The demographics of the United States haemophilia treatment centre social workers: the results of a national survey.

Social Workers (SWs) are vital members of the multidisciplinary health care teams at Hemophilia Treatment Centers (HTCs) across the US. However, little research has been done to identify the demographics and qualifications of HTC SWs. In response to this lack of data, a subcommittee from the Social Work Working Group sponsored by the National Hemophilia Foundation conducted a national online survey in 2010. The authors attempted to ascertain the demographics and characteristics of SWs who work at HTCs across the country. The purpose of this article is to report the results of this online survey and evaluate the parameters of SW demographics in HTCs. Electronic surveys were sent to 143 HTC SWs. Ten were excluded and 100 were completed and returned, yielding a 75% response rate. The great majority of HTC SWs are women and almost half are middle-aged (aged 40-59). They represent a highly educated, very experienced group of professionals. When asked why respondents stayed in their positions at the HTCs, answers appeared to highly correlate to factors related to the HTC multidisciplinary team model. The high survey response rate of 75% reflects the interest of HTC SWs in obtaining data that describe and quantify their qualifications. This information may serve as validation of the haemophilia SW role in times of funding cuts. It may also give a basis for the recruitment and retention of SWs in the haemophilia field.

Issues of disclosure and condom use in adolescents with hemophilia and HIV. Hemophilia Behavioral Evaluative Intervention Project Staff.

PURPOSE: To examine the patterns, facilitators, and barriers to disclosure of HIV seropositivity in an adolescent population and to determine the relationship between disclosure and condom use. BACKGROUND: In recent years, public health efforts have focused on methods to prevent the transmission of the Human Immunodeficiency Virus (HIV). These efforts have included safer sex education, skill building and self-efficacy training, behavioral change techniques, and encouragement of serostatus disclosure to sexual partners. In 1990, the Centers for Disease Control and Prevention (CDC) funded 10 hemophilia treatment centers to develop and implement a theory-based behavioral intervention to prevent the sexual transmission of HIV. METHODS: A baseline survey, focusing on barriers to safer sex, the influence of parents, peers, and sexual partners, alcohol and drug use, and communication and disclosure patterns, was administered to 321 young males (ages 12 to 25) with hemophilia and HIV. RESULTS: Fifty-eight percent of the sexually experienced adolescents did not disclose their HIV status to their most recent sexual partners (i.e., nondisclosers) compared to 42 percent who reported that either they informed their partners or their partners already knew their HIV status (i.e., disclosers). There was no correlation between disclosure and condom use. The most significant predictor of disclosure was the perception that peers would disclose their HIV status. CONCLUSION: The results suggest that disclosure does not necessarily facilitate condom use in this population. This conclusion may have implications for future public health efforts in HIV prevention. Rather than focusing primarily on the promotion of serostatus disclosure, behavioral interventions should emphasize the practice of safer sex, utilizing peer educators and support networks.

Maintaining safer sex behaviours in HIV-infected adolescents with haemophilia. The Hemophilia Behavioral Evaluative Intervention Project Committee.

Adolescents with haemophilia comprise 44% of the reported AIDS cases in teenagers. Unprotected sexual intercourse among this group increases the risk of HIV transmission. Understanding the influences which others may have on the sexual behaviour of adolescents with HIV and haemophilia may lead to the development of effective risk reduction strategies. An evaluative instrument, administered to 307 HIV-infected adolescents with haemophilia, assessed their behavioural stage of change (Prochaska & DiClemente), attitudes, beliefs and behaviours about safer sex practices. The influence of parents, peers and sexual partners on sexual behaviour was compared between (1) those who were sexually experienced and (2) and those who were sexually inexperienced. Barriers and facilitators to practising safer sex were identified. Although parents influenced the sexual behaviour of both groups, this influence was significantly greater in the sexually inactive group. Fewer than 20% reported that their peers impacted their decisions about sexual behaviour. Eighty-six per cent of the sexually active indicated that partners significantly impacted their sexual decisions, while 60% of the sexually inactive indicated that future partners would affect their decisions about sex. Most participants agreed that disclosure of HIV status before intercourse was desirable, but only 31% of the sexually active said they told every partner. Fear of rejection or a negative reaction from the partner, and lack of communication skills were the greatest barriers to disclosure of HIV status and practising safer sex. This study indicates that behavioural interventions for both groups should focus on developing communication skills and self-efficacy. Interventions should include the key influences for each group--parents for the sexually inactive and partners for the sexually active.