Attitudes and beliefs related to HIV/AIDS in urban religious congregations: Barriers and opportunities for HIV-related interventions

Abstract

HIV-related stigmas have been seen as a barrier to greater religious congregation involvement in HIV prevention and care in the United States and elsewhere. We explored congregational and community norms and attitudes regarding HIV, sexuality, and drug use through a qualitative case study of 14 diverse religious congregations in Los Angeles County, California between December 2006 and May 2008. Data collected included semi-structured interviews with 57 clergy and lay leaders across the congregations, structured observations of congregational activities, review of archival documents, and a questionnaire on congregational characteristics. Across and within congregations, we found a wide range of views towards HIV, people with HIV, and populations at risk for HIV, from highly judgmental and exclusionary, to “loving the sinner, not the sin,” to accepting and affirming. Attitudes and norms about HIV, homosexuality, and substance abuse appeared to be related to the type and intensity of congregational HIV-related activities. However, even among the higher activity congregations, we found a range of perceptions, including ones that were stigmatizing. Results suggest that affirming norms and attitudes are not a prerequisite for a congregation to initiate HIV activities, a finding relevant for HIV service providers and researchers seeking to engage congregations on this issue. HIV stigma-reduction is not a prerequisite for congregational HIV involvement: both may occur simultaneously, or one before the other, and they dynamically affect each other. Strategies that are congruent with congregations’ current levels of comfort and openness around HIV can themselves facilitate a process of attitudinal and normative change.

Stigma and racial/ethnic HIV disparities: Moving toward resilience.

“…A third insight is the dynamic nature of stigma and how the basis and nature of stigma can vary for the same person across contexts. For instance, Black men living with HIV who have sex with men may be stigmatized in White communities due to their race, in Black communities (e.g., faith-based organizations) due to their sexual orientation, and in Black and gay communities due to their sero-status (Bluthenthal et al, 2012).…”

Counselor-Based Rapid HIV Testing in Community Pharmacies

“…12,13 Still, stigma associated with HIV continues to be a major barrier to HIV prevention and care in the United States and globally. 14,15 Populations with the least access to care continue to suffer from HIV/AIDS in a disproportionate way. African Americans have a seven times greater incidence rate of HIV/AIDS compared to whites, and the highest rate of new HIV of any racial group, and according to the most recent CDC data, the highest rate of persons living with infection ever classified as AIDS were among blacks/African Americans (551.2 per 100,000) and Hispanics (196.1 per 100,000).…”

The Organization of HIV and Other Health Activities within Urban Religious Congregations

“…could have eased their introduction and increased the sustainability of HIV involvement, particularly in the face of stigma. 23 The fact that we see a range of HIV activity levels within this model suggests that it may be a sustainable model for congregations not only to initiate, but grow, HIV activities.…”