Jennifer Stewart, PhD, RNUniversity of Pennsylvania

School of Nursing

Factors Contributing to the Development of an HIV Ministry within an African American Church

Funded by Health Disparities in Underserved Populations Training Grant (T32NR007964; Barbara Dancy, PI) from the National Institutes of Health/National Institute of Nursing Research (NIH/NINR)

Background The incidence of HIV infection among

African Americans is the highest among any other racial/ethnic group

In the United States, 85% of African Americans report a religious affiliation, with 79% of African Americans reporting formal attendance at a Christian church.

A fairly large portion of churches are open to HIV programming if in alignment with church beliefs and values

Purpose: The purpose of this study was to examine how an African American church’s religious culture supported the development, implementation and maintenance of an HIV Ministry within the church.

Research questions: What role did the religious culture have in the (1) development, (2) implementation, and (3) maintenance of an HIV Ministry within an African American church?

Dorr-Bremme’s Constitutive Ethnographic Theory of Social Organization

Religious Culture Shared beliefs, norms,

attitudes, and acquired knowledge used to interpret experiences

and generate social behavior10,11

Model has been used to show how educational programs can be socially organized12.

Culture and behavior of a social group have a continuous reciprocal relationship.

Social Context

Norms

Attitudes Knowledge

Beliefs

Religious Culture

Social Behavior

Method

Research Design qualitative, ethnographic case study

Setting large African American church in a Midwest urban setting

Sample one pastor, one pastor emeritus, one associate pastor and six individuals who were involved with the development, implementation, or maintenance of the HIV Ministry 50 members of the general congregation

Method

Tools non-participant observation summary, Participant observation guide, Document review guide, Ethnographic interview guide, HIV risk reduction awareness questionnaire, Demographic questionnaire

Recruitment Procedure convenience sample, snowball technique

Data Analysis analyzed and interpreted throughout the data gathering period and at conclusion Auerbach and Silverstein’s “grounded theory coding” method16. prolonged engagement and triangulationthorough, detailed descriptions and rich quotations15 taken directly from observations and interviewsaudit trail detailing the research process

Results

Church DemographicsTotal Active Members: 8,854Median Income of Surrounding Community: 43, 201

Themes Overview

Specifically, themes common were: a belief in helping others and treating them with respect and dignity, feelings of compassion towards individuals infected with HIV/AIDS, and an emphasis on the importance of HIV education for HIV Ministry leaders as well as the general congregation.

Data from the development of the HIV Ministry also noted the importance of pastoral support and the importance of integrating the HIV Ministry into the culture of the church.

Results--Development

Beliefs– the pastoral leadership and support was important in the

development of an HIV Ministry;– acceptance of all individuals regardless of their sexual orientation.

Norm – the church’s role is to provide for the needs of its congregants

whatever they may be. Attitude

– the congregation was positive, the developers felt compassion towards people with HIV.

Acquired Knowledge– promote knowledge for members and congregants.

Results--Implementation

• Belief• members felt/feel they were/are called to fight against

the stigma of HIV and help those who are infected or could be affected by HIV.

• Norm• Christians are to help others and treat them with

respect and dignity in all circumstances.

• Attitude• a feeling of excitement and passion about their

involvement in the HIV Ministry.

• Acquired knowledge• HIV education was provided for members and

congregants.

Results--Maintenance

Beliefs– Jesus calls all Christians to love others, particularly those who are

generally neglected, ignored and discriminated against. – service in this ministry is about the belief that human beings

deserve to be loved and cared for. Norm

– the HIV Ministry is an integral and important component of the church.

Attitude– the congregation enjoys maintaining the HIV Ministry.

Acquired Knowledge– members of the HIV Ministry know that rates are on the rise in the

African American community particularly in certain age groups.

Notable Findings

feelings of compassion towards individuals infected with HIV/AIDS“The first person to self identify in the membership of being full blown was Frank. Frank came to me. He said, ‘there’s no way of dancing around this, I’ve got AIDS and she [his wife] couldn’t deal with it and she left me’. Within three or four weeks he said something that really convicted me, he said, ‘nobody should have to die like this.’ And he was right. We made sure his death was as peaceful as it could be but then we decided that no, this can’t happen, this is not how a church is supposed to function and that was really the germination of the AIDS Ministry, how it started.

pastoral support “I would say that’s very important, pastoral leadership. If they’re supportive its likelihood of taking off and being effective is much better than if they are resisting. If the pastoral leadership of the church is not supportive it ain’t going to happen because people will follow his lead.”

integrating the HIV Ministry into the culture of the church“the HIV Ministry has been a continual tradition at the church. It has been a model program. It is in line with the teaching of the church over the years. The core values were already set in place before I got here. The hardcore work had already been done. So it’s a part of the culture now. It’s expected.”

Implications

Practice Implications– importance of gaining a strong understanding of church culture

prior to attempting to develop church based HIV risk reduction programs.

– can better develop programs that can be effective, well supported, and maintained if within the context of the church’s religious culture.

Research Implications– may provide an effective model with which to understand the

development implementation and maintenance of an HIV Ministry over time.

– Using the concept of religious culture, a church can construct a role in the fight against HIV that is tailored to their needs and resonates with their beliefs and norms

Conclusion

Findings show the importance of religious culture which is instrumental in providing a framework for understanding and supporting the church’s role in HIV Ministry.

Additionally, findings support the idea that awareness and

acceptance of individuals living with HIV, a theology that is open to addressing sensitive issues, pastoral support, and awareness of the prevalence of HIV in the surrounding community may be important building blocks in development and maintenance of a HIV Ministry.

Acknowledgements

Dr. Barbara Dancy Study participants Dr. Mi Ja Kim Dr. Karyn Holm Dr. Marilyn Sommers Dr. Loretta Sweet Jemmott Dr. Janet Deatrick National Institutes of Health/National Institute of Nursing

Research (T32NR007964; Barbara Dancy, PI)

Questions?