Facilitators and Barriers to HIV Activities in Religious Congregations: Perspectives of Clergy and Lay Leaders from a Diverse Urban Sample

Abstract

This paper examines facilitators and barriers to HIV activities within religious congregations, the relative internal or external sources of these influences, and suggestive differences across congregational types. Results are based on in-depth interviews with clergy and lay leaders (n = 57) from 14 congregations in Los Angeles County, California, purposively selected to reflect diversity in racial-ethnic composition, denomination, size, and HIV activity level. Many common facilitators and barriers were related to norms and attitudes, only a few of which appeared overtly associated with theological orientations. Clergy support was a facilitator particularly prevalent among congregations having higher HIV activity levels, indicating its importance in sustaining and expanding HIV programs. Resource issues were also prominent, with material resource barriers more frequently mentioned by smaller congregations and human resource barriers more among larger congregations. Organizational structure issues were mostly centered on external linkages with various social service, public health, and faith-based entities. Analysis of internal versus external sources highlights the roles of different stakeholders within and outside congregations in promoting HIV activities. Potential differences across congregational types represent fruitful areas for future research.

Predictors of the Existence of Congregational HIV Programs: Similarities and Differences Compared with other Health Programs

“…colleagues 42 found, congregational HIV programs are related to perceived need in the congregation or broader community. In small congregations, this may be particularly important, since the amount of human and financial capital may never be large enough for the congregation to engage in HIV-related programs in the absence of a commitment to issues of particular concern to the gay community.…”

Congregational involvement in HIV: A qualitative comparative analysis of factors influencing HIV activity among diverse urban congregations

“…[For further details on these methods, see (27)]. The thematic results have been reported extensively in previous articles (27,(41)(42)(43)(44)(45), and subsequently used to generate variables for the comparative analysis described below.…”

“…We then reviewed the congregational case histories and qualitative themes identified in prior published analyses (41)(42)(43)(44)(45) to identify factors that emerged as explanatory variables.…”

Promoting Health from the Pulpit: A Process Evaluation of HIV Sermons to Reduce HIV Stigma and Promote Testing in African American and Latino Churches

“…Sermons were audio-recorded and transcribed verbatim by a data transcription company. A systematic religious service observation questionnaire was adapted from a previous study (Derose et al, 2011; Mendel et al, 2014) and gathered qualitative and quantitative data about the service and attendees on intervention sermon days. The questionnaire included a 10-item checklist of sermon objectives, similar to checklists commonly used in process evaluations (Baranowski & Stables, 2000), to assess fidelity to key messages in the sermon guide.…”

“…In recent years, there have been a growing number of faith-based HIV interventions, nearly all in AA churches (Abara, Coleman, Fairchild, Gaddist, & White, 2015; Berkley-Patton et al, 2010; Berkley-Patton et al, 2016; Francis & Liverpool, 2009; Griffith, Campbell, Allen, Robinson, & Stewart, 2010; Lindley, Coleman, Gaddist, & White, 2010; Wooster et al, 2011). Many barriers to HIV programs in faith-based settings exist, including HIV-related attitudes and stigma, low HIV knowledge, lack of experience with HIV programming, lack of lay leadership and congregant support, and financial barriers (Coleman, Lindley, Annang, Saunders, & Gaddist, 2012; Cunningham, Kerrigan, McNeely, & Ellen, 2011; Derose et al, 2014; Mendel et al, 2014; Pichon, Powell, Ogg, Williams, & Becton-Odum, 2016; Pryor, Gaddist, & Johnson-Arnold, 2015; Smith, Simmons, & Mayer, 2005; Williams, Pichon, Latkin, & Davey-Rothwell, 2014; Wooster et al, 2011). AA faith leaders have also expressed concerns about HIV prevention strategies (e.g., discussing condoms and sexual education) that may be viewed as conflicting with doctrine (Nunn et al, 2012).…”