Skip to main content

Advertisement

Log in

Creating Social Spaces to Tackle AIDS-Related Stigma: Reviewing the Role of Church Groups in Sub-Saharan Africa

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

An expanding body of literature explores the role of African church groups in facilitating or hindering the support of people living with AIDS and challenging or contributing to HIV/AIDS-related stigma. Treating church groups as social spaces in which HIV/AIDS-related stigma may potentially be challenged, we systematically review this literature, identifying five themes that highlight the complex and contradictory role of the church as a potential agent of health-enhancing social change. In many ways the church perpetuates HIV/AIDS-related stigma through (i) moralistic attitudes and (ii) its reinforcement of conservative gender ideologies. However some churches have managed move towards action that makes a more positive contribution to HIV/AIDS management through (iii) promoting various forms of social control for HIV prevention, (iv) contributing to the care and support of the AIDS-affected and (v) providing social spaces for challenging stigmatising ideas and practices. We conclude that church groups, including church leadership, can play a key role in facilitating or hindering the creation of supportive social spaces to challenge stigma. Much work remains to be done in developing deeper understandings of the multi-layered factors that enable some churches, but not others, to respond effectively to HIV/AIDS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Walker M. The new demography of the 21st century: part 1—the birthrate surprise. Strategy Leadersh. 2008;36(6):42–8.

    Article  Google Scholar 

  2. Haddad B. Reflections on the church and HIV/AIDS: South Africa. Theol Today. 2005;62(1):29–37.

    Article  Google Scholar 

  3. Haddad B. “We pray but we cannot heal”: theological challenges posed by the HIV/AIDS crisis. J Theol South Afr. 2006;125:80–90.

    Google Scholar 

  4. Campbell C, Foulis C, Maimane S, Sibiya Z. “I have an evil child in my house”: stigma and HIV/AIDS management in a South African community. Am J Public Health. 2005;95:808–15.

    Article  PubMed  Google Scholar 

  5. Campbell C, Nair Y, Maimane S, Nicholson J. ‘Dying twice’—a multi-level model of the roots of AIDS stigma in two South African communities. J Health Psychol. 2007;12(3):403–16.

    Article  PubMed  Google Scholar 

  6. Deacon H, Stephney I, Prosalendis S. Understanding HIV/AIDS stigma: a theoretical and methodological analysis. Cape Town: HSRC Press; 2005.

    Google Scholar 

  7. Wouters E, Van Damme W, Van Loon F, Van Rensburg D, Meulemans H. Public-sector ART in the Free State Province, South Africa: community support as an important determinant of outcome. Soc Sci Med. 2009;69(8):1177–85.

    Article  PubMed  Google Scholar 

  8. Campbell C, Gibbs A, Maimane S, Nair Y, Sibiya Z. Youth participation in the fight against AIDS in South Africa: from policy to practice. J Youth Stud. 2009;12(1):93–109.

    Article  Google Scholar 

  9. Low-Beer D, Stoneburner R. AIDS communications through social networks: catalyst for behaviour changes in Uganda. Afr J AIDS Res. 2004;3(1):1–13.

    Article  Google Scholar 

  10. Epstein H. The invisible cure: why we are losing the fight against AIDS in Africa. 1st Picador ed. New York: Picador/Farrar, Straus and Giroux; 2008.

  11. Barnett T, Whiteside A. AIDS in the twenty-first century: disease and globalization. 2nd ed. Basingstoke: Palgrave Macmillan; 2006.

    Google Scholar 

  12. Camlin C, Snow R. Parental investment, club membership, and youth sexual risk behavior in Cape Town. Health Educ Behav. 2008;35(4):522–40.

    Article  PubMed  Google Scholar 

  13. Campbell C, Williams B, Gilgen D. Is social capital a useful conceptual tool for exploring community level influences on HIV infection? An exploratory case study from South Africa. AIDS Care. 2002;14(1):41–54.

    Article  PubMed  CAS  Google Scholar 

  14. Gregson S, Terceira N, Mushati P, Nyamukapa C, Campbell C. Community group participation: can it help young women to avoid HIV? An exploratory study of social capital and school education in rural Zimbabwe. Soc Sci Med. 2004;58(11):2119–32.

    Article  PubMed  Google Scholar 

  15. Chiu J, Grobbelaar J, Sikkema K, Vandormael A, Bomela N, Kershaw T. HIV-related stigma and social capital in South Africa. AIDS Educ Prev. 2008;20(6):519–30.

    Article  PubMed  Google Scholar 

  16. Agadjanian V. Religion, social milieu, and contraceptive revolutions. Popul Stud. 2001;55:135–48.

    Article  Google Scholar 

  17. Buttimer A. Social space in interdisciplinary perspective. Am Geogr Soc. 1969;59(3):417–26.

    Google Scholar 

  18. Latane B, Liu J. The intersubjective geometry of social space. J Commun. 1996;46(4):26–34.

    Article  Google Scholar 

  19. Liu J, Sibley C. Attitudes and behaviour in social space: public good interventions based on shared representations and environmental influences. J Environ Psychol. 2004;24:373–84.

    Article  CAS  Google Scholar 

  20. Campbell C, Nair Y, Maimane S. Building contexts that support effective community responses to HIV/AIDS: a South African case study. Am J Community Psychol. 2007;39(3–4):347–63.

    Article  PubMed  Google Scholar 

  21. Campbell C, Deacon H. Unravelling the contexts of stigma: from internalisation to resistance to change. J Commun Appl Soc Psychol. 2006;16(6):411–7.

    Article  Google Scholar 

  22. Nhamo M, Campbell C, Gregson S. Obstacles to local-level ‘AIDS competence’ in rural Zimbabwe: putting HIV prevention in context. AIDS Care (in press).

  23. Campbell C, Nair Y, Maimane S, Gibbs A. Strengthening community responses to AIDS: possibilities and challenges. In: Rohleder P, Swartz L, Kalichman S, editors. HIV/AIDS in South Africa 25 years on. London: Springer; 2009.

    Google Scholar 

  24. The cartography of HIV and AIDS, religion and theology—a partially annotated bibliography [database on the Internet]. The Collaborative for HIV and AIDS, Religion and Theology, University of KwaZulu-Natal. 2009. http://chart.ukzn.ac.za/images/stories/1004_chart_cartography.pdf.

  25. Moscovici S. Social representations: explorations in social psychology. New York: New York University Press; 2000.

    Google Scholar 

  26. Zou J, Yamanaka Y, John M, Watt M, Ostermann J, Thielman N. Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes. BMC Public Health. 2009;9(1):75.

    Article  PubMed  Google Scholar 

  27. Watt M, Maman S, Jacobson M, Laiser J, John M. Missed opportunities for religious organizations to support people living with HIV/AIDS: findings from Tanzania. AIDS Patient Care STDs. 2009;23(5):389–94.

    Article  PubMed  Google Scholar 

  28. Otolok-Tanga E, Atuyambe L, Murphy C, Ringheim K, Woldehanna S. Examining in the actions of faith-based organizations and their influence on HIV/AIDS-related stigma: a case study of Uganda. Afr Health Sci. 2007;7(1):55–60.

    PubMed  Google Scholar 

  29. Pfeiffer J. Condom social marketing, pentecostalism, and structural adjustment in Mozambique: a clash of AIDS prevention messages. Med Anthropol Q. 2004;18(1):77–103.

    Article  PubMed  Google Scholar 

  30. Marshall M, Taylor N. Tackling HIV and AIDS with faith-based communities: learning from attitudes on gender relations and sexual rights within local evangelical churches in Burkina Faso, Zimbabwe, and South Africa. Gend Dev. 2006;14(3):363–74.

    Article  Google Scholar 

  31. Lagarde E, Enel C, Seck K, Gueye-Ndiaye A, Piau JP, Pison G, et al. Religion and protective behaviours towards AIDS in rural Senegal. AIDS. 2000;14:2027–33.

    Article  PubMed  CAS  Google Scholar 

  32. Agha S, Hutchinson P, Kusanthan T. The effects of religious affiliation on sexual initiation and condom use in Zambia. J Adolesc Health. 2006;38(5):550–5.

    Article  PubMed  Google Scholar 

  33. Smith D. Youth, sin and sex in Nigeria: Christianity and HIV/AIDS-related beliefs and behaviour among rural-urban migrants. Cult Health Sex. 2004;6(5):425–37.

    Article  Google Scholar 

  34. Santmyire A, Jamison M. Educating African pastors on mother-to-child transmission of HIV/AIDS. J Nurs Scholarsh. 2006;38(4):321.

    Article  PubMed  Google Scholar 

  35. Agadjanian V. Gender, religious involvement, and HIV/AIDS prevention in Mozambique. Soc Sci Med. 2005;61:1529–39.

    Article  PubMed  Google Scholar 

  36. Takyi B. Religion and women’s health in Ghana: insights into HIV/AIDs preventive and protective behavior. Soc Sci Med. 2003;56(6):1221–34.

    Article  PubMed  Google Scholar 

  37. Allman D, Adebajo S, Myers T, Odumuye O, Ogunsola S. Challenges for the sexual health and social acceptance of men who have sex with men in Nigeria. Cult Health Sex. 2007;9(2):153–68.

    Article  PubMed  Google Scholar 

  38. Plattner I, Meiring N. Living with HIV: the psychological relevance of meaning making. AIDS Care. 2006;18(3):241–5.

    Article  PubMed  CAS  Google Scholar 

  39. UNAIDS. Operational plan for UNAIDS action framework: addressing women, girls, gender equality and HIV. Geneva: UNAIDS; 2009.

  40. Garner RC. Safe sects? Dynamic religion and AIDS in South Africa. J Mod Afr Stud. 2000;38:41–69.

    Article  PubMed  CAS  Google Scholar 

  41. Addai I. Religious affiliation and the sexual initiation among Ghanaian women. Rev Relig Res. 2000;41:328–43.

    Article  Google Scholar 

  42. Parsitau D. Keep holy distance and abstain till he comes: interrogating a Pentecostal church’s engagements with HIV/AIDS and the youth in Kenya. Afr Today. 2009;56(1):45–64.

    Google Scholar 

  43. Trinitapoli J, Regnerus M. Religion and HIV risk behaviors among married men: Initial results from a study in rural sub-Saharan Africa. J Sci Study Relig. 2006;45(4):505–28.

    Article  Google Scholar 

  44. Gregson S, Zhuwau T, Anderson R, Chandiwana S. Apostles and Zionists: the influence of religion on demographic change in rural Zimbabwe. Popul Stud. 1999;53(2):179–93.

    Article  CAS  Google Scholar 

  45. Trinitapoli J. Religious teachings and influences on the ABCs of HIV prevention in Malawi. Soc Sci Med. 2009;69(2):199–209.

    Article  PubMed  Google Scholar 

  46. Becker F, Geissler W. Searching for pathways in a landscape of death: religion and AIDS in East Africa. J Relig Afr. 2007;37(1):1–15.

    Article  Google Scholar 

  47. Adogame A. HIV/AIDS support and african pentecostalism the case of the Redeemed Christian Church of God (RCCG). J Health Psychol. 2007;12(3):475–84.

    Article  PubMed  Google Scholar 

  48. Trinitapoli J. Religious responses to aids in sub-Saharan Africa: an examination of religious congregations in rural Malawi. Rev Relig Res. 2006;47(3):253–70.

    Google Scholar 

  49. Dahl B. The “failures of culture”: Christianity, kinship, and moral discourses about orphans during Botswana’s AIDS crisis. Afr Today. 2009;56(1):23–43.

    Google Scholar 

  50. Bazant E, Boulay M. Factors associated with religious congregation members’ support to people living with HIV/AIDS in Kumasi, Ghana. AIDS Behav. 2007;11(6):936–45.

    Article  PubMed  Google Scholar 

  51. Agadjanian V, Sen S. Promises and challenges of faith-based AIDS care and support in Mozambique. Am J Public Health. 2007;97:362–6.

    Article  PubMed  Google Scholar 

  52. Haddad B. Surviving the HIV and AIDS epidemic in South Africa: women living and dying, theologising and being theologised. J Theol South Afr. 2008;131:47–57.

    Google Scholar 

  53. Black B. HIV/AIDS and the Church: Kenyan religious leaders become partners in prevention. Aidscaptions. 1997;4(1):23–6.

    PubMed  CAS  Google Scholar 

  54. Hartwig K, Kissioki S, Hartwig C. Church leaders confront HIV/AIDS and stigma: a case study from Tanzania. J Commun Appl Soc Psychol. 2006;16(6):492–7.

    Article  Google Scholar 

  55. Miller A, Rubin D. Factors leading to self-disclosure of a positive HIV diagnosis in Nairobi, Kenya: people living with HIV/AIDS in the sub-Sahara. Qual Health Res. 2007;17(5):586–98.

    Article  Google Scholar 

  56. Maman S, Cathcart R, Burkhardt G, Omba S, Behets F. The role of religion in HIV-positive women’s disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo. Soc Sci Med. 2009;68(5):965–70.

    Article  PubMed  Google Scholar 

  57. Friedman G. AIDS Prevention and the Church, Kenya: mixed messages. AIDS Soc. 1995;6(2):4.

    Google Scholar 

  58. Gusman A. HIV/AIDS, Pentecostal Churches, and the “Joseph Generation” in Uganda. Afr Today. 2009;56(1):67–86.

    Google Scholar 

  59. Dilger H. Healing the wounds of modernity: salvation, community and care in a Neo-Pentecostal church in Dar Es Salaam, Tanzania. J Relig Afr. 2007;37:59–83.

    Article  Google Scholar 

  60. Sadgrove J. ‘Keeping up appearances’: sex and religion amongst university students in Uganda. J Relig Afr. 2007;37(1):116–44.

    Article  Google Scholar 

  61. Crawford R. The boundaries of the self and the unhealthy other: reflections on health, culture and AIDS. Soc Sci Med. 1994;38(1):1347–65.

    Article  PubMed  CAS  Google Scholar 

  62. Czerny M. ARVs when possible. In: Bujo B, Czerny M, editors. AIDS in Africa—theological reflections. Nairobi: Paulines Publications Africa; 2007.

    Google Scholar 

  63. Campbell C, Nair Y, Maimane S, Sibiya Z. Understanding and Challenging HIV/AIDS Stigma. Durban: HIVAN Publication; 2005. URL: http://www.lse.ac.uk/collections/socialPsychology/pdf/Understanding_Challenging_HIVAIDS_Stigma.pdf. Retrieved 18 June 2010.

  64. Vaughan C. Dialogue, critical consciousness and praxis. In: Hook D, Franks B, Bauer M, editors. Social psychology of communication. Basingstoke: Palgrave; 2010.

    Google Scholar 

  65. Freire P. Education for critical consciousness. New York: Seabury press; 1973.

    Google Scholar 

  66. Freire P. Pedagogy of the oppressed. London: Penguin Books Ltd; 1970.

    Google Scholar 

  67. Howarth C. Race as stigma: positioning the stigmatized as agents, not objects. J Commun Appl Soc Psychol. 2006;16(6):442–51.

    Article  Google Scholar 

  68. Gaventa J, Cornwall A. Power and knowledge. In: Reason P, Bradbury H, editors. Handbook of action research. London: SAGE; 2006. p. 71–82.

    Google Scholar 

  69. Minkler M, Wallerstein N. Introduction to community based participatory research. In: Minkler M, Wallerstein N, Hall B, editors. Community-based partcipatory research for health. San Francisco: Jpssey Bass Wiley; 2003. p. 3–26.

    Google Scholar 

  70. Cornish F. Empowerment to participate: a case study of participation by Indian sex workers in HIV prevention. J Commun Appl Soc Psychol. 2006;16:301–15.

    Article  Google Scholar 

  71. Moletsane R, de Lange NCM, Stuart J, Buthelezi T, Taylor M. Photo-voice as a tool for analysis and activism in response to HIV and AIDS stigmatisation in a rural KwaZulu-Natal school. J Child Adolesc Ment Health. 2007;19(1):19–28.

    Article  Google Scholar 

  72. Skovdal M. Picturing the coping strategies of caregiving children in Western Kenya: from images to action. Am J Public Health (in press).

  73. Vaughan C. ‘When the road is full of potholes, I wonder why they are bringing condoms?’ Social Spaces for understanding young Papau New Guineans’ health-related knowledge and health-promoting action. AIDS Care (in press).

  74. Skovdal M. Community relations and child-led microfinance: a case study of caregiving children in Western Kenya. AIDS Care (in press).

  75. UNDP. Upscaling community conversations in Ethiopia 2004: unleashing capacities of communities for the HIV/AIDS response. Addis Ababa: UNDP; 2004.

  76. UNDP. Community capacity enhancement strategy note—the answer lies within. New York: UNDP; 2005. http://www.undp.org/hiv/docs/prog_guides/cce_strategy_note.pdf. Retrieved 18 June 2010.

  77. Regnerus M, Salinas V. Religious affiliation and AIDS-based discrimination in sub-Saharan Africa. Rev Relig Res. 2007;48(4):385–400.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Campbell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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 15, 1204–1219 (2011). https://doi.org/10.1007/s10461-010-9766-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-010-9766-0

Keywords

Navigation