Potential Roles of Black Churches in HIV/AIDS Prevention

Abstract

This study examines the role of Black churches in AIDS/HIV prevention. This is a pilot survey study design administered to 11 churches represented by 11 ministers and one church member. The analysis is both qualitative and quantitative. The results showed that most of the ministers had spoken with their congregation on HIV/AIDS. A few ministers had previously sponsored or taken part in HIV/AIDS workshops and disseminated HIV/AIDS educational material in the African American community. None of the churches had an established HIV/AIDS prevention program. Most of the ministers were receptive to implementing an HIV/AIDS prevention program, provided that it did not violate the church doctrines. The findings in this study suggest that Black churches represent an important potential resource for HIV/AIDS prevention. For success, the initial strategy should involve the minister in the early planning stage. Future research should focus on expanding the scope of this study and improving communication between the church, community-based organizations, and health professionals.     

Preventing HIV/AIDS Among Trinidad and Tobago Teens Using a Family-Based Program

Summary

This paper describes a family-based HIV/AIDS prevention project currently underway in Trinidad and Tobago—an English speaking twin-island nation in the Caribbean. The project involves a partnership between U.S.-based researchers and a social service agency on the Islands. It describes the development and adaptation of the intervention and reports preliminary outcomes from a pilot intervention (n= 32). Findings indicate high participant retention; statistically significant pre to posttest changes in HIV/AIDS knowledge and awareness; parent/youth discussions at home; condom self-efficacy; and parental monitoring. Findings are discussed within the context of collaborative HIV/AIDS prevention research.     

HIV Prevention Programs in the Black Church: A Viable Health Promotion Resource for African American Women?

ABSTRACT

Nearly 40 million people worldwide are living with the human immunodeficiency virus (HIV). The Centers for Disease Control report that women account for more than 50% of the existing 40 million HIV/AIDS cases to date. Moreover, African-American women are infected with HIV/AIDS 25 times more often than white women and four times more often than Hispanic women, making HIV/AIDS the leading cause of death for black women ages 25–34. Given the increasing rate of transmission with this population, the purpose of this article was to review the existing literature to investigate the risk factors associated with African-American women with HIV/AIDS and identify an effective method of HIV prevention for them. A discussion of religion and African-Americans in terms of the Black church and its health promotion efforts was also included. The article concludes with a discussion of program elements of HIV prevention programs in the Black church and possible challenges faced for the programs.     

A Commentary on the Triadic Theory of Influence as a Guide for Adapting HIV Prevention Programs for New Contexts and Populations

Summary

The purpose of this paper is to illustrate how the Collaborative HIV Prevention and Adolescent Mental Health Project-South Africa (CHAMPSA) began and to present some of the results from this South African version of CHAMP. This paper informs readers of a number of lessons about international program translation. The first important lesson is that there are universal principles of health behavior change that seem to be useful across cultures. The implementation of these principles, however, needs to be informed by an in-depth understanding of local cultural contexts. The second important lesson is that it is possible to undertake large-scale, scientifically sophisticated community-based prevention research in developing countries through international collaborative research projects. It is the authors' hope that this mixture of science, service, and business will inspire other public health, community mental health, research, and business professionals to develop international prevention interventions that can be shown to be effective, and disseminated on a wide scale.     

Stigma,AIDS, and HIV Prevention in Africa: Reports from Community Organizations Providing Prevention Services

ABSTRACT

The AIDS epidemic in Africa remains a serious health crisis. Nongovernmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services. An important barrier to their HIV prevention efforts is stigma directed at persons living with HIV/AIDS. In order to understand how stigma affects HIV prevention programming, we conducted in-depth qualitative interviews with NGO directors in 29 African countries. Qualitative analytic approaches were used to identify key themes. Substantial discrimination and stigmatization of HIV-positive persons was reported. HIV-positive women were particularly likely to suffer negative social and economic consequences. The stigma associated with HIV interfered with disclosure of HIV status, risk-reduction behaviors, and HIV testing, creating significant barriers to HIV prevention efforts.

Interventions to reduce AIDS-related stigma in Africa are urgently needed. Reducing the burden of stigma is critical to fighting the epidemic in Africa and could play an important role in global HIV reduction.     

A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.     

Family-Based HIV Preventive Intervention

Summary

Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth's exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth's best hope to grow up and survive multiple dangers in urban neighborhoods (Pequegnat& Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided.     

Voices from the Community

Summary

When community members are allowed to participate in the planning and implementation process of a program, they are empowering themselves and their community. The CHAMP Family Program uses a collaborative programming approach with a focus on building the capacities of community members to deliver a family-based HIV prevention program. The CHAMP Program has a Collaborative Board that oversees all aspects of the research project. Using an empowerment framework, this article explores Community Board members' perspectives on their experience in working on CHAMP. Recommendations to researchers in the form of ten key ingredients for community collaboration are presented. The key points primarily focus on building trust with the community, recognizing community strengths, developing skills, building intragroup relations, and involving the community as partners from the beginning to the end.     

Gay Bars and Serendipity

Abstract

HIV/AIDS continues to be a serious public health issue. As HIV changes from an acute disease to a more chronic illness, it places increased responsibility on family caregivers to provide on-going assistance. Based on a conceptual model of caregiving resilience, this study found high variation in caregiving outcomes with many caregivers demonstrating high levels of well-being despite adverse life circumstances. Factors that contributed significantly to caregiver well-being included income, caregiver health, discrimination, multiple loss, dispositional optimism and self-empowerment. These findings suggest that HIV/AIDS and caregiving entail more than stress and distress and that future research needs to consider caregiving within the context of a historically disadvantaged community, resilience of informal caregivers, and risk and protective factors at the personal, cultural and community levels. Such information is necessary to design community-based interventions to support informal caregivers and persons living with HIV/AIDS.     

Suicide Prevention in the Dot Com Era: Technological Aspects of a University Suicide Prevention Program

Abstract

Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this program, which complement other program activities in meeting program goals. The Web site and use of social networking Web sites have been very well received by members of the university and wider community. Although initial outcomes of each component are positive, low participation in the online training course has limited the usefulness of pretest–posttest comparisons. It is thought that other campus suicide prevention programs may benefit from using technology as a primary method in their suicide prevention programming efforts.     

Masturbation and Sexual Health

Abstract

In this study we applied research examining the hypothesized benefits of masturbation in dealing with sexual problems to the urgent health crisis posed by the HIV/AIDS pandemic. This is the first study to test the hypothesized relationship between masturbation and HIV risk as predicted by the Sexual Health Model, a sex-positive approach to sexual health developed in response to the need for a more explicit focus on sexuality and relationships in HIV prevention. This is also the first study to examine the relationship between several masturbation variables (i.e., masturbation guilt, lifetime masturbation, and current masturbation) and HIV-related sexual behaviors and attitudes in a sample of African American women (N =239). Data was collected using face-to-face structured interviews as part of the Women's Initiative for Sexual Health (WISH), a randomized, controlled trial of an HIV prevention intervention based on the Sexual Health Model, targeting low income, adult African American women. Contrary to expectations, results showed that participants who reported masturbating were more likely to report having multiple partners, being in a nonmonogamous relationship and engaging in high-risk sexual behaviors. There was no significant relationship between level of masturbation guilt and HIV risk nor between masturbation and consistent condom use or attitudes toward condoms. This study adds to the growing empirical support for associations between sexual health variables and safer sex and argues for a more explicit focus on sexuality in HIV prevention.     

Theory-Based Community Practice for HIV Prevention in Midlife and Older Women

ABSTRACT

In the last decade there has been a significant increase in HIV transmission among midlife and older women, particularly those from racial/ethnic minority communities. Although the number of women aged 50 and older diagnosed with HIV infection in the United States is increasing, they are rarely included in community HIV prevention strategies. This article presents integrating social capital with social justice themes into a socioecological framework for community practice that can significantly impact the efficacy of HIV prevention programs for midlife and older women. It also reviews the research and program implications for including midlife and older women in community interventions to halt the spread of HIV infection in this at-risk group. Suggestions for HIV prevention community practice with this underserved population are presented.     

HIV Voluntary Testing among Portuguese Women Attending Family Planning Clinics: Implications for HIV Prevention Education and Testing

ABSTRACT

Objectives: The aim of this article is to analyze the factors associated with HIV testing among 767 sexually active women. Methods: Participants were administered several self-report questionnaires that assessed behavioral and psychosocial measures. Results: Overall, 59.8% of the participants reported ever having tested for HIV. Results show that higher levels of education, being pregnant or having been pregnant, concern about AIDS, AIDS knowledge, self-efficacy in condom negotiation and perception of no risk in partner significantly predicted the likelihood of testing among women. Attending the mass was negatively associated with HIV testing. Conclusions: These findings provide information that can be used in the development of a focused gender sensitive HIV prevention program to increase HIV testing.     

Gendered Economic,Social, and Cultural Challenges to HIV/AIDS Prevention and Intervention for Chinese Women

ABSTRACT

China is experiencing the most rapidly expanding HIV prevalence in the world, with the percentage of Chinese women living with HIV/AIDS also increasing significantly. Chinese women's risk of HIV infection is heavily influenced by patriarchal cultural beliefs, Confucian doctrines, and rapid social and economic changes in China. Chinese women generally have a low level of awareness of HIV/AIDS. With inherent inferior social status and economic disadvantage, their vulnerability to HIV infection is heightened by adverse impacts of massive rural-to-urban migration, explosion of the commercial sex industry, and prevalence of gender-based violence. In order to target HIV/AIDS prevention and treatment programs for Chinese women, their specific needs and gendered obstacles must be addressed and tackled. These include strategies that aim to fight against poverty, improve education, enhance HIV/AIDS awareness, facilitate new life-skills acquisition and behavior change, make available woman-centered services for testing and treatment of HIV, and eradicate gender-based discrimination and violence. There is also an urgent need to further develop various public health infrastructure in China, especially in remote and rural areas. The pool of gender experts in China should also be expanded to conduct a thorough gender analysis and design a national response to address the evolving HIV/AIDS epidemic in Chinese women.     

HIV/AIDS and constructs of gay community: Researching educational practice within community-based health promotion for gay men

This paper reports on the methodology of a comparative study of three gay communities in Australia as they struggle with HIV/AIDS. The study focused on the pedagogy and practice of HIV/AIDS education for disease prevention and for health maintenance for people living with HIV/AIDS, through the investigation of three problematics: (1) constructs of 'community'; (2) the centrality of gay community-based health educators; and (3) the relations of gay men within and to their communities. The study was conceived of as a critical ethnography involving a three-part sample in the three sites and using three related research methods: (1) individual and group interviews; (2) textual analysis; and (3) participant observation. The theoretical bases for the study and its design lay in notions of 'performativity', community and adult education, organizational and institutional processes, and the idea of a 'post-AIDS' sociality. The methodology is explained in detail, as are various consultative processes embedded in the design to facilitate and enable a productive relationship with the communities researched.     

Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model

HIV/AIDS stigma and homophobia are associated with significant negative health and social outcomes among people living with HIV/AIDS (PLWHA) and those at risk of infection. Interventions to decrease HIV stigma have focused on providing information and education, changing attitudes and values, and increasing contact with people living with HIV/AIDS (PLWHA), activities that act to reduce stereotyped beliefs and prejudice, as well as acts of discrimination. Most anti-homophobia interventions have focused on bullying reduction and have been implemented at the secondary and post-secondary education levels. Few interventions address HIV stigma and homophobia and operate at the community level. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a community-level, multi-component anti-HIV/AIDS stigma and homophobia intervention designed to reduce HIV stigma and homophobia thus increasing access to HIV prevention and treatment access. The theory-based intervention included three primary components: workshops and trainings with local residents, businesses and community-based organizations (CBO); space-based events at a CBO-partner drop-in storefront and “pop-up” street-based events and outreach; and a bus shelter ad campaign. This paper describes the intervention design process, resultant intervention and the study team’s experiences working with the community. We conclude that CHHANGE was feasible and acceptable to the community. Promoting the labeling of gay and/or HIV-related “space” as a non-stigmatized, community resource, as well as providing opportunities for residents to have contact with targeted groups and to understand how HIV stigma and homophobia relate to HIV/AIDS prevalence in their neighborhood may be crucial components of successful anti-stigma and discrimination programming.