When asked about the main challenges in the lives of members in their congregation, very few people mention HIV. This points to the fact that few people are immediately concerned with HIV. This finding is in line with the fact that there is no one who is publicly known to be HIV+ in any of the three congregations. Perceptions of the seriousness of HIV vary markedly between respondents. Looking at the whole sample, the survey respondents mildly disagreed with the statement “I feel that HIV is an issue in my congregation”. Respondents generally agreed with the statement “I feel that HIV is an issue in my community”, however. Respondents strongly agreed with the statement “I feel that HIV is an issue in South Africa”. This indicates that HIV is generally accepted as a concern. However, HIV is seen as a concern for others, rather than for one’s own congregation.
Another indicator of HIV awareness is the number of people who reported having had an HIV test. In total, 76% of respondents said they had been tested at least once. The percentage in Ocean View and amongst clergy is close to the total sample, 75% and 73%, respectively, while it is somewhat lower in Constantia (64%) and much higher in Lentegeur (93%). Even though the reasons for getting an HIV test are many, from routine check-ups in antenatal care to compulsory HIV tests in certain lines of work, the large extent to which people have had HIV tests shows that many people have come into close contact with HIV issues. This is confirmed in the interview material in which respondents stress the anxiety that an HIV test entails as one is necessarily forced to consider whether one could have contracted the virus.
In Ocean View, 19 out of the 32 survey respondents (59%) reported that HIV is talked about in the congregation. If one assumes that HIV talk can only address questions of HIV if it is noted and thus adds the four participants who answered that they do not know whether HIV is spoken of to the nine voices saying that HIV was not addressed, it appears that roughly half of the people see the church to engage in HIV talk. This finding is confirmed in the other three contexts.
The divergent assessments are rooted in different ideas of what constitutes HIV talk. From the interview material, it becomes clear that HIV is mostly addressed around and on World AIDS day on December 1. HIV is also mentioned in services and particularly in the sermon at times. When HIV is talked about, it is most often to raise awareness and to promote acceptance of and compassion towards people living with HIV. However, survey respondents in Ocean View and Constantia also reported that HIV was at times talked about as a concern chiefly for other people.
During the period of participant observation, HIV was mentioned twice in St. Clare. The first time, HIV was mentioned in connection with the introduction of the researcher and the research project. On that occasion HIV + individuals were offered confidential counselling. The other time was in intercession on Mother’s Day, 9 May 2016, when prayer included all mothers infected with HIV.
HIV is, however, rather mentioned than talked about. Survey participants see the unwillingness to seriously engage HIV to be rooted in the sensitive nature of the topic. People are afraid to address the issue, because of stigma, taboo, and ignorance. There is also the feeling that HIV is not relevant as it affects others. One of the apparent wants in the local Anglican Church is that HIV is not publicly self-disclosed. There is agreement among interviewees from Ocean View, Lentegeur, and Constantia that people do not feel comfortable disclosing their status publicly in the local church. The absence of self-disclosures adds to the feeling that HIV is an issue that chiefly pertains to others.
The situation regarding practical HIV work is similar to that of HIV talk. The HIV Task Team in Ocean View was formed 2008 with the purpose to provide counselling, support, and care for people and families infected with and affected by HIV. The team also provided food support for people living with HIV. However, no one from the congregation came to disclose their status or to receive counselling, either because there was no need or due to an unwillingness to disclose one’s status. The team subsequently decided to broaden the scope of its commitment in social issue and got involved in three general foster homes. In 2014, it was decided to rename the group to Task Team, thus dropping the HIV.
The experience from Ocean View is mirrored in both Lentegeur and Constantia. Also Christ the Saviour had an HIV Task Team which was eventually discontinued as members became involved in other projects, even though the Women’s Ministry continues to engage in food support for people living with HIV. The same happened to the HIV projects at Christ Church. The fact that of the 92 HIV Task Groups that were active in 2005 only 37 continued to be active in 2015 shows that this is a more general phenomenon (Kareithi et al. 2005; Fikelela AIDS Project 2015).
While HIV awareness is important in breaking the silence around HIV, it is equally important what is said and how HIV is understood. In the local Anglican Church, HIV is clearly associated with certain groups, lifestyles, and contexts. These groupings generally describe groups of people who are seen to either have HIV or to be especially at risk of contracting the virus.
During interviews people linked HIV most often to people who sell sex and to promiscuity. The sexual nature of HIV transmission is thus emphasised. Other groups seen as likely to be exposed to HIV are drug users, often because drug use is seen to lead to unprotected and imprudent sex. Interviewees also make a connection between people who sell sex and drug users. Prostitution is understood to be related to poverty, which together with homosexuality, lack of education, and unemployment leads to people being exposed to HIV. Importantly, some interviewees report that people see HIV to only happen to others; the poor, the unemployed, and the badly educated, who sell sex, use drugs, and are generally promiscuous. Other interviewees perceive everybody as being exposed to HIV and understand the virus to affect all people equally. A third assessment relates HIV to the innocent victims of rape, abuse, or unfaithful spouses. Also children are seen to be the innocent victims of HIV.
The survey results confirm the interview findings. In the parish of St. Clare of Assisi, people exposed to HIV are most often perceived to be drug users, those engaging in unprotected sex, and those being unaware of the virus. The results from the parish of Christ the Saviour and Christ Church are similar to respondents focussing on people engaging in unprotected sex, drug use, and promiscuity in Christ the Saviour and unprotected sex and unfaithful partners in Constantia. The clergy deviate from this pattern to some degree with the three groups being seen as most exposed to HIV being young women, the poor, and youth.
Interview participants are well aware of HIV stigma, and many see it as an immense challenge in the HIV response. Stigma is identified as being rooted in a lack of education and knowledge, and ultimately in fear generally and the fear of contagion in particular. Anticipated stigma is strong in St. Clare with participants expecting people to gossip and thus single out HIV+ members of the community, to avoid sitting next to an HIV+ person, to eschew holding the hand of an HIV+ person during the peace, and to refuse to drink from the challis if they expect that an HIV+ person drank from it. The label “being HIV” leads to ostracism and social isolation.
Many interviewees commented also on the availability of HIV information and education, as well as HIV treatment and support. HIV help and medication are perceived as being accessible and available. Availability leads to the idea that no one has an excuse not to know. With the available education, HIV is seen as a choice. Condoms are felt to be freely available in a number of places. There is, however, the feeling that people do not want to listen to education, that especially young people are not taking the opportunity, and that even though everyone knows about HIV prevention and the importance of using condoms, people refuse to follow the good advice. Interviewees suggest that it is through a lifestyle of clubbing and drugs that people are being infected. In other words, HIV + people have to blame themselves and accept the consequences of their actions. Responsibility is shifted to the infected person, and blame is assigned to those who should have known better.