CBO & ASO & HIV Burnout

Protect your mental health—your passion deserves it

by George M. Johnson

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Community-based organizations and AIDS service organizations have been staples in the fight against HIV for going on thirty-plus years. They were some of the first organizations that started back in the eighties, when inaction of the federal government toward the HIV epidemic birthed a movement toward obtaining treatment, funding, and a race to stop the thousands of people who were dying on a yearly basis. Although they have done great work, they unfortunately come with a downside that many of us have experienced but few have ever publicly talked about.

Working for a CBO or ASO is not something for the weak or faint of heart. For the past two and a half years, I’ve been consistently working in the field of HIV for a small community-based organization in the Washington, D.C., area. In that time, I served in a multitude of capacities, wearing multiple hats, and shifting through job titles and promotions faster than any other job I had ever had. To date, I started out as a community healthcare worker (CHW), then manager of a grant program, then Young MSM services, then YMSM services and Counseling and Testing, then accounting, then the head of Finance. Working for a CBO, any and everything that you can possibly do will get assigned as “other duties” and you are required to fulfill those duties to the best of your ability. Even if you don’t have the full training necessary at times.

The hours working in HIV are long, twenty-four hours a day and seven days a week. Although we are trained to leave work at work and not take our clients problems home with us, it is almost impossible to do so once you have made a personal connection with clients. The clients’ problems can often become your problems as you work toward finding a solution for them at all costs. The extended-hours part comes in when you talk testing and outreach. The testing typically happens throughout the day from 9–6 for us. Then you have events on the weekend where testing can go from 9 p.m. until 2 and 3 a.m., depending on the location. This also doesn’t account for testing during special events that could be going on during the week. Your job also doesn’t just stop at the test.

As a CHW, you are the person who connects your client to care. Meaning, you become their built-in support system, which at times can be burdensome, especially with a newly diagnosed client. They may not have anyone but you during those initial months and you are expected to be there for them to the best of your ability. I have also seen where, even when you go the extra mile, there is a lack of appreciation for that work you are doing. There are so many deliverables for grants, deadlines, and requirements that even when you are going above and beyond, there is not much compassion for the employee but to keep delivering the good numbers.

Mental health is the one problem I see most employees of CBO work having to deal with on a personal level. There have been several times where I have had to just take a day to do nothing because of the juggling of so many things due. However, the downside to that is the work doesn’t go away nor is there a person that you can just transfer some of it over to. The workload can at times be simply too much to bear, especially at the low wages. CBOs and ASOs are usually grant-funded but can also be privately funded; however, the smaller organizations tend to not have budgets for high wages on the front-line worker end. So, you are typically overworked, underpaid, and left with only passion to keep you driven within the work.

Now, don’t get me wrong, there are still some perks that come with this life. The family that is created when working for a HIV-based CBO is nothing like I’ve ever seen before. There aren’t a lot of employees, so everybody knows everybody. You also get to make some awesome networks across the country with other people who work on similar projects and get to make awesome lifetime connections and friendships. There is also a greater sense of flexibility for when you have other businesses or hustles to help supplement the shortage of pay you may be seeing on the wage side. The cross-training and experience is also great because you can transfer those skills to other organizations when it becomes time for you to leave.

Burnout is a real thing and it leaves a lot of people that work in the field with a bad taste in their mouth. The best advice I could give is to get out before you resent the work and the people that you work with. I know for me, the transition out has been hard, but it was done on my terms, and I couldn’t be happier to no longer be burning the candle from both ends.


George M Johnson is a black queer journalist and activist. He has written for Ebony, TheGrio, JET, Teen Vogue, Huffington Post, Black Youth Project, and several HIV publications. Follow him on Twitter @iamgmjohnson.