This study describes volunteers who were trained at a large HIV social care centre in South London during its first two years of operation. Many shared similar backgrounds to their clients; indeed some service users were also volunteers. Common motivations for volunteering were to learn more about HIV, to give something back to affected communities, and for gaining job-relevant experience. Selection, training and induction procedures were elaborate. But there were problems. Turnover was high, with half the volunteers dropping out in their first year. This matches reports for HIV organizations elsewhere, but is higher than for the voluntary sector in general. The high rate is attributed not to the nature of the work, but partly to the unusual social groups from whom volunteers are drawn and partly to the changing relationships between volunteers and the organization, symptomatic of which was loss of communication with staff and managers, and a consequent feeling of being undervalued. This can be linked to pressures arising from the pace of change in such organizations which have had the effect of marginalizing the role of volunteers. The new contractual arrangements with statutory agencies are contributing to the alienation, though ironically they were intended to strengthen the voluntary sector. The study questions whether AIDS service organizations should accept that the voluntaristic basis on which many originated is now over.

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SummaryIn this article we ask what kind of phenomenon is internet sex addiction. From the perspectives of two practising psychiatrists, one of whom has worked in a weekly sexual disorders clinic for 12 years, and an anthropologist we explore whether a moral panic is emerging over sexual behaviour and the internet, and whether internet sex addiction forms part of any such panic. We ask whether many individuals who diagnose themselves as addicted to internet-based sex do so more out of a media-activated sensibility than a clinical reality. We also consider what developments in DSM-5 hold for this area.

Khan (published in 1816), which he claimed to have written after an opium-induced dream. Set against this is Thomas de Quincey's Confessions of an Opium Eater, which dwells more on the pain than the pleasures resulting from laudanum use. Baudelaire's observation in Les Paradis Artificiels is perhaps one that substance use workers can easily identify with. He was considering the use of hashish and opium as aids to poetic creativity: 'Even if one can say that they heighten the senses they so stifle the will that one is incapable of any daily routine.'