Occupational stress experienced by caregivers working in the HIV/AIDS field in South Africa

The burden of HIV on caregivers is especially heavy in South Africa where an estimated 5.5 million people were living with HIV in 2006, and where an estimated one in every three to four patients admitted to some public hospitals is HIV-positive. Occupational stress and burnout merit concern in South Africa as the severity and intensity of the HIV epidemic is often perceived as overwhelming, leaving many caregivers with intense feelings of hopelessness and despair. This study explores and describes the experiences, feelings and perceptions of South African caregivers working in various capacities (healthcare, counselling and teaching) in the HIV/AIDS field. A questionnaire investigating stress factors involved in HIV/AIDS-related care, symptoms of occupational stress, and employer support was completed by 243 caregivers. The results specify in what sense these caregivers find their work extremely stressful. Commonly, they battle with bereavement overload, over-identify with their patients, fear occupational exposure to HIV, and find it difficult to cope with their own and patients' stigmatisation and confidentiality issues. The caregivers generally believed that they had not been adequately trained to offer HIV-related counselling; they largely felt unsupported by their employers, family and friends; and they were frequently angry about slow government processes and misleading health messages. Caregivers working in different capacities found HIV-care-related factors equally stressful, while school teachers claimed significantly more symptoms of occupational stress than counsellors and healthcare workers. The results clearly indicate that these categories of caregivers work in extremely difficult circumstances and require support from their employers to prevent burnout. Suggestions on how to assist such caregivers in their work environment are made, and support strategies are discussed.