselor’s feeling of competence in their work can help to reduce potential burnout.”

Kerr, Zachary Y., Erika L. Grafsky, Katye Miller, and Randi Love. “Stressors and Coping Strategies for HIV-Test Counselors Giving Rapid HIV-Test Results: An Exploratory Qualitative Study.” AIDS Patient Care and STDs 25.8 (2011): 483-91. Print.

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • EricS


    November 19th, 2011 at 4:35 PM

    Wow now that must be one more stressful job, and so sad at times too. I guess I had never really given any realy thought to how prone to burnout those in these kinds of positions must find themselves. But think of the rewards that you could face too. I guess in some ways it kind of balances out, especially for those who take such care and pride in helping others.

  • Steven


    November 20th, 2011 at 7:32 AM

    Burnout affects so many professions where you are constantly helping others but then you lose them and that is such an enormous letdown. Can you imagine losing people that you have come to know and love almost on a daily basis? That could be the reality of an HIV counselors job. Those are some really giving and unselfish people who get into that field; think of the good that they are doing with so much hurt involved and very little monetary compensation.

  • JOSH


    November 20th, 2011 at 11:56 AM

    Wow I never thot bout this! Although I’ve thought bout how much a person diagnosed with HIV would be stressed n depressed I never thot of these people who spend all their time in such an environment. They need not only a good compensation but also all the support that they could need.

  • Deanna


    November 21st, 2011 at 5:14 AM

    Well the problem that I have with this is that these are smart and educated people. Don’t you think that they could have thought a little about the potential burnout factor BEFORE going into this?

    I mean this does not take a rocket scientist to see that this is a job that could end up taking a lot out of you and that you might need some ways to cope with that before it overwhelms you.

    I am not saying that I don’t have sympathy, but you have to know some of these things going in.

  • g.


    September 21st, 2017 at 7:08 AM

    Clearly you are not someone who has been in a position of helping and serving others. Of course professionals in this realm have an understanding of the potential of burnout, it is not until you do not live and experience it that you do not fully grasp this notion. What you are saying is like saying that a chef should know before he/she goes into that career that they will not have the best schedule – yes most chefs are aware of this but this is not going to stop them from pursuing their passion. Or, like saying that cops know they could get injured or killed on the job so therefore they should not go into it or think more deeply about going into law enforcement. Point being is that if people simply focused on the what ifs of what could happen with stress and burnout in their roles and careers we would have no chefs, no police, and no one dedicating their sanity to human services work. You must think about things much deeper than just the surface as your comment was vain.

  • lesley


    November 21st, 2011 at 10:12 AM

    fear of transmission could be a big problem I’d imagine..but these people are educated and a lot more knowledgeable about HIV than others,so I would think they would not fall prey to myths generally associated with transmission of the virus..

  • James


    November 21st, 2011 at 4:42 PM

    Now tell me something- why would these organizations be satisfied with hiring people who do not have a degree in psychology and are not trained as a counselor to deal with all of the issues that people in these positions are going to be faced with? I know that money is probably an issue sometimes and paying someone to fill those spots, but there are enough dedicated in the field who would work there no matter the pay. And they would be effectively trained to better deal with the patients as well as find resources for them to take advantage of as they learn to live with the disease.

  • LEO


    November 22nd, 2011 at 8:54 AM

    Being a doctor,I know how hard things can be because one wrong diagnose from your side and it could lead to a lot of problems to your patient and could affect you in turn too. And for something like HIV, where the effects on a person after being diagnosed are so huge mentally, the level of pressure that these people face has to be huge!

  • Jenny


    November 22nd, 2011 at 5:12 PM

    One great thing that someone can do to de-stress and de-compress is to find a way to get away from the work for a while.
    That does not mean that you necessarily have to physically get away, but find some things that will take your mind off of the day to day drudge and focus on other things that bring you happiness.
    How about taking up a hobby, or finding a way to occupy your time like going on a walk or maybe even getting involved in some outside groups?
    Anything that will reinforce your reason for being without having you constantly thinking about your jobs and the things that you always have to encounter there.
    Everyone needs a little escape from all of that.

  • p.van


    November 23rd, 2011 at 8:17 AM

    burnout and stress will be prevalent if the people being considered are volunteers and those that are not exactly qualified for the job. what is even the reason for doing this study when instead they should be trying to replace these less-qualified people with professionals in the field?!

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