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Kanagasabai U, Aholou T, Chevalier MS, Tobias JL, Okuku J, Shiraishi RW, Sheneberger R, Pande YC, Chifuwe C, Mamane LE, Njika G, Obongo C, Thorsen VC. Reaching Youth Through Faith Leaders: Evaluation of the Faith Matters! Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:82-99. [PMID: 37406142 PMCID: PMC11075127 DOI: 10.1521/aeap.2023.35.suppa.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Faith leaders can be uniquely positioned to guide and support young people on health issues, particularly HIV/AIDS and sexual violence. Faith Matters!, a 2-day training workshop for faith leaders, was delivered in September 2021 in Zambia. Sixty-six faith leaders completed a questionnaire at baseline, 64 at posttraining, and 59 at 3-month follow-up. Participants' knowledge, beliefs, and comfort communicating about HIV/AIDS and sexual violence were assessed. More faith leaders accurately identified common places where sexual violence occurs at the 3-month point compared to baseline: at church (2 vs. 22, p = .000), the fields (16 vs. 29, p = .004), parties (22 vs. 36, p = .001), and clubs (24 vs. 35, p = .034). More faith leaders stated that they engaged in conversations that supported people living with HIV (48 at baseline vs. 53, p = .049 at 3-month follow-up). These findings can inform future HIV/AIDS initiatives focusing on increasing the capacity among communities of faith.
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Affiliation(s)
- Udhayashankar Kanagasabai
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Tiffiany Aholou
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Michelle S Chevalier
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - James L Tobias
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jackson Okuku
- Division of Global HIV & TB, CGH, CDC, Lusaka, Zambia
| | - Ray W Shiraishi
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | | | - Clifton Chifuwe
- Executive Director and Global Master Trainer at the Centre for Peace Research and Advocacy, Zambia
| | - Lauren Erickson Mamane
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
- Office of the Director, CGH, CDC, Atlanta, Georgia
| | | | - Chris Obongo
- Regional Measurement Specialist and Global Master Trainer at PATH, Kenya
| | - Viva C Thorsen
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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2
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Rosenthal AE, Spezia M, Sosnowy C, Chan PA. Acceptability of HIV Prevention Approaches Among USA Faith-Based Leaders. JOURNAL OF RELIGION AND HEALTH 2023; 62:1658-1675. [PMID: 36515812 DOI: 10.1007/s10943-022-01705-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
HIV/AIDS disproportionately impacts underserved communities in the USA. This study evaluated the acceptability of partnering with faith communities to improve HIV prevention, screening, and engagement in care with a focus on Hispanic/Latinx (H/L) communities. We engaged faith-based leaders to identify how the cultural competence and foundations of trust within these communities may be leveraged to improve HIV-related healthcare access for underserved groups including H/L individuals. Using a semi-structured qualitative interview approach, we interviewed N = 20 faith-based leaders in Providence County, Rhode Island (RI). Data were analyzed using the framework approach which utilized inductive generation of themes and systematic grouping into predetermined categories. Seven of the 20 interviewees self-identified as H/L faith leaders and discussed needs specific to H/L communities including destigmatization of HIV, increased access to care, and partnerships founded on mutual respect. The other 13 faith leaders did not personally identify as H/L but all served communities with significant H/L populations. We included these individuals given their communities already performed HIV and/or other health outreach and could provide insight into what approaches could be adapted to the needs expressed by H/L leaders. All interviewees were accepting of developing partnerships with outside organizations to engage in HIV prevention, and all identified potential solutions to identified barriers. Results suggested that faith-based outreach should be further investigated as a method of improving HIV prevention in the general and H/L populations.
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Affiliation(s)
- Alex E Rosenthal
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
| | - Marie Spezia
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Collette Sosnowy
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Philip A Chan
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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3
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Mendel P, Green HD, Palar K, Kanouse DE, Bluthenthal RN, Mata MA, Oden CW, Derose KP. Congregational involvement in HIV: A qualitative comparative analysis of factors influencing HIV activity among diverse urban congregations. Soc Sci Med 2019; 246:112718. [PMID: 31931449 DOI: 10.1016/j.socscimed.2019.112718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
Abstract
Religious congregations can potentially reach disproportionately affected populations with HIV programming, however, factors that influence congregational involvement in HIV are not well-studied. Utilizing comparative case methods and in-depth qualitative data from a diverse sample of 14 urban congregations, we examine a range of attitudinal, organizational, resource, and demographic factors to systematically identify different case scenarios-i.e., combinations of characteristics-associated with the level and types of HIV activities in which the congregational cases tended to be involved. For example, White or mixed race congregations with active gay constituencies and an African-American congregation with a strong lay HIV champion were among the high HIV involvement case scenarios, compared to African-American congregations with a health emphasis but no lay HIV champion among the medium HIV involvement scenarios, and fundamentalist African-American and Latino congregations among the low HIV involvement scenarios. Two key factors that appeared influential across case scenarios included the existence of lay champions for HIV activities and the general theological orientation of the congregation.
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Affiliation(s)
| | - Harold D Green
- RAND Corporation, Santa Monica, CA, USA; Indiana University, Bloomington, IN, USA
| | - Kartika Palar
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Ricky N Bluthenthal
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Clyde W Oden
- Bethel Oxnard African Methodist Episcopal Church, Oxnard, CA, USA
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4
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Nunn A, Jeffries WL, Foster P, McCoy K, Sutten-Coats C, Willie TC, Ransome Y, Lanzi RG, Jackson E, Berkley-Patton J, Keefer M, Coleman JD. Reducing the African American HIV Disease Burden in the Deep South: Addressing the Role of Faith and Spirituality. AIDS Behav 2019; 23:319-330. [PMID: 31444712 DOI: 10.1007/s10461-019-02631-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nearly half of HIV infections in the United States are concentrated among African Americans, and over half of new HIV infections occur in the South. African Americans have poorer outcomes in the entire continua of HIV and PrEP care. Complex social, structural, and behavioral factors contribute to our nation's alarming racial disparities in HIV infection, particularly in the Deep South. Despite the importance of faith, spirituality and religious practice in the lives of many African Americans, there has been little scientific investment exploring how African Americans' religious participation, faith and spirituality may impact our nation's HIV epidemic. This article summarizes the state of the science on this critical issue. We also identify opportunities for new scholarship on how faith, spirituality and religious participation may impact HIV care continuum outcomes in the South and call for greater federal research investment on these issues.
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Affiliation(s)
- Amy Nunn
- Center for Health Equity Research, Brown University, 121 S. Main St, G-810, Providence, RI, 02903, USA.
- Rhode Island Public Health Institute, Providence, USA.
| | - William L Jeffries
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Antlanta, USA
| | - Pamela Foster
- Department of Community Medicine/Population Health, University of Alabama School of Medicine, Tuscaloosa Regional Campus, Tuscaloosa, USA
| | - Katryna McCoy
- School of Nursing & Health Studies, University of Washington - Bothell, Bothell, USA
| | - Cassandra Sutten-Coats
- Center for Health Equity Research, Brown University, 121 S. Main St, G-810, Providence, RI, 02903, USA
- Rhode Island Public Health Institute, Providence, USA
| | - Tiara C Willie
- Rhode Island Public Health Institute, Providence, USA
- Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, USA
| | - Robin Gaines Lanzi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, USA
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
| | - Edward Jackson
- Center for AIDS Research, University of Alabama at Birmingham, Birmingham, USA
| | | | - Michael Keefer
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA
| | - Jason D Coleman
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, USA
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Kamaara E, Oketch D, Chesire I, Coats CS, Thomas G, Ransome Y, Willie TC, Nunn A. Faith and healthcare providers' perspectives about enhancing HIV biomedical interventions in Western Kenya. Glob Public Health 2019; 14:1744-1756. [PMID: 31390958 DOI: 10.1080/17441692.2019.1647263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Adult HIV prevalence in Kenya was 5.9% in 2017. However, in the counties of Kisumu, Siaya, and Homa Bay, HIV prevalence was over 15%. Biomedical interventions, including home-based testing and counselling (HBTC), HIV treatment and pre-exposure prophylaxis (PrEP) provide opportunities to reduce HIV transmission, particularly in rural communities with limited access to health services. Faith-based institutions play an important role in the Kenyan social fabric, providing over 40% of all health care services in Kenya, but have played limited roles in promoting HIV prevention interventions. We conducted qualitative interviews with 45 medical professionals and focus groups with 93 faith leaders in Kisumu and Busia Counties, Kenya. We explored their knowledge, opinions, and experiences in promoting biomedical HIV prevention modalities, including HBTC and PrEP. Knowledge about and engagement in efforts to promote HIV prevention modalities varied; few health providers had partnered with faith leaders on HIV prevention programmes. Faith leaders and health providers agreed about the importance of increasing faith leaders' participation in HIV prevention and were positive about increasing their HIV prevention partnerships. Most faith leaders requested capacity building to better understand biomedical HIV prevention modalities and expressed interest in collaborating with clinical partners to spread awareness about HIV prevention modalities.
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Affiliation(s)
- Eunice Kamaara
- Department of Philosophy & Religious Studies, Moi University , Eldoret , Kenya
| | - Dismas Oketch
- Kenya Medical Research Institute (KEMRI)/CDC Clinical Research Center , Kisumu , Kenya
| | - Irene Chesire
- Department of Behavioral Science, School of Medicine, Moi University , Eldoret , Kenya
| | - Cassandra Sutten Coats
- Center for Health Equity Research, Brown University School of Public Health , Providence , RI , USA
| | - Gladys Thomas
- Department of Behavioral and Social Science, Brown University School of Public Health , Providence , RI , USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health , Hartford , CT , USA
| | - Tiara C Willie
- Department of Medicine, Brown University Warren Alpert Medical School , Providence , RI , USA
| | - Amy Nunn
- Center for Health Equity Research, Brown University School of Public Health , Providence , RI , USA.,Department of Behavioral and Social Science, Brown University School of Public Health , Providence , RI , USA
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6
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Adimora AA, Goldmon MV, Coyne-Beasley T, Ramirez CB, Thompson GA, Ellis D, Stevenson JL, Williams JM, Howard DL, Godley PA. Black Pastors' Views on preaching about sex: barriers, facilitators, and opportunities for HIV prevention messaging. ETHNICITY & HEALTH 2019; 24:560-574. [PMID: 28670980 DOI: 10.1080/13557858.2017.1346180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Despite the disproportionately high rates of heterosexually transmitted HIV infection among US Blacks and ongoing need for effective inexpensive behavioral interventions, the use of sermons as an HIV prevention tool in Black churches has received little research attention. The Black church plays an important role in Black communities and is a potential ally in development and delivery of sexual risk prevention messages. The objective of this study was to examine Black pastors' thoughts about whether sermons should address issues related to heterosexual relationships - and the barriers and facilitators to discussing these topics in a sermon setting. DESIGN We conducted in-depth semi-structured, individual interviews among 39 pastors of Black churches in North Carolina and analyzed the interview data using thematic analysis strategies based on grounded theory. RESULTS Pastors expressed widely ranging opinions, especially about discussion of condom use, but generally agreed that sermons should discuss marriage, abstinence, monogamy, dating, and infidelity - behaviors that impact sexual networks and HIV transmission. The major barriers to incorporation of these subjects into sermons include the extent to which a concept undermines their religious beliefs and uncertainty about how to incorporate it. However, scriptural support for a prevention message and the pastor's perception that the message is relevant to the congregation facilitate incorporation of related topics into sermons. CONCLUSIONS These findings have implications for the potential utility of sermons as an HIV prevention tool and suggest that it is possible for public health professionals and pastors of Black churches to form partnerships to develop messages that are consonant with pastors' religious convictions as well as public health recommendations.
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Affiliation(s)
- Adaora A Adimora
- a School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- b Cecil G. Sheps Center for Health Services Research , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- c UNC Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | | | - Tamera Coyne-Beasley
- a School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- b Cecil G. Sheps Center for Health Services Research , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Catalina B Ramirez
- a School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | | | - Danny Ellis
- f Ellis Research & Consulting Service , LLC , Wilson , NC , USA
| | | | | | - Daniel L Howard
- i Public Policy Research Institute , Texas A&M University , College Station , TX , USA
- j Department of Sociology , Texas A&M University, College Station , TX , USA
| | - Paul A Godley
- a School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- b Cecil G. Sheps Center for Health Services Research , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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7
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Payán DD, Flórez KR, Bogart LM, Kanouse DE, Mata MA, Oden CW, Derose KP. Promoting Health from the Pulpit: A Process Evaluation of HIV Sermons to Reduce HIV Stigma and Promote Testing in African American and Latino Churches. HEALTH COMMUNICATION 2019; 34:11-20. [PMID: 29053386 PMCID: PMC5927848 DOI: 10.1080/10410236.2017.1384352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Embedding health messages into sermons is a potentially valuable strategy to address HIV and other health disparities in churches that predominantly serve racial and ethnic minorities. This study explores implementation of an HIV sermon as part of a multi-component intervention in three churches (Latino Catholic, Latino Pentecostal, and African American Baptist) in high HIV prevalence areas of Los Angeles County, California. Clergy were given an HIV sermon guide that included local public health data, stigma reduction cues, HIV testing messages, and a sample sermon. Findings are based on a process evaluation (i.e., reach, dose delivered, fidelity, and implementation) and in-depth content analysis to explore HIV frames and messages used by clergy. Sermons were audio-recorded, transcribed verbatim, and coded using an inductive approach. Complementary data were collected through systematic observation. Overall, five clergy delivered nine HIV sermons to majority African American or Latino audiences. On average, 174 congregants were reached per sermon. We found large variation in fidelity to communicating key HIV messages from the sermon guide. While promoting HIV testing from the pulpit seemed viable and acceptable to all the participating clergy, fewer embedded explicit stigma reduction cues. Most spoke about HIV using compassionate and non-judgmental terms, however, issue framing varied across clergy. Structured training of clergy may be necessary to implement the more theoretically driven stigma reduction cues included in the sermon guide. More research is needed on the viability and acceptability of embedding specific health promotion messages into sermons.
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Affiliation(s)
- Denise D. Payán
- School of Social Sciences, Humanities and Arts, University of California, Merced
- Health Program, RAND Corporation
| | - Karen R. Flórez
- Health Program, RAND Corporation
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York
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8
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Ransome Y, Bogart LM, Nunn AS, Mayer KH, Sadler KR, Ojikutu BO. Faith leaders' messaging is essential to enhance HIV prevention among black Americans: results from the 2016 National Survey on HIV in the black community (NSHBC). BMC Public Health 2018; 18:1392. [PMID: 30567530 PMCID: PMC6300012 DOI: 10.1186/s12889-018-6301-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 12/04/2018] [Indexed: 11/17/2022] Open
Abstract
Background To investigate whether religious service attendance and faith leaders’ messages about HIV and same-sex relationships are associated with acceptance of HIV prevention strategies. Methods Multivariable Poisson regression assessed whether attending religious services, faith leaders’ messages about HIV and same-sex relationships, and supportiveness of those messages were associated with HIV testing, as well as knowledge of and willingness to use pre-exposure prophylaxis (PrEP) among 868 Black Americans [45% men; M (SD) = 34 (9) years-old] in the 2016 National Survey on HIV in the Black Community, USA. Results Participants who reported attending services monthly and/or hearing faith leaders’ messages that were supportive of same-sex relationships had a significantly higher likelihood of willingness to use PrEP (adjusted Rate Ratio[ARR] = 1.76; 95% confidence interval [CI] = 1.09, 2.48) and aRR = 2.19; 95% CI = 1.35, 3.55, respectively), independent of HIV risk. Homophobia was significantly associated with higher likelihood of being aware of PrEP and testing for HIV testing in the past 12 months. Conclusions Faith leaders’ messaging can influence Black Americans’ perceptions and uptake of HIV prevention strategies. Faith institutions and faith leaders should be involved in designing and disseminating HIV prevention strategies.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, LEPH, New Haven, CT, 06510, USA.
| | | | - Amy S Nunn
- Brown School of Public Health, Providence, RI, USA
| | - Kenneth H Mayer
- Harvard Medical School and Beth Israel Deaconess Medical Center, and Fenway Health, Boston, MA, USA
| | - Keron R Sadler
- National Association for the Advancement of Colored People (NAACP), Baltimore, MD, USA
| | - Bisola O Ojikutu
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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9
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Bradley ELP, Sutton MY, Cooks E, Washington-Ball B, Gaul Z, Gaskins S, Payne-Foster P. Developing FAITHH: Methods to Develop a Faith-Based HIV Stigma-Reduction Intervention in the Rural South. Health Promot Pract 2018; 19:730-740. [PMID: 29383967 PMCID: PMC6211576 DOI: 10.1177/1524839917754044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human immunodeficiency virus (HIV) disproportionately affects Blacks/African Americans, particularly those residing in the southern United States. HIV-related stigma adversely affects strategies to successfully engage people in HIV education, prevention, and care. Interventions targeting stigma reduction are vital as additional tools to move toward improved outcomes with HIV prevention and care, consistent with national goals. Faith institutions in the South have been understudied as partners in HIV stigma-reduction efforts, and some at-risk, Black/African American communities are involved with southern faith institutions. We describe the collaborative effort with rural, southern faith leaders from various denominations to develop and pilot test Project Faith-based Anti-stigma Initiative Towards Healing HIV/AIDS (FAITHH), an HIV stigma-reduction intervention that built on strategies previously used with other nonrural, Black/African American faith communities. The eight-module intervention included educational materials, myth-busting exercises to increase accurate HIV knowledge, role-playing, activities to confront stigma, and opportunities to develop and practice delivering a sermon about HIV that included scripture-based content and guidance. Engaging faith leaders facilitated the successful tailoring of the intervention, and congregation members were willing participants in the research process in support of increased HIV awareness, prevention, and care.
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Affiliation(s)
- Erin L P Bradley
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Madeline Y Sutton
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Cooks
- 2 University of Alabama, Tuscaloosa, AL, USA
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10
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Nunn A, Parker S, McCoy K, Monger M, Bender M, Poceta J, Harvey J, Thomas G, Johnson K, Ransome Y, Sutten Coats C, Chan P, Mena L. African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi. Ethn Dis 2018; 28:85-92. [PMID: 29725192 DOI: 10.18865/ed.28.2.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Mississippi has some of the most pronounced racial disparities in HIV infection in the country; African Americans comprised 37% of the Mississippi population but represented 80% of new HIV cases in 2015. Improving outcomes along the HIV care continuum, including linking and retaining more individuals and enhancing adherence to medication, may reduce the disparities faced by African Americans in Mississippi. Little is understood about clergy's views about the HIV care continuum. We assessed knowledge of African American pastors and ministers in Jackson, Mississippi about HIV and the HIV care continuum. We also assessed their willingness to promote HIV screening and biomedical prevention technologies as well as efforts to enhance linkage and retention in care with their congregations. Four focus groups were conducted with 19 African American clergy. Clergy noted pervasive stigma associated with HIV and believed they had a moral imperative to promote HIV awareness and testing; they provided recommendations on how to normalize conversations related to HIV testing and treatment. Overall, clergy were willing to promote and help assist with linking and retaining HIV positive individuals in care but knew little about how HIV treatment can enhance prevention or new biomedical technologies such as pre-exposure prophylaxis (PrEP). Clergy underscored the importance of building coalitions to promote a collective local response to the epidemic. The results of this study highlight important public health opportunities to engage African American clergy in the HIV care continuum in order to reduce racial disparities in HIV infection.
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Affiliation(s)
- Amy Nunn
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Sharon Parker
- Department of Sociology and Social Work, North Carolina Agriculture and Technology State University, Greensboro, North Carolina
| | - Katryna McCoy
- University of Washington Bothell, School of Nursing & Health Studies, Bothell, Washington
| | - Mauda Monger
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Melverta Bender
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Joanna Poceta
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Julia Harvey
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Gladys Thomas
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Kendra Johnson
- Mississippi State Department of Health, Jackson, Mississippi
| | - Yusuf Ransome
- Yale School of Public Health, New Haven, Connecticut
| | - Cassandra Sutten Coats
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island
| | - Phil Chan
- Warren Alpert Medical School of Brown University, Providence, Rhode Island.,The Miriam Hospital, Providence, Rhode Island
| | - Leandro Mena
- University of Mississippi Medical Center, Jackson, Mississippi
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11
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Flórez KR, Payán DD, Derose KP, Aunon FM, Bogart LM. Process Evaluation of a Peer-Driven, HIV Stigma Reduction and HIV Testing Intervention in Latino and African American Churches. Health Equity 2017; 1:109-117. [PMID: 30283840 PMCID: PMC6071886 DOI: 10.1089/heq.2017.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose: Faith-based organizations may be effective in addressing HIV-related disparities, but few interventions have been implemented across diverse churches. The Facilitating Awareness to Increase Testing for HIV (FAITH) intervention harnessed peer leadership to decrease HIV stigma and promote HIV testing in African American and Latino congregations. A pilot study found more consistent effects among Latino congregations. This process evaluation evaluates implementation of FAITH to better understand the pilot study's findings. Methods: Data sources included HIV education and peer leader workshop evaluation forms, participant views of the community's perspective of HIV, and peer leader follow-up interviews. Data were triangulated with systematic observation notes and analyzed using process-related themes of recruitment, reach, context, implementation, dose-delivered, and fidelity. Results: At the Latino churches (compared to the African American church), facilitators spent more time addressing community-based misconceptions about HIV. The peer leader model was well received, especially among Latino participants, and most said that after the workshop they felt comfortable speaking with others about HIV-related topics. Latino peer leaders reported speaking with up to 20 people within their social networks (particularly with family members); African Americans reported up to 4. Implementation challenges at the African American church may have contributed to the limited intervention effects. Nevertheless, we found the peer motivator model feasible and acceptable across diverse faith settings. Conclusion: Peer-based models within faith settings are promising for addressing HIV. However, differences among groups in HIV knowledge, social network characteristics and norms, and church preferences may influence overall effectiveness.
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Affiliation(s)
- Karen R Flórez
- CUNY Graduate School of Public Health and Health Policy, New York, New York.,RAND Corporation, Santa Monica, California
| | - Denise D Payán
- RAND Corporation, Santa Monica, California.,UCLA Fielding School of Public Health, Los Angeles, California
| | | | - Frances M Aunon
- Department of Psychology, University of Washington, Seattle, Washington
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12
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Jeffries WL, Sutton MY, Eke AN. On the Battlefield: The Black Church, Public Health, and the Fight against HIV among African American Gay and Bisexual Men. J Urban Health 2017; 94:384-398. [PMID: 28409359 PMCID: PMC5481215 DOI: 10.1007/s11524-017-0147-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
HIV affects African American gay and bisexual men (AAGBM) more disproportionately than any other group in the USA. The Black Church, which has been a historic mainstay for African American empowerment and well-being, has the potential to be a public health partner for HIV prevention with AAGBM. Public health partnerships with the Black Church can strengthen HIV prevention efforts with AAGBM by [1] adapting church-based prevention strategies developed for other African American subgroups [2], providing prevention and referral services [3], considering how scripture supports prevention efforts, and [4] emphasizing the tenets of liberation theology. Public health should consider how thoughtful engagement, research, and interventions can support these approaches. Developing partnerships with the Black Church and African American clergy can promote effective HIV prevention efforts for AAGBM.
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Affiliation(s)
- William L Jeffries
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Agatha N Eke
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
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13
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Aholou TM, Cooks E, Murray A, Sutton MY, Gaul Z, Gaskins S, Payne-Foster P. "Wake Up! HIV is at Your Door": African American Faith Leaders in the Rural South and HIV Perceptions: A Qualitative Analysis. JOURNAL OF RELIGION AND HEALTH 2016; 55:1968-1979. [PMID: 26883229 DOI: 10.1007/s10943-016-0193-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In Alabama, 70 % of new HIV cases are among African Americans. Because the Black Church plays an important role for many African Americans in the south, we conducted qualitative interviews with 10 African American pastors recruited for an HIV intervention study in rural Alabama. Two main themes emerged: (1) HIV stigma is prevalent and (2) the role of the Black Church in addressing HIV in the African American community. Our data suggest that pastors in rural Alabama are willing to be engaged in HIV prevention solutions; more formalized training is needed to decrease stigma, strengthen HIV prevention and support persons living with HIV/AIDS.
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Affiliation(s)
- Tiffiany M Aholou
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
| | - Eric Cooks
- University of Alabama, Tuscaloosa, AL, USA
| | - Ashley Murray
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Zaneta Gaul
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
- ICF International, Atlanta, GA, USA
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14
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Stewart JM, Hanlon A, Brawner BM. Predictors of HIV/AIDS Programming in African American Churches: Implications for HIV Prevention, Testing, and Care. HEALTH EDUCATION & BEHAVIOR 2016; 44:385-393. [PMID: 27540035 DOI: 10.1177/1090198116663695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using data from the National Congregational Study, we examined predictors of having an HIV/AIDS program in predominately African American churches across the United States. We conducted regression analyses of Wave II data ( N = 1,506) isolating the sample to churches with a predominately African American membership. The dependent variable asked whether or not the congregation currently had any program focused on HIV or AIDS. Independent variables included several variables from the individual, organizational, and social levels. Our study revealed that region, clergy age, congregant disclosure of HIV-positive status, permitting cohabiting couples to be members, sponsorship or participation in programs targeted to physical health issues, and having a designated person or committee to address health-focused programs significantly increased the likelihood of African American churches having an HIV/AIDS program. A paucity of nationally representative research focuses on the social-, organizational-, and individual-level predictors of having HIV/AIDS programs in African American churches. Determining the characteristics of churches with HIV/AIDS programming at multiple levels is a critical and necessary approach with significant implications for partnering with African American churches in HIV or AIDS initiatives.
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Affiliation(s)
| | - Alexandra Hanlon
- 2 University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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15
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Derose KP, Kanouse DE, Bogart LM, Griffin BA, Haas A, Stucky BD, Williams MV, Flórez KR. Predictors of HIV-related stigmas among African American and Latino religious congregants. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2016; 22:185-95. [PMID: 26213890 PMCID: PMC4729667 DOI: 10.1037/cdp0000062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To inform church-based stigma interventions by exploring dimensions of HIV stigma among African American and Latino religious congregants and determining how these are related to drug addiction and homosexuality stigmas and knowing someone HIV-positive. METHOD In-person, self-administered surveys of congregants 18+ years old across 2 African American and 3 Latino churches (n = 1,235, response rate 73%) in a western U.S. city with high HIV prevalence. Measures included 12 items that captured dimensions of HIV stigma, a 5-item scale that assessed attitudes toward people who are addicted to drugs, a 7-item scale assessing attitudes toward homosexuality, and questions regarding sociodemographics and previous communication about HIV. RESULTS Of the survey participants, 63.8% were women, mean age was 40.2 years, and 34.4% were African American, 16.8% were U.S.-born Latinos, 16.0% were foreign-born, English-speaking Latinos, and 32.9% were foreign-born, Spanish-speaking Latinos. Exploratory and confirmatory factor analyses identified 4 dimensions of HIV stigma: discomfort interacting with people with HIV (4 items, α = .86), feelings of shame "if you had HIV" (3 items, α = .78), fears of rejection "if you had HIV" (3 items, α = .71), and feelings of blame toward people with HIV (2 items, α = .65). Across all dimensions, after controlling for sociodemographic characteristics and previous communication about HIV, knowing someone with HIV was associated with lower HIV stigma, and greater stigma concerning drug addiction and homosexuality were associated with higher HIV stigma. CONCLUSIONS Congregation-based HIV stigma reduction interventions should consider incorporating contact with HIV-affected people. It may also be helpful to address attitudes toward drug addiction and sexual orientation. (PsycINFO Database Record
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Affiliation(s)
| | | | - Laura M. Bogart
- Department of Pediatrics, Children’s Hospital Boston and Harvard Medical School, Boston, MA
| | | | - Ann Haas
- RAND Corporation, Pittsburgh, PA
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16
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Nunn A, Sanders J, Carson L, Thomas G, Cornwall A, Towey C, Lee H, Tasco M, Shabazz-El W, Yolken A, Smith T, Bell G, Feller S, Smith E, James G, Shelton Dunston B, Green D. African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment, and care: results from a community-based participatory research project in Philadelphia, Pennsylvania. Health Promot Pract 2014; 16:91-100. [PMID: 24879446 DOI: 10.1177/1524839914534855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is 5 times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended that (a) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders, (b) local HIV-prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission, (c) resources should be distributed to the most heavily affected neighborhoods of Philadelphia, and (d) faith institutions should play a critical role in HIV testing, treatment, and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This community-based participatory research case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change.
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Affiliation(s)
- Amy Nunn
- The Miriam Hospital, Providence, RI, USA
| | | | - Lee Carson
- Black Gay Men's Leadership Council, Philadelphia, PA, USA
| | | | | | | | | | - Marian Tasco
- Philadelphia City Council, Philadelphia, PA, USA
| | | | | | - Tyrone Smith
- Black Gay Men's Leadership Council, Philadelphia, PA, USA
| | - Gary Bell
- Bebashi, Inc., Philadelphia, PA, USA
| | | | | | - George James
- Council for Relationships, Philadelphia, PA, USA
| | | | - Derek Green
- Philadelphia City Council, Philadelphia, PA, USA
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