Allen M Omoto, PhD. University of Kansas

HIV disease, including AIDS, has had and continues to have major medical, social, and societal impact. A critical component of society?s response to the HIV epidemic is expressed in the community-based organizations of volunteers involved in caring for people living with HIV and AIDS (PWAs) and in educating the public about HIV and PWAs. In the US, AIDS service organizations (ASOs) have emerged in every state, in cities large and small, and in rural areas. Some volunteers provide emotional and social support as "buddies" to PWAs, others help PWAs with household chores or transportation; still others staff information and referral hotlines, make educational presentations, or engage in advocacy. Community volunteers also raise funds to support the work of ASOs and/or to directly assist PWAs. AIDS volunteers donate valuable services; the cost of caring for PWAs is greatly reduced in areas with active volunteer programs and AIDS-related deaths have become less likely to take place in inpatient hospital settings and more likely to occur at home or in hospices most likely because of support services provided by volunteers. Clearly, AIDS volunteerism has considerable economic, public policy, and public health significance.

In my program of research, conducted in collaboration with Mark Snyder, Ph.D., of the University of Minnesota, I seek to understand the social and psychological aspects of volunteerism. AIDS volunteers play critical roles in helping to meet the physical and psychological needs of PWAs to be sure, but they have mental health needs of their own. In addition, societal change related to HIV may importantly depend on volunteers, the preventive and palliative services they provide, and their ability to enact effective programs of education and advocacy. The research is grounded in a three-stage conceptual model of volunteerism that specifies psychological and behavioral features associated with each stage and speaks to activity at three levels of analysis: the individual volunteer, the organizational context in which volunteering takes place, and the broader social system, including PWAs, friends and family members, and communities at large. This model draws on many subdisciplines of psychology, as well as the fields of sociology, anthropology, public health, and business. In the model, volunteerism is seen as a process involving three interactive and sequential stages: antecedents of volunteerism, experiences as volunteers, and the consequences of volunteering (see Omoto, Snyder, & Berghuis, 1993; Omoto & Snyder, 1992). The over-arching goals of this research program are to understand why people become AIDS volunteers, what sustains their volunteer activities over time and in the face of personal costs of volunteerism, what volunteers and others gain from their efforts, and how volunteering affects the lives of volunteers, PWAs, and communities at large. In addressing these broad questions, coordinated field-based and laboratory studies employing longitudinal and cross-sectional research methodologies and drawing from diverse populations of volunteers and non-volunteers have been conducted. With this comprehensive investigative strategy, we seek to understand AIDS volunteerism as it occurs in naturalistic settings and to systematically explore and evaluate causal models of the processes of volunteerism.

At the level of the volunteer, the antecedent's stage of the volunteer process addresses the characteristics that volunteers bring to ASOs and to their work. Potential volunteers have differing personalities that predispose them to offer certain kinds of help and have different personal experiences with HIV disease and volunteerism. Their motivations for enlisting as AIDS volunteers and their expectations for their work are also likely to vary. AIDS volunteerism allows some people to express their personal values and beliefs or to satisfy felt humanitarian obligations to help others; a values motivation. Another relatively other-focused motivation expressed by volunteers is that of community concern, or volunteering out of obligation or concern about a community or particular social grouping. This type of motivation tends to be endorsed to a greater extent by self-identified gay, lesbian, and bisexual volunteers than non-gay volunteers (see Omoto & Crain, 1995). The remaining three primary motivations are more self-focused in nature. Some AIDS volunteers come to their work primarily in search of greater understanding of AIDS and how people cope with HIV disease, some for reasons related to personal development such as to challenge themselves or enlarge their social networks. The fifth and final motivation is esteem enhancement, or volunteering to feel better about oneself or escape pressures and stress in other areas of one?s life. In general, values motivation tends to be endorsed most strongly by AIDS volunteers and esteem enhancement least strongly; the other three motivations fall somewhere in between (see Omoto & Snyder, 1993). In short, however, it is clear that the same act of AIDS volunteerism is initiated and maintained for different and sometimes changing reasons. In terms of practical import, knowing about these different motivations should permit ASOs to target volunteer recruitment efforts to the specific motivations of particular people, an issue that we are currently pursuing in our research.

In focusing on the experiences stage of volunteerism for volunteers themselves, we have observed that volunteers who serve as buddies for PWAs have relatively high expectations for the quality of the relationships they will develop with client PWAs before they meet, and that actual volunteer-PWA relationships are experienced as lower in quality than these expectations (Omoto, Gunn, & Crain, 1998). Similarly, volunteer satisfaction with buddy relationships falls short of expectations and volunteers report some stress from these relationships. Evidence suggests that the stress experienced in these relationships by volunteers is related to the closeness of the volunteer-PWA relationship and the client?s health; less close relationships early on and healthier clients are related to less volunteer stress. With encouraging trends in the treatment and medical management of HIV, this pattern of findings bodes well for future volunteer-PWA relationships and the psychological demands they place on volunteers.

Volunteers also report feelings of stigmatization and discomfort resulting from their work as AIDS volunteers. In fact, many report that the reactions of members of their own social networks have caused them to feel embarrassed or stigmatized because of their AIDS volunteerism (Omoto, Snyder, & Crain, 1998a, 1998b; Snyder, Omoto, & Crain, in press). This stigmatization is ironic in that national surveys indicate that the general public overwhelmingly believes that the need for charitable organizations is greater now than in the recent past and that charitable organizations help to make communities better places to live (Independent Sector, 1996). This stigmatization, moreover, comes from volunteering to work in an ASO; hospice volunteers report significantly lower feelings of stigmatization from the work they do (Omoto, Snyder, & Crain, 1998b). Thus, it is likely that the association of HIV disease with marginalized and already stigmatized members of society leads to "spill-over" stigmatization of AIDS volunteers. This explanation has been supported in our laboratory research (Omoto, Snyder, & Crain, 1998a).

At the consequence stage, we have found that volunteers are indeed changed by their experiences, with, for example, increases in knowledge about safer sex practices, less stereotyped beliefs about PWAs, and significantly greater comfort with AIDS and AIDS-related issues. In their own self-reports, moreover, volunteers state that their experiences have powerfully affected and changed them (Omoto & Snyder, 1995, 1998).

In exploring longevity of service, we have found that duration of service of one group of AIDS volunteers was related to their reported satisfaction with their work, the amount of support they perceived from their social network, and the motivations they reported for becoming AIDS volunteers (Omoto & Snyder, 1995). Specifically, volunteers tended to serve longer to the extent that they were more satisfied with their work, had less social support, and reported stronger, and particularly self-focused, motivation for volunteering. The fact that greater social support was actually related to shorter length of service is consistent with our findings about the stigmatization of AIDS volunteers. To the extent that volunteer efforts disrupt harmonious relations with social network members and these member respond negatively to this disruption and to AIDS volunteerism, volunteers may be likely to quit their ASO sooner than if their work is supported by others.

We have conducted several laboratory studies and analyses of longitudinal data from AIDS volunteers that all converge to suggest influences of stigmatization across the volunteer process. People who believe that they will be targets of stigmatization for AIDS-related volunteerism are less likely to follow through on their initial intentions to become volunteers, and those people who report to volunteer training expecting the most negative reactions from others are least likely to complete training. For those who become AIDS volunteers, greater perceptions of stigmatization is related to an increased likelihood of early termination of service, and particularly if the experiences of stigmatization were relatively unanticipated (Omoto, Snyder, & Crain, 1998a; Snyder, Omoto, & Crain, in press).

Engaging in AIDS volunteerism for reasons related to understanding, personal development, or esteem enhancement all predicted longer duration of service, whereas ratings of the values and community concern motivations were unrelated to longevity of service. Thus, volunteers who can and did get something back from their efforts in ASOs were likely to stay involved longer. Volunteering for relatively more other-focused reasons, however, may not sustain people in the face of the stress and stigmatization they are likely to encounter as AIDS volunteers. This finding has implications not only for the recruitment of volunteers by ASOs, but also for their training and for strategies of retention. Volunteers may need to be inoculated against potential stigmatization resulting from their work and also assisted in seeing the many personal (as well as societal) benefits that volunteer work provides. Focusing on these considerations should aid in increasing the satisfaction and retention of AIDS volunteers.

Today, the face of the HIV epidemic continues to evolve and many of the needs of PWAs are becoming less acute. In addition, what was once pressing social concern about HIV has begun to wane (Rofes, 1998). Volunteer organizations, not surprisingly and perhaps partially as a result of their own success, also have changed. Many have become institutionalized and sometimes slowed by their own bureaucracy, while still others battle to remake themselves in response to the changes in the HIV epidemic. Understanding AIDS volunteerism, like much of the HIV epidemic, involves aiming at moving targets. Still, it is clear that the need, both current and future, for volunteers to provide education, care, and advocacy related to HIV will continue and is likely to increase.

References

Independent Sector (1996). Giving and volunteering in the United States: Findings from a national survey. Washington, DC: Author.

Omoto, A. M., Gunn, D. O., & Crain, A. L. (1998). Helping in hard times: Relationship closeness and the AIDS volunteer experience. In V. J. Derlega & A. P. Barbee (Eds.), HIV & social interaction (pp. 106-128). Thousand Oaks, CA: Sage.

Omoto, A. M., & Snyder, M. (1993). AIDS volunteers and their motivations: Theoretical issues and practical concerns. Nonprofit Management and Leadership, 4, 157-176.

Omoto, A. M., & Snyder, M. (1995). Sustained helping without obligation: Motivation, longevity of service, and perceived attitude change among AIDS volunteers. Journal of Personality and Social Psychology, 68, 671-686.

Omoto, A. M., & Snyder, M. (1998). [Personal and social change among AIDS volunteers as a result of their work]. Unpublished raw data.

Omoto, A. M., Snyder, M., & Berghuis, J. P. (1993). The psychology of volunteerism: A conceptual analysis and a program of action research. In J. B. Pryor & G. D. Reeder (Eds.), The social psychology of HIV infection (pp. 333-356). Hillsdale, NJ: Erlbaum.

Omoto, A. M., Snyder, M., & Crain, A. L. (1998a). Hurt because you help: Stigmatization as a barrier to social action. Unpublished manuscript, University of Kansas.

Omoto, A. M., Snyder, M., Crain, A. L. (1998b). On the stigmatization of people who do good work: The case of AIDS volunteers. Unpublished manuscript, University of Kansas.

Rofes, E. (1998). Dry bones breathe: Gay men creating post-AIDS identities and cultures. New York: Harrington Park Press.

Snyder, M. & Omoto, A. M. (1992). Volunteerism and society's response to the HIV epidemic. Current Directions in Psychological Science, 1, 113-116.

Snyder, M., Omoto, A. M., & Crain, A. L. (in press). Punished for their good deeds: Stigmatization of AIDS volunteers. American Behavioral Scientist.