Individuals with HIV/AIDS present special challenges to the post-disaster worker. Due to the widespread myths and lack of knowledge about the transmission of HIV, survivors develop fear and anxiety when they find out that an individual who is HIV-positive is living, sleeping, or using the toilet facilities near them in a shelter. Mental health workers can help educate survivors and other crisis workers to reduce the fear of infection.
Reliance on disaster workers with different educational and professional backgrounds results in a mix of values, attitudes, and cultural characteristics, as well as various levels of emergency preparedness.
In a disaster, there is a phenomenon of focusing on some problem, perhaps even a small one, that may provide some sense of control for disaster survivors. Experienced disaster workers are more comfortable with HIV/AIDS-related information than new, inexperienced workers.
The following is a summary of the HIV/AIDS knowledge base needed by workers in post-disaster programs:
1. Recognition that individuals with HIV/AIDS are a new at-risk population in disaster assistance planning.
2. Identification of the unique needs of HIV-infected survivors, including medical, psychosocial, and legal needs.
3. Development within emergency agencies of clear lines of responsibility for the needs of individuals with HIV/AIDS in shelters, specialized housing, and hospitals.
4. Planning in a coordinated structure to link medical and government agencies to address the needs of survivors diagnosed with HIV/AIDS.
5. Incorporation in all training and emergency manuals of emergency care guidelines for the care of disaster survivors with HIV/AIDS.
6. Development of an inventory of existing and potential resources to respond to HIV/AIDS-related problems, including availability of health and mental health personnel; capabilities of the public health system, prison system, and mental health institutions; and preparedness of existing community-based organizations and networks.
7. Development of training materials about disaster management for incorporation in all community HIV/AIDS training programs.
8. Development of a "shelter-model" process to deal with the day-to-day problems of disaster survivors living with individuals who are HIV-infected or have AIDS.
9. Development of community emergency models that focus on preplanning and prevention approaches to the care of HIV-infected disaster survivors.
10. Awareness of the legal rights of individuals with HIV/AIDS.
11. Consultation with mental health agencies and HIV/AIDS agencies regarding medical and nonmedical mental health personnel and health personnel specially trained for disaster work.
12. Specialized training in mental health management during times of disaster to encourage therapeutic attitudes for survivors with HIV/AIDS.