Current HIV/AIDS Reports

, Volume 10, Issue 4, pp 324–332

Spirituality and Religion among HIV-Infected Individuals

Behavioral Aspects of HIV Management (RJ DiClemente and JL Brown, Section Editors)

Abstract

Spirituality and religion are important to many people living with HIV (PLWH). Recent research has focused on special populations (ethnic-minorities, women, and youth), spirituality/religion measurement, mediating/moderating mechanisms, and individual and community-level interventions. Spirituality/religion in PLWH has been refined as a multidimensional phenomenon, which improves health/quality of life directly and through mediating factors (healthy behaviors, optimism, social support). Spirituality/religion helps people to cope with stressors, especially stigma/discrimination. Spiritual interventions utilizing the power of prayer and meditation and addressing spiritual struggle are under way. Faith-based community interventions have focused on stigma and could improve individual outcomes through access to spiritual/social support and care/treatment for PLWA. Community engagement is necessary to design/implement effective and sustainable programs. Future efforts should focus on vulnerable populations; utilize state-of-the-art methods (randomized clinical trials, community-based participatory research); and, address population-specific interventions at individual and community levels. Clinical and policy implications across geographic settings also need attention.

Keywords

Spirituality Religion Religiosity Faith Religious organizations Faith-based organizations HIV AIDS People living with HIV Outcomes Well-being Quality of life Stress Coping Social support Spiritual support Spiritual health Spiritual well-being Stigma 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Szaflarski M, Ritchey PN, Leonard AC, et al. Modeling the effects of spirituality/religion on patients’ perceptions of living with HIV/AIDS. J Gen Intern Med. 2006;21 Suppl 5:S28–S38.PubMedCrossRefGoogle Scholar
  2. 2.
    Trevino KM, Pargament KI, Cotton S, et al. Religious coping and physiological, psychological, social, and spiritual outcomes in patients with HIV/AIDS: cross-sectional and longitudinal findings. AIDS Behav. 2010;14:379–89.PubMedCrossRefGoogle Scholar
  3. 3.
    Tsevat J, Leonard AC, Szaflarski M, et al. Change in quality of life after being diagnosed with HIV: a multicenter longitudinal study. AIDS Patient Care STDs. 2009;23:931–7.PubMedCrossRefGoogle Scholar
  4. 4.
    •• Vance DE, Brennan M, Enah C, Smith GL, Kaur J. Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic. Clin Intervent Aging. 2011;6:101–9. This paper draws attention to the aging HIV epidemic and proposes a model of successful aging that incorporates spirituality/religion as a coping mechanism as well as a source of stress. Implications for practice are discussed. CrossRefGoogle Scholar
  5. 5.
    •• Szaflarski M, Kudel I, Cotton S, et al. Multidimensional assessment of spirituality/religion in patients with HIV: conceptual framework and empirical refinement. J Relig Health. 2012;51:1239–60. This study refines the conceptualization and measurement of spirituality/religion in PLWH using the conceptual framework underlying the Brief Multidimensional Measure of Religiousness/Spirituality, a “gold standard”. A collective of 56 spirituality and religion items were analyzed by using confirmatory factor analysis. Results suggest 8 dimensions of spirituality/religion that are salient in PLWH. PubMedCrossRefGoogle Scholar
  6. 6.
    Dalmida SG, Holstad MM, DiIorio C, Laderman G. The meaning and use of spirituality among African American women living with HIV/AIDS. West J Nurs Res. 2012;34:736–65.PubMedCrossRefGoogle Scholar
  7. 7.
    Koenig HG. Medicine, religion, and health: Where science and spirituality meet. West Conshohocken: Templeton Foundation Press; 2008.Google Scholar
  8. 8.
    Koenig HG, McCullough ME, Larson DB. Handbook of religion and health. Oxford: Oxford University Press; 2001.CrossRefGoogle Scholar
  9. 9.
    Miller WR, Thoresen CE. Spirituality, religion, and health. An emerging research field. Am Psychol. 2003;58:24–35.PubMedCrossRefGoogle Scholar
  10. 10.
    Ironson G, Stuetzle R, Fletcher MA. An increase in religiousness/spirituality occurs after HIV diagnosis and predicts slower disease progression over 4 years in people with HIV. J Gen Intern Med. 2006;21 Suppl 5:S62–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Tsevat J, Sherman SN, McElwee JA, et al. The will to live among HIV-infected patients. Ann Intern Med. 1999;131:194–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Jenkins R. Religion and HIV: implications for research and intervention. J Soc Issues. 1995;51:247–70.CrossRefGoogle Scholar
  13. 13.
    Parsons SK, Cruise PL, Davenport WM, Jones V. Religious beliefs, practices and treatment adherence among individuals with HIV in the southern United States. AIDS Patient Care STDS. 2006;20:97–111.PubMedCrossRefGoogle Scholar
  14. 14.
    Tarakeshwar N, Khan N, Sikkema KJ. A relationship-based framework of spirituality for individuals with HIV. AIDS Behav. 2006;10:59–70.PubMedCrossRefGoogle Scholar
  15. 15.
    • Balaji AB, Oster AM, Viall AH, et al. Role flexing: how community, religion, and family shape the experiences of young black men who have sex with men. AIDS Patient Care STDS. 2012;26:730–7. This qualitative study addresses homosexuality in the context of religious organizations’ responses to HIV in the U.S. Deep South. Findings suggest that homosexuality remains highly stigmatized. Young black MSM in the study used “role flexing” to modify their behavior to fit into a faith community. PubMedCrossRefGoogle Scholar
  16. 16.
    Molzahn A, Sheilds L, Bruce A, et al. People living with serious illness: stories of spirituality. J Clin Nurs. 2012;21:2347–56.PubMedCrossRefGoogle Scholar
  17. 17.
    Martinez J, Lemos D, Hosek S. Adolescent medicine trials N: stressors and sources of support: the perceptions and experiences of newly diagnosed Latino youth living with HIV. AIDS Patient Care STDS. 2012;26:281–90.PubMedCrossRefGoogle Scholar
  18. 18.
    Folkman S. The case for positive emotions in the stress process. Anxiety Stress Coping. 2008;21:3–14.PubMedCrossRefGoogle Scholar
  19. 19.
    Baumgartner L, Niemi E. The perceived effect of HIV/AIDS on other identities. Qual Rep. 2013;18:1–23.Google Scholar
  20. 20.
    Cuevas JE, Vance DE, Viamonte SM, Lee SK, South JL. A comparison of spirituality and religiousness in older and younger adults with and without HIV. J Spiritual Ment Health. 2010;12:273–87.CrossRefGoogle Scholar
  21. 21.
    Cotton S, Tsevat J, Szaflarski M, et al. Changes in religiousness and spirituality attributed to HIV/AIDS: are there sex and race differences? J Gen Intern Med. 2006;21 Suppl 5:S14–20.PubMedCrossRefGoogle Scholar
  22. 22.
    Remle RC, Koenig H. Religion and health in HIV/AIDS communities. In: Plante TG, Sherman AC, editors. Faith and health: psychological perspectives. The Guilford Press; 2001.p. 195–212.Google Scholar
  23. 23.
    Garfield CF, Isacco A, Sahker E. Religion and spirituality as important components of men's health and wellness: an analytic review. Am J Lifestyle Med. 2012;7:27–37.CrossRefGoogle Scholar
  24. 24.
    Tuck I. A critical review of a spirituality intervention. West J Nurs Res. 2012;34:712–35.PubMedCrossRefGoogle Scholar
  25. 25.
    • Campbell C, Skovdal M, Gibbs A. Creating social spaces to tackle AIDS-related stigma: reviewing the role of church groups in sub-Saharan Africa. AIDS Behav. 2011;15:1204–19. This is a systematic literature review to examine the role of religious groups in the HIV epidemic in sub-Saharan Africa. Five themes emerge in the review that highlight the complex and contradictory responses of congregations to HIV. PubMedCrossRefGoogle Scholar
  26. 26.
    Aja GN, Modeste NN, Montgomery SB. Qualitative inquiry into church-based assets for HIV/AIDS prevention and control: a forum focus group discussion approach. Qual Rep. 2012;17:1–15.Google Scholar
  27. 27.
    Alexander CS, Memiah P, Henley YB, et al. Palliative care and support for persons with HIV/AIDS in 7 African countries: implementation experience and future priorities. Am J Hosp Palliat Care. 2012;29:279–85.PubMedCrossRefGoogle Scholar
  28. 28.
    Balthip Q, Petchruschatachart U, Piriyakoontorn S, Boddy J. Achieving peace and harmony in life: Thai Buddhists living with HIV/AIDS. Int J Nurs Pract. 2013;19 Suppl 2:7–14.PubMedCrossRefGoogle Scholar
  29. 29.
    Caixeta CR, Nascimento LC, Pedro IC, Rocha SM. Spiritual support for people living with HIV/AIDS: a Brazilian explorative, descriptive study. Nurs Health Sci. 2012;14:514–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Mkandawire-Valhmu L, Kako PM, Kibicho JW. Perceptions of the character of God as narrated by East African women living with HIV. J Christ Nurs. 2012;29:164–72.PubMedCrossRefGoogle Scholar
  31. 31.
    Musheke M, Bond V, Merten S. Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programs. AIDS Res Ther. 2013;10:12.PubMedCrossRefGoogle Scholar
  32. 32.
    Olsen M, Jensen NK, Tesfaye M, Holm L. Conceptual equivalence of WHOQOL-HIV among people living with HIV in Ethiopia. Qual Life Res. 2013;22:361–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Sofolahan YA, Airhihenbuwa CO. Childbearing decision making: a qualitative study of women living with HIV/AIDS in Southwest Nigeria. AIDS Res Treat. 2012;2012:478065.PubMedGoogle Scholar
  34. 34.
    Vance DE, Antia L, Blanshan SA, et al. A structural equation model of religious activities on biopsychosocial outcomes in adults with HIV. J Spiritual Ment Health. 2008;10:328–49.CrossRefGoogle Scholar
  35. 35.
    Kremer H, Ironson G, Kaplan L. The fork in the road: HIV as a potential positive turning point and the role of spirituality. AIDS Care. 2009;21:368–77.PubMedCrossRefGoogle Scholar
  36. 36.
    •• Ironson G, Stuetzle R, Ironson D, et al. View of God as benevolent and forgiving or punishing and judgmental predicts HIV disease progression. J Behav Med. 2011;34:414–25. This is a large, longitudinal study that has been able to document effects of perceptions of God on the health status of PLWH. In this study, positive perceptions of God were associated with slower while negative perceptions of God were associated with faster HIV disease progression. PubMedCrossRefGoogle Scholar
  37. 37.
    Chaudoir SR, Norton WE, Earnshaw VA, et al. Coping with HIV stigma: do proactive coping and spiritual peace buffer the effect of stigma on depression? AIDS Behav. 2012;16:2382–91.PubMedCrossRefGoogle Scholar
  38. 38.
    Yi MS, Mrus JM, Wade TJ, et al. Religion, spirituality, and depressive symptoms in patients with HIV/AIDS. J Gen Intern Med. 2006;21 Suppl 5:S21–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Steglitz J, Ng R, Mosha JS, Kershaw T. Divinity and distress: the impact of religion and spirituality on the mental health of HIV-positive adults in Tanzania. AIDS Behav. 2012;16:2392–8.PubMedCrossRefGoogle Scholar
  40. 40.
    Vance DE. Spirituality of living and aging with HIV: a pilot study. J Relig Spiritual Aging. 2006;19:57–74.CrossRefGoogle Scholar
  41. 41.
    Vance DE, Burrage Jr J, Couch A, Raper J. Promoting successful aging with HIV through hardiness: implications for nursing practice and research. J Gerontol Nurs. 2008;34:22–9.PubMedCrossRefGoogle Scholar
  42. 42.
    Vance DE, Struzick TC, Russell T. Spiritual and religious implications of aging with HIV: a conceptual and methodological review. J Relig Spiritual Aging. 2007;19:21–42.CrossRefGoogle Scholar
  43. 43.
    Vance DE, Struzick TC, Raper JL. Biopsychosocial benefits of spirituality in adults aging with HIV: implications for nursing practice and research. J Holist Nurs. 2008;26:119–25.PubMedCrossRefGoogle Scholar
  44. 44.
    Vance DE, Woodley RA. Spiritual expressions of coping in adults with HIV: implications for successful aging. J Relig Disabil Health. 2008;12:37–57.CrossRefGoogle Scholar
  45. 45.
    Suzuki-Crumly JK, Ackerman ML, Vance DE, et al. The role of religiosity in mediating biopsychosocial outcomes in homosexuals and heterosexuals with HIV: a structural equation modeling comparison study. J Spiritual Ment Health. 2010;12:209–23.CrossRefGoogle Scholar
  46. 46.
    Ackerman ML, Vance DE, Antia L, et al. The role of religiosity in mediating biopsychosocial outcomes between African Americans and Caucasians with HIV. J Spiritual Ment Health. 2009;11:312–27.CrossRefGoogle Scholar
  47. 47.
    McIntosh RC, Rosselli M. Stress and coping in women living with HIV: a meta-analytic review. AIDS Behav. 2012;16:2144–59.PubMedCrossRefGoogle Scholar
  48. 48.
    Deribew A, Deribe K, Reda AA, et al. Change in quality of life: a follow-up study among patients with HIV infection with and without TB in Ethiopia. BMC Publ Health. 2013;13:408.CrossRefGoogle Scholar
  49. 49.
    Huang D, Sangthong R, McNeil E, et al. Effects of a phone call intervention to promote adherence to antiretroviral therapy and quality of life of HIV/AIDS patients in Baoshan, China: a randomized controlled trial. AIDS Res Treat. 2013;2013:580974.PubMedGoogle Scholar
  50. 50.
    Tran BX. Quality of life outcomes of antiretroviral treatment for HIV/AIDS patients in Vietnam. PLoS One. 2012;7:e41062.PubMedCrossRefGoogle Scholar
  51. 51.
    Pecoraro A, Royer-Malvestuto C, Rosenwasser B, et al. Factors contributing to dropping out from and returning to HIV treatment in an inner city primary care HIV clinic in the United States. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV 2013, Feb 21. [Epub ahead of print].Google Scholar
  52. 52.
    Ekwunife OI, Oreh C, Ubaka CM. Concurrent use of complementary and alternative medicine with antiretroviral therapy reduces adherence to HIV medications. Int J Pharm Pract. 2012;20:340–3.PubMedCrossRefGoogle Scholar
  53. 53.
    Manglos ND, Trinitapoli J. The third therapeutic system: faith healing strategies in the context of a generalized aids epidemic. J Health Soc Behav. 2011;52:107–22.PubMedCrossRefGoogle Scholar
  54. 54.
    Selman L, Siegert RJ, Higginson IJ, et al. The “Spirit 8” successfully captured spiritual well-being in African palliative care: factor and Rasch analysis. J Clin Epidemiol. 2012;65:434–43.PubMedCrossRefGoogle Scholar
  55. 55.
    Hansen NB, Harrison B, Fambro S, et al. The structure of coping among older adults living with HIV/AIDS and depressive symptoms. J Health Psychol. 2013;18:198–211.PubMedCrossRefGoogle Scholar
  56. 56.
    Kemppainen J, Bormann JE, Shively M, et al. Living with HIV: responses to a mantram intervention using the critical incident research method. J Altern Complement Med. 2012;18:76–82.PubMedCrossRefGoogle Scholar
  57. 57.
    Brown J, Hanson JE, Schmotzer B, Webel AR. Spirituality and optimism: a holistic approach to component-based, self-management treatment for HIV. J Relig Health. 2013;1–12 [Epub ahead of print].Google Scholar
  58. 58.
    Sikkema KJ, Hansen NB, Ghebremichael M, et al. A randomized controlled trial of a coping group intervention for adults with HIV who are AIDS bereaved: longitudinal effects on grief. Health Psychol. 2006;25:563–70.PubMedCrossRefGoogle Scholar
  59. 59.
    Dallas RH, Wilkins ML, Wang J, et al. Longitudinal pediatric palliative care: quality of life and spiritual struggle (FACE): design and methods. Contemp Clin Trials. 2012;33:1033–43.PubMedCrossRefGoogle Scholar
  60. 60.
    •• Bluthenthal RN, Palar K, Mendel P, et al. Attitudes and beliefs related to HIV/AIDS in urban religious congregations: barriers and opportunities for HIV-related interventions. Soc Sci Med. 2012;74:1520–7. This community-engaged, qualitative study examines a range of congregational views on HIV and PLWH. The views ranged in the study from highly judgmental to accepting/affirming, depending on the level of congregational HIV involvement. However, some highly involved congregations displayed stigmatizing attitudes, suggesting that stigma reduction efforts should coincide with congregations’ other HIV activities. PubMedCrossRefGoogle Scholar
  61. 61.
    Szaflarski M, Ritchey PN, Jacobson CJ, et al. Faith-based HIV prevention and counseling programs: findings from the Cincinnati Census of Religious Congregations. AIDS Behav. 2013;17:1839–54.PubMedCrossRefGoogle Scholar
  62. 62.
    Williams MV, Palar K, Derose KP. Congregation-based programs to address HIV/AIDS: elements of successful implementation. J Urban Health. 2011;88:517–32.PubMedCrossRefGoogle Scholar
  63. 63.
    Muñoz-Laboy MA, Murray L, Wittlin N, et al. Beyond faith-based organizations: using comparative institutional ethnography to understand religious responses to HIV and AIDS in Brazil. Am J Public Health. 2011;101:972–8.PubMedCrossRefGoogle Scholar
  64. 64.
    Eke AN, Wilkes AL, Gaiter J. Organized religion and the fight against HIV/AIDS in the black community: The role of the Black Church. In: McCree DH, editor. African Americans and HIV/AIDS. New York: Springer; 2010. p. 53–68.CrossRefGoogle Scholar
  65. 65.
    Keough L, Marshall K. Faith communities engage the HIV/AIDS crisis: Lessons learned and paths forward. Washington, DC: Georgetown University; 2007.Google Scholar
  66. 66.
    Lightfoot AF, Woods BA, Jackson M, et al. “In my house”: laying the foundation for youth HIV prevention in the Black church. Prog Commun Health Partnersh. 2012;6:451–6.CrossRefGoogle Scholar
  67. 67.
    Nunn A, Cornwall A, Chute N, et al. Keeping the faith: African American faith leaders’ perspectives and recommendations for reducing racial disparities in HIV/AIDS infection. PLoS One. 2012;7:e36172.PubMedCrossRefGoogle Scholar
  68. 68.
    Coleman JD, Lindley LL, Annang L, Saunders RP, Gaddist B. Development of a framework for HIV/AIDS prevention programs in African American churches. AIDS Patient Care STDS. 2012;26:116–24.PubMedCrossRefGoogle Scholar
  69. 69.
    Foster PP, Cooper K, Parton JM, Meeks JO. Assessment of HIV/AIDS prevention of rural African American Baptist leaders: implications for effective partnerships for capacity building in American communities. J Natl Med Assoc. 2011;103:323–31.PubMedGoogle Scholar
  70. 70.
    Palar K, Mendel P, Derose KP. The organization of HIV and other health activities within urban religious congregations. J Urban Health. 2012. doi:10.1007/s11524-012-9783-6.
  71. 71.
    Frenk SM, Chaves M. Proportion of US congregations that have people living with HIV. J Relig Health. 2012;51:371–80.PubMedCrossRefGoogle Scholar
  72. 72.
    Fulton BR. Black Churches and HIV/AIDS: factors influencing congregations’ responsiveness to social issues. J Sci Study Relig. 2011;50:617–30.PubMedCrossRefGoogle Scholar
  73. 73.
    Slomka J, Lim JW, Gripshover B, Daly B. How have long-term survivors coped with living with HIV? J Assoc Nurses AIDS Care. 2012. doi:10.1016/j.jana.2012.09.004.PubMedGoogle Scholar
  74. 74.
    Monshipouri M, Trapp T. HIV/AIDS, religion, and human rights: a comparative analysis of Bangladesh, Indonesia, and Iran. Human Rights Rev. 2012;13:187–204.CrossRefGoogle Scholar
  75. 75.
    Sutton MY, Parks CP. 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. J Relig Health. 2013;52:514–30.PubMedCrossRefGoogle Scholar
  76. 76.
    Szaflarski M, Vaughn LM. Using concept mapping to mobilize a black faith community to address HIV. UAB Health Disparities Research Annual Symposium. Birmingham, AL; 2012.Google Scholar
  77. 77.
    Lindley LL, Coleman JD, Gaddist BW, White J. Informing faith-based HIV/AIDS interventions: HIV-related knowledge and stigmatizing attitudes at project F.A.I.T.H. churches in South Carolina. Public Health Rep. 2010;125 Suppl 1:12–20.PubMedGoogle Scholar
  78. 78.
    Garcia J, Parker RG. Resource mobilization for health advocacy: Afro-Brazilian religious organizations and HIV prevention and control. Soc Sci Med. 2011;72:1930–8.PubMedCrossRefGoogle Scholar
  79. 79.
    Muñoz-Laboy M, Garcia J, Moon-Howard J, Wilson PA, Parker R. Religious responses to HIV and AIDS: understanding the role of religious cultures and institutions in confronting the epidemic. Glob Public Health. 2011;6 Suppl 2:S127–31.PubMedCrossRefGoogle Scholar
  80. 80.
    Muñoz-Laboy M, Murray LR, Wittlin N, et al. Divine targets: youth at the center of catholic and Pentecostal responses to HIV and AIDS in Brazil. Cult Health Sex. 2011;13:657–68.PubMedCrossRefGoogle Scholar
  81. 81.
    Murray LR, Garcia J, Muñoz-Laboy M, Parker RG. Strange bedfellows: the Catholic Church and Brazilian National AIDS Program in the response to HIV/AIDS in Brazil. Soc Sci Med. 2011;72:945–52.PubMedCrossRefGoogle Scholar
  82. 82.
    Rios LF, De Aquino FL, Muoz-Laboy M, et al. The Catholic Church, moral doctrine, and HIV prevention in Recife, Brazil. Negotiating the contradictions between religious belief and the realities of everyday life. Cult Relig. 2011;12:355–72.PubMedCrossRefGoogle Scholar
  83. 83.
    Rios LF, Oliveira C, Garcia J, et al. Blood, sweat and semen: the economy of axé and the response of Afro-Brazilian religions to HIV and AIDS in Recife. Glob Public Health. 2011;6 (Suppl 2):S257–70.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of SociologyUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department Health BehaviorUniversity of Alabama at BirminghamBirminghamUSA

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