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Journal of Religion and Health

, Volume 55, Issue 6, pp 1968–1979 | Cite as

“Wake Up! HIV is at Your Door”: African American Faith Leaders in the Rural South and HIV Perceptions: A Qualitative Analysis

  • Tiffiany M. AholouEmail author
  • Eric Cooks
  • Ashley Murray
  • Madeline Y. Sutton
  • Zaneta Gaul
  • Susan Gaskins
  • Pamela Payne-Foster
Original Paper

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.

Keywords

Black Church African Americans HIV Stigma Rural south 

Notes

Acknowledgments

This study was funded in part by the Centers for Disease Control and Prevention, Program Announcement PS11-003; 5U01PS003320. We thank all of the ministerial liaisons and pastors who participated in this study.

Compliance with Ethical Standards

Conflicts of interest

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors have no financial conflicts of interest relevant to this study.

References

  1. Agate, L. L., Cato-Watson, D. M., Mullins, J. M., Scott, G. S., Rolle, V., Markland, D., & Roach, D. L. (2005). Churches United to Stop HIV (CUSH): A faith-based HIV prevention initiative. Journal of the National Medical Association, 97(7 Suppl), 60S.PubMedPubMedCentralGoogle Scholar
  2. Aholou, T. M. C., Gale, J. E., & Slater, L. M. (2011). African American clergy share perspectives on addressing sexual health and HIV prevention in premarital counseling: A pilot study. Journal of Religion and Health, 50(2), 330–347. doi: 10.1007/s10943-009-9257-7.CrossRefPubMedGoogle Scholar
  3. Berkley-Patton, J., Bowe-Thompson, C., Bradley-Ewing, A., Hawes, S., Moore, E., Williams, E., & Goggin, K. (2010). Taking it to the pews: A CBPR-guided HIV awareness and screening project with black churches. AIDS Education and Prevention, 22(3), 218. doi: 10.1521/aeap.2010.22.3.218.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Berkley-Patton, J. Y., Moore, E., Berman, M., Simon, S. D., Thompson, C. B., Schleicher, T., & Hawes, S. M. (2013). Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention. Journal of the International AIDS Society, 16(3 Suppl 2), 18644. doi: 10.7448/IAS.16.3.18644.PubMedPubMedCentralGoogle Scholar
  5. Blank, M. B., Mahmood, M., Fox, J. C., & Guterbock, T. (2002). Alternative mental health services: The role of the Black Church in the South. American Journal of Public Health, 92(10), 1668–1672. doi: 10.2105/AJPH.92.10.1668.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Bluthenthal, R. N., Palar, K., Mendel, P., Kanouse, D. E., Corbin, D. E., & Derose, K. P. (2012). Attitudes and beliefs related to HIV/AIDS in urban religious congregations: Barriers and opportunities for HIV-related interventions. Social Science and Medicine, 74(10), 1520–1527. doi: 10.1016/j.socscimed.2012.01.020.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Bogart, L. M., Cowgill, B. O., Kennedy, D., Ryan, G., Murphy, D. A., Elijah, J., & Schuster, M. A. (2008). HIV-related stigma among people with HIV and their families: A qualitative analysis. AIDS and Behavior, 12(2), 244–254. doi: 10.1007/s10461-007-9231-x.CrossRefPubMedGoogle Scholar
  8. Centers for Disease Control and Prevention. (2014). Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas—2012. HIV surveillance supplemental report 2014, Vol. 19, No. 3. http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed 26 March 2015.
  9. Centers for Disease Control and Prevention. (2015). HIV surveillance report 2013, Vol. 25. http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed 26 March 2015.
  10. Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., & Fleming, T. R. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine, 365(6), 493–505. doi: 10.1056/NEJMoa1105243.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Coleman, J. D., Lindley, L. L., Annang, L., Saunders, R. P., & Gaddist, B. (2012). Development of a framework for HIV/AIDS prevention programs in African American churches. AIDS Patient Care and STDs, 26(2), 116–124. doi: 10.1089/apc.2011.0163.CrossRefPubMedGoogle Scholar
  12. Cotton, S., Puchalski, C. M., Sherman, S. N., Mrus, J. M., Peterman, A. H., Feinberg, J., & Tsevat, J. (2006). Spirituality and religion in patients with HIV/AIDS. Journal of General Internal Medicine, 21(S5), S5–S13. doi: 10.1111/j.1525-1497.2006.00642.x.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Division of HIV/AIDS Prevention and Control, Alabama Department of Public Health. (2011). HIV/AIDS Integrated Epidemiological Profile. https://www.adph.org/aids/assets/IntegratedEpiProfile2011.pdf. Accessed 28 January 2015.
  14. Division of HIV/AIDS Prevention and Control, Alabama Department of Public Health. (2014). HIV 4th Quarter. http://adph.org/aids/assets/HIV4thQuarter2014(Demo).pdf. Accessed 28 January 2015.
  15. Eke, A. N., Wilkes, A. L., & Gaiter, J. (2010). Organized religion and the fight against HIV/AIDS in the black community: The role of the Black Church. In D. H. McCree, M. Kenneth Terrill Jones, & A. O’Leary (Eds.), African Americans and HIV/AIDS: Understanding and addressing the epidemic (pp. 53–68). New York, NY: Springer.CrossRefGoogle Scholar
  16. Emlet, C. A. (2007). Experiences of stigma in older adults living with HIV/AIDS: A mixed-methods analysis. AIDS Patient Care and STDs, 21(10), 740–752. doi: 10.1089/apc.2007.0010.CrossRefPubMedGoogle Scholar
  17. Foster, P. P., Cooper, K., Parton, J. M., & Meeks, J. O. (2011). Assessment of HIV/AIDS prevention of rural African American Baptist leaders: Implications for effective partnerships for capacity building in American communities. Journal of the National Medical Association, 103(4), 323–331.CrossRefPubMedGoogle Scholar
  18. Foster, P. P., & Gaskins, S. W. (2009). Older African Americans’ management of HIV/AIDS stigma. AIDS Care, 21(10), 1306–1312. doi: 10.1080/09540120902803141.CrossRefPubMedGoogle Scholar
  19. Gielen, A. C., O’campo, P., Faden, R. R., & Eke, A. (1997). Women’s disclosure of HIV status: Experiences of mistreatment and violence in an urban setting. Women and Health, 25(3), 19–31. doi: 10.1300/J013v25n03_02.CrossRefPubMedGoogle Scholar
  20. Goffman, E. (1963). Stigma. notes on the management of spoiled identity. New York: Simon and Shuster.Google Scholar
  21. Golub, S. A., Operario, D., & Gorbach, P. M. (2010). Pre-exposure prophylaxis state of the science: Empirical analogies for research and implementation. Current HIV/AIDS Reports, 7(4), 201–209. doi: 10.1007/s11904-010-0057-1.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Guest, G., MacQueen, K. M., & Namey, E. E. (2011). Applied thematic analysis. Thousand Oaks: Sage.Google Scholar
  23. Guest, G., & McLellan, E. (2003). Distinguishing the trees from the forest: Applying cluster analysis to thematic qualitative data. Field Methods, 15(2), 186–201. doi: 10.1177/1525822X03015002005.CrossRefGoogle Scholar
  24. Heckman, B. D. (2006). Psychosocial differences between whites and African Americans living with HIV/AIDS in rural areas of 13 US states. The Journal of Rural Health, 22(2), 131–139.CrossRefPubMedGoogle Scholar
  25. Herek, G. M., Capitanio, J. P., & Widaman, K. F. (2002). HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991–1999. American Journal of Public Health, 92(3), 371–377. doi: 10.2105/AJPH.92.3.371.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Hicks, K. E., Allen, J. A., & Wright, E. M. (2005). Building holistic HIV/AIDS responses in African American urban faith communities: A qualitative, multiple case study analysis. Family & Community Health, 28(2), 184–205.CrossRefGoogle Scholar
  27. Hruschka, D. J., Schwartz, D., John, D. C. S., Picone-Decaro, E., Jenkins, R. A., & Carey, J. W. (2004). Reliability in coding open-ended data: Lessons learned from HIV behavioral research. Field Methods, 16(3), 307–331. doi: 10.1177/1525822X04266540.CrossRefGoogle Scholar
  28. Ironson, G., Stuetzle, R., & Fletcher, M. A. (2006). An increase in religiousness/spirituality occurs after HIV diagnosis and predicts slower disease progression over 4 years in people with HIV. Journal of General Internal Medicine, 21(S5), S62–S68. doi: 10.1111/j.1525-1497.2006.00648.x.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Jeffries, W. L, I. V., Townsend, E. S., Gelaude, D. J., Torrone, E. A., Gasiorowicz, M., & Bertolli, J. (2015). HIV stigma experienced by young men who have sex with men (MSM) living with HIV infection. AIDS Education and Prevention, 27(1), 58–71. doi: 10.1521/aeap.2015.27.1.58.CrossRefPubMedGoogle Scholar
  30. Lemelle, A. (2004). African American attitudes toward gay males: Faith-based initiatives and implications for HIV/AIDS services. Journal of African American Studies, 7(4), 59–74. doi: 10.1007/s12111-004-1019-8.CrossRefGoogle Scholar
  31. Lincoln, C. E., & Mamiya, L. H. (1990). The Black Church in the African American experience. Durham, NC: Duke University Press.CrossRefGoogle Scholar
  32. Lindley, L. L., Coleman, J. D., Gaddist, B. W., & White, J. (2010). Informing faith-based HIV/AIDS interventions: HIV-related knowledge and stigmatizing attitudes at Project FAITH churches in South Carolina. Public Health Reports, 125(Suppl 1), 12. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788404/.
  33. Litwinczuk, K. M., & Groh, C. J. (2007). The relationship between spirituality, purpose in life, and well-being in HIV-positive persons. Journal of the Association of Nurses in AIDS Care, 18(3), 13–22. doi: 10.1016/j.jana.2007.03.004.CrossRefPubMedGoogle Scholar
  34. Lorenz, K., Hays, R. D., Shapiro, M. F., Cleary, P., Asch, S. M., & Wenger, N. S. (2005). Religiousness and spirituality among HIV-infected Americans. Journal of Palliative Medicine, 8(4), 774–781. doi: 10.1089/jpm.2005.8.774.CrossRefPubMedGoogle Scholar
  35. Moore, D., Onsomu, E. O., Timmons, S. M., Abuya, B. A., & Moore, C. (2012). Communicating HIV/AIDS through African American churches in North Carolina: Implications and recommendations for HIV/AIDS faith-based programs. Journal of Religion and Health, 51(3), 865–878. doi: 10.1007/s10943-010-9396-x.CrossRefPubMedGoogle Scholar
  36. National Association for the Advancement of Colored People (NAACP). (2014). The Black Church and HIV: The social justice imperative. http://www.theblackchurchandHIV.org. Accessed 28 January 2015.
  37. Nunn, A., Cornwall, A., Chute, N., Sanders, J., Thomas, G., James, G., & Flanigan, T. (2012). Keeping the faith: African American faith leaders’ perspectives and recommendations for reducing racial disparities in HIV/AIDS infection. PLoS One, 7(5), e36172. doi: 10.1371/journal.pone.0036172.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Nunn, A., Cornwall, A., Thomas, G., Callahan, P. L., Waller, P. A., Friend, R., & Flanigan, T. (2013). What’s God got to do with it? Engaging African-American faith-based institutions in HIV prevention. Global Public Health, 8(3), 258–269. doi: 10.1080/17441692.2012.759608.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Poindexter, C. C., & Linsk, N. L. (1999). HIV-related stigma in a sample of HIV-affected older female African American caregivers. Social Work, 44(1), 46–61. doi: 10.1093/sw/44.1.46.CrossRefPubMedGoogle Scholar
  40. Siegel, K., & Schrimshaw, E. W. (2002). The perceived benefits of religious and spiritual coping among older adults living with HIV/AIDS. Journal for the Scientific Study of Religion, 41(1), 91–102. doi: 10.1111/1468-5906.00103.CrossRefGoogle Scholar
  41. Simoni, J. M., Martone, M. G., & Kerwin, J. F. (2002). Spirituality and psychological adaptation among women with HIV/AIDS: Implications for counseling. Journal of Counseling Psychology, 49(2), 139. doi: 10.1037/0022-0167.49.2.139.CrossRefGoogle Scholar
  42. Smith, J., Simmons, E., & Mayer, K. H. (2005). HIV/AIDS and the black church: What are the barriers to prevention services? Journal of the National Medical Association, 97(12), 1682–1685.PubMedPubMedCentralGoogle Scholar
  43. Stall, R., Hoff, C., Coates, T. J., Paul, J., Phillips, K. A., Ekstrand, M., & Diaz, R. (1996). Decisions to get HIV tested and to accept antiretroviral therapies among gay/bisexual men: Implications for secondary prevention efforts. JAIDS Journal of Acquired Immune Deficiency Syndromes, 11(2), 151–160. doi: 10.1097/00042560-199602010-00006.CrossRefGoogle Scholar
  44. Stroman, C. A. (2005). Disseminating HIV/AIDS information to African Americans. Journal of Health Care for the Poor and Underserved, 16(4), 24–37. doi: 10.1353/hpu.2005.0085.CrossRefPubMedGoogle Scholar
  45. Sutton, M. Y., & Parks, C. P. (2013). HIV/AIDS prevention, faith, and spirituality among Black/African American and Latino Communities in the United States: Strengthening scientific faith-based efforts to shift the course of the epidemic and reduce HIV-related health disparities. Journal of Religion and Health, 52(2), 514–530. doi: 10.1007/s10943-011-9499-z.CrossRefPubMedGoogle Scholar
  46. The White House Office of National AIDS Policy. (2010). National HIV/AIDS strategy for the United States. Retrieved from http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf.
  47. Tullos, A. (2004). The Black Belt. Retrieved April 3, 2015, from http://southernspaces.org/2004/black-belt.
  48. U.S. Census Bureau. (2013). United States Census Bureau State & county quick facts: Alabama. United States Census Bureau. http://quickfacts.census.gov/qfd/states/01000.html.
  49. Vyavaharkar, M., Moneyham, L., Corwin, S., Saunders, R., Annang, L., & Tavakoli, A. (2010). Relationships between stigma, social support, and depression in HIV-infected African American women living in the rural southeastern united states. Journal of the Association of Nurses in AIDS Care, 21(2), 144–152. doi: 10.1016/j.jana.2009.07.008.CrossRefPubMedGoogle Scholar
  50. Webster, G. R., & Bowman, J. (2008). Quantitatively delineating the black belt geographic region. Southeastern Geographer, 48(1), 3–18. doi: 10.1353/sgo.0.0007.CrossRefGoogle Scholar
  51. Wooster, J., Eshel, A., Moore, A., Mishra, M., Toledo, C., Uhl, G., & Aguero, L. W. (2011). Opening up their doors: Perspectives on the involvement of the African American faith community in HIV prevention in four communities. Health Promotion Practice, 12(5), 769–778. doi: 10.1177/1524839910362313.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York (outside the USA) 2016

Authors and Affiliations

  • Tiffiany M. Aholou
    • 1
    Email author
  • Eric Cooks
    • 2
  • Ashley Murray
    • 1
  • Madeline Y. Sutton
    • 1
  • Zaneta Gaul
    • 1
    • 3
  • Susan Gaskins
    • 2
  • Pamela Payne-Foster
    • 2
  1. 1.Division of HIV/AIDS PreventionCenters for Disease Control and PreventionAtlantaUSA
  2. 2.University of AlabamaTuscaloosaUSA
  3. 3.ICF InternationalAtlantaUSA

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