Church-based HIV prevention programs in the African-American church: a scoping analysis
Dowers, Donovan Paul
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In lifetime risk for Human Immunodeficiency Virus (HIV), Black men who have sex with men (BMSM) are at the greatest risk of all demographic groups. Creative modes of engagement have been established to reach this group in prevention efforts, including prevention programming in community-based organizations such as churches. Church-based HIV prevention is an emerging area of research and existing studies fall into one of three categories: BMSM’s perspectives on church and church-based HIV prevention, church leaders’ and members’ perspectives on HIV prevention in their congregations, and reported outcomes of HIV prevention interventions that have been conducted in church settings. Given the paucity of research in this area, a scoping analysis was conducted to survey the existing studies in order to identify overarching themes and gaps for future research efforts. In a review of the research, facilitators and barriers to successful implementation of HIV programming in churches emerged. Prominent barriers were stigmatizing sermons given in church and pastoral denial that HIV is a relevant issue to the Black community. Facilitators reported commonly were BMSM’s comfort found in faith and a pastor’s blessing of HIV prevention efforts in churches. Interventions primarily reported lessons learned in implementation of church-based HIV programs. A frequently reported lesson learned was the importance of close collaboration with participant churches to develop program curricula that were effectively couched within church doctrine, and that would be received well by church members. Some interventions also measured intervention efficacy outcomes, one of which showed a statistically significant decrease in HIV stigma post-intervention. This research has important implications for the effective development, implementation, and reporting of outcomes for future, church-based HIV interventions. As research in HIV prevention in the church continues to develop, it may be able to serve as a template for other community-based HIV prevention efforts and open doors for inclusion of other high risk groups such as injection drug users and sex workers.