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AIDS and Behavior
Published in: AIDS and Behavior 3/2019

01-10-2019 | Human Immunodeficiency Virus | Original Paper

Reducing the African American HIV Disease Burden in the Deep South: Addressing the Role of Faith and Spirituality

Authors: Amy Nunn, William L. Jeffries IV, Pamela Foster, Katryna McCoy, Cassandra Sutten-Coats, Tiara C. Willie, Yusuf Ransome, Robin Gaines Lanzi, Edward Jackson, Jannette Berkley-Patton, Michael Keefer, Jason D. Coleman

Published in: AIDS and Behavior | Special Issue 3/2019

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Abstract

Nearly half of HIV infections in the United States are concentrated among African Americans, and over half of new HIV infections occur in the South. African Americans have poorer outcomes in the entire continua of HIV and PrEP care. Complex social, structural, and behavioral factors contribute to our nation’s alarming racial disparities in HIV infection, particularly in the Deep South. Despite the importance of faith, spirituality and religious practice in the lives of many African Americans, there has been little scientific investment exploring how African Americans’ religious participation, faith and spirituality may impact our nation’s HIV epidemic. This article summarizes the state of the science on this critical issue. We also identify opportunities for new scholarship on how faith, spirituality and religious participation may impact HIV care continuum outcomes in the South and call for greater federal research investment on these issues.
Literature
1.
Centers for Disease Control and Prevention. HIV in the United States by geography. Atlanta, Georgia; 2017.
2.
Centers for Disease Control and Prevention. HIV among African Americans. Atlanta, Georgia; 2017.
3.
Centers for Disease Control and Prevention. HIV surveillance report, 2016; November 2017.
4.
Centers for Disease Control and Prevention. HIV in the southern United States May 2016; 2016.
5.
6.
Adimora AA, Schoenbach VJ, Doherty IA. HIV and African americans in the southern United States: sexual networks and social context. Sex Transm Dis. 2006;33(7):S39–45.PubMedCrossRef
7.
Aral SO, Adimora AA, Fenton KA. Understanding and responding to disparities in HIV and other sexually transmitted infections in African Americans. Lancet. 2008;372(9635):337–40.PubMedCrossRef
8.
9.
Hallfors DD, Iritani BJ, Miller WC, Bauer DJ. Sexual and drug behavior patterns and HIV and STD racial disparities: the need for new directions. Am J Public Health. 2007;97(1):125–32.PubMedPubMedCentralCrossRef
10.
Millett GA, Flores SA, Peterson JL, Bakeman R. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS. 2007;21(15):2083–91.PubMedCrossRef
11.
Rosenberg ES, Millett GA, Sullivan PS, del Rio C, Curran JW. Understanding the HIV disparities between black and white men who have sex with men in the USA using the HIV care continuum: a modelling study. Lancet HIV. 2014;1(3):e112–8.PubMedPubMedCentralCrossRef
12.
Johnson AS, Hess KL, Hu S, et al. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data: United States and 6 dependent areas, 2016; 2018.
13.
Stopka TJ, Brinkley-Rubinstein L, Johnson K, et al. HIV clustering in mississippi: spatial epidemiological study to inform implementation science in the deep south. JMIR Public Health Surveill. 2018;4(2):e35.PubMedPubMedCentralCrossRef
14.
Nunn A, Yolken A, Cutler B, et al. Geography should not be destiny: focusing HIV/aids implementation research and programs on microepidemics in us neighborhoods. Am J Public Health. 2014;104(5):775–80.PubMedPubMedCentralCrossRef
15.
Chan PA, Patel R, Mena L, et al. One year retention in PrEP care outcomes in a three-site implementation science program in the United States. Paper presented at: HIV Research 4 Prevention 2018; Madrid, Spain.
16.
Arnold T, Brinkley-Rubinstein L, Chan PA, et al. Social, structural, behavioral and clinical factors influencing retention in pre-exposure prophylaxis (PrEP) care in Mississippi. PLoS ONE. 2017;12:e0172354.PubMedPubMedCentralCrossRef
17.
Arnold T, Gomilla C, Bologna ES, et al. Young African American msms speak out: recommendation for enhancing retention in PrEP care for us implementation science programs in the deep south. 9th IAS Conference on HIV Science. Paris, France; July 2017.
18.
Goodenow MM. Nih strategic plan for HIV and HIV-related research, fy 2019/2020. In: Research OoA, ed.
19.
Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV epidemic: a plan for the united statesending the HIV epidemiceditorial. JAMA. 2019;321(9):844–5.PubMedCrossRef
20.
21.
22.
Vidal AC. Faith-based organizations in community development; 1999.
23.
Campbell MK, Hudson MA, Resnicow K, et al. Church-based health promotion interventions: evidence and lessons learned. Annu Rev Public Health. 2007;28:213–34.PubMedCrossRef
24.
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(4):323–31.PubMedCrossRef
25.
Sahgal N, Smith G. A religious portrait of African americans. Paper presented at The Pew forum on religion and public life; 2009.
26.
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(2):116–24.PubMedCrossRef
27.
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(5):e36172.PubMedPubMedCentralCrossRef
28.
Berkley-Patton J, Thompson CB, Martinez DA, et al. Examining church capacity to develop and disseminate a religiously appropriate HIV tool kit with African American churches. J. Urban Health. 2013;90(3):482–99.PubMedCrossRef
29.
Foster ML, Arnold E, Rebchook G, Kegeles SM. ‘It’s my inner strength’: spirituality, religion and HIV in the lives of young African American men who have sex with men. Cult Health Sex. 2011;13(9):1103–17.PubMedPubMedCentralCrossRef
30.
Nunn A, Parker S, McCoy K, et al. African American clergy perspectives about the HIV care continuum: results from a qualitative study in jackson, mississippi. Ethn Dis. 2018;28(2):85–92.PubMedPubMedCentralCrossRef
31.
Prevention CfDCa. High-impact prevention: At-a-glance. In: National Center for HIVB/AIDS Viral Hepatitis S, and TB Prevention, ed; 2018.
32.
Payne-Foster P, Bradley EL, Aduloju-Ajijola N, et al. Testing our faithh: HIV stigma and knowledge after a faith-based HIV stigma reduction intervention in the rural south. AIDS Care. 2018;30(2):232–9.PubMedCrossRef
33.
Ellison CG, Sherkat DE. The “semi-involuntary institution” revisited: regional variations in church participation among black americans. Soc Forces. 1995;73(4):1415–37.CrossRef
34.
Taylor RJ, Ellison CG, Chatters LM, Levin JS, Lincoln KD. Mental health services in faith communities: the role of clergy in black churches. Soc Work. 2000;45(1):73–87.PubMedCrossRef
35.
Wyatt GE, Williams JK, Henderson T, Sumner L. On the outside looking in promoting: HIV/AIDS research initiated by African American investigators. Am Public Health. 2009;99(S1):S48–53.CrossRef
36.
Sutton MY, Lanier YA, Willis LA, et al. Strengthening the network of mentored, underrepresented minority scientists and leaders to reduce HIV-related health disparities. Am J Public Health. 2013;103(12):2207–14.PubMedPubMedCentralCrossRef
37.
Nunn A, Cornwall A, Thomas G, et al. What’s god got to do with it? Engaging African-American faith-based institutions in HIV prevention. Glob Public Health. 2013;8(3):258–69.PubMedPubMedCentralCrossRef
38.
Nunn A, Sanders J, Carson L, et al. African American community leaders’ policy recommendations for reducing racial disparities in HIV infection, treatment, and care: results from a community-based participatory research project in philadelphia, pennsylvania. Health Promot Pract. 2015;16(1):91–100.PubMedCrossRef
39.
Abara W, Coleman JD, Fairchild A, Gaddist B, White J. A faith-based community partnership to address HIV/aids in the southern United States: implementation, challenges, and lessons learned. J Relig Health. 2015;54(1):122–33.PubMedCrossRef
40.
Coleman JD, Tate AD, Gaddist B, White J. Social determinants of HIV-related stigma in faith-based organizations. Am J Public Health. 2016;106(3):492–6.PubMedPubMedCentralCrossRef
41.
Aholou TM, Cooks E, Murray A, et al. “Wake up! HIV is at your door”: African American faith leaders in the rural south and HIV perceptions: a qualitative analysis. J Relig Health. 2016;55(6):1968–79.PubMedCrossRef
42.
Foster PP, Gaskins SW. Older African americans’ management of HIV/AIDS stigma. AIDS Care. 2009;21(10):1306–12.PubMedCrossRef
43.
Foster PP, Thomas M, Lewis D. Reverse migration, the black church and sexual health: implications for building HIV/aids prevention capacity in the deep south. AIMS Public Health. 2016;3(2):242–54.PubMedPubMedCentralCrossRef
44.
Berkley-Patton J, Bowe-Thompson C, Bradley-Ewing A, et al. Taking it to the pews: a cbpr-guided HIV awareness and screening project with black churches. AIDS Educ Prev. 2010;22(3):218–37.PubMedPubMedCentralCrossRef
45.
Berkley-Patton J, Moore EW, Hawes SM, Thompson CB, Bohn A. Factors related to HIV testing among an African American church-affiliated population. AIDS Educ Prev. 2012;24(2):148–62.PubMedPubMedCentralCrossRef
46.
Berkley-Patton J, Thompson CB, Bradley-Ewing A, et al. Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: a faith community health needs assessment. Eval Progr Plan. 2018;67:19–28.CrossRef
47.
Berkley-Patton J, Thompson CB, Moore E, et al. An HIV testing intervention in African American churches: pilot study findings. Ann Behav Med. 2016;50(3):480–5.PubMedCrossRef
48.
Berkley-Patton JY, Moore E, Berman M, et al. Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention. J Int AIDS Soc. 2013;16(3 Suppl 2):18644.PubMedPubMedCentralCrossRef
49.
Berkley-Patton JY, Thompson CB, Moore E, et al. Feasibility and outcomes of an HIV testing intervention in African American churches. AIDS Behav. 2018;23(1):76–90.CrossRef
50.
Wingood GM, Simpson-Robinson L, Braxton ND, Raiford JL. Design of a faith-based HIV intervention: successful collaboration between a university and a church. Health Promot Pract. 2011;12(6):823–31.PubMedCrossRef
51.
Lanzi RG, Footman A, JAckson R, et al. Love with no exceptions: a community-engaged faith-based HIV training with African methodist episcopal (ame) clergy and laity in the deep south. Paper presented at 146th Annual American Public Health Association Meeting; San Diego, CA; November, 2018.
52.
Lanzi RG, Footman AP, Jackson E, et al. Love with no exceptions: a faith-based community partnership for HIV training in the African methodist episcopal church—a statewide initiative in Alabama. AIDS Behav.
53.
Pichon LC, Griffith DM, Campbell B, et al. Faith leaders’ comfort implementing an HIV prevention curriculum in a faith setting. J Health Care Poor Underserved. 2012;23(3):1253–65.PubMedCrossRef
54.
Pichon LC, Powell TW, Ogg SA, Williams AL, Becton-Odum N. Factors influencing black churches’ readiness to address HIV. J Relig Health. 2016;55(3):918–27.PubMedCrossRef
55.
Pichon LC, Williams TT, Campbell B. An exploration of faith leaders’ beliefs concerning HIV prevention: thirty years into the epidemic. Fam Community Health. 2013;36(3):260–8.PubMedCrossRef
56.
Obong’o CO, Pichon LC, Powell TW, Williams AL. Strengthening partnerships between black churches and HIV service providers in the United States. AIDS Care. 2016;28(9):1119–23.PubMedCrossRef
57.
Jeffries WL IV, Sutton MY, Eke AN. On the battlefield: the black church, public health, and the fight against HIV among African American gay and bisexual men. J Urban Health. 2017;94(3):384–98.PubMedCrossRef
58.
Lassiter JM. Reconciling sexual orientation and christianity: Black same-gender loving men’s experiences. Ment Health Relig Cult. 2015;18(5):342–53.CrossRef
59.
Baldwin JA, Daley E, Brown EJ, et al. Knowledge and perception of STI/HIV risk among rural African-American youth: lessons learned in a faith-based pilot program. J HIV AIDS Prev Child Youth. 2008;9(1):97–114.CrossRef
60.
Collins CE, Whiters DL, Braithwaite R. The saved sista project: a faith-based HIV prevention program for black women in addiction recovery. Am J Health Stud. 2007;22(2):76–82.
61.
Medved Kendrick H. Are religion and spirituality barriers or facilitators to treatment for HIV: a systematic review of the literature. AIDS Care. 2017;29(1):1–13.CrossRef
62.
Doolittle B, Justice A, Fiellin D. Religion, spirituality, and HIV clinical outcomes: a systematic review of the literature. AIDS Behav. 2018;22(6):1792–801.PubMedCrossRef
63.
Van Wagoner N, Mugavero M, Westfall A, et al. Church attendance in men who have sex with men diagnosed with HIV is associated with later presentation for HIV care. Clin Infect Dis. 2013;58(2):295–9.PubMedPubMedCentralCrossRef
64.
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(12):730–7.PubMedCrossRef
65.
Williams MV, Palar K, Derose KP. Congregation-based programs to address HIV/AIDS: elements of successful implementation. J Urban Health. 2011;88(3):517–32.PubMedPubMedCentralCrossRef
66.
Ransome Y, Bogart L, Nunn A, et al. Faith leaders’ messaging is essential to enhance HIV prevention among black Americans: results from the 2016 national survey on HIV in the black community (NSHBC). BMC Public Health. 2018;18(1):1392.PubMedPubMedCentralCrossRef
67.
Centers for Disease Control and Prevention. HIV and youth. Atlanta, GA; 2018.
68.
Centers for Disease Control Prevention. Results from the school health policies and practices study 2014. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2015. p. 60–74.
69.
Lightfoot AF, Woods BA, Jackson M, et al. “ In my house”: laying the foundation for youth HIV prevention in the black church. Prog Community Health Partnersh. 2012;6(4):451–6.PubMedCrossRef
70.
World Health Organization. Faith-based organizations play a major role in HIV/aids care and treatment in sub-Saharan Africa; 2007.
71.
Blevins J. Are faith-based organizations assets or hindrances for adolescents living with HIV-they are both. Brown J World Aff. 2015;22:25.
72.
Fulton BR. Black churches and HIV/aids: factors influencing congregations’ responsiveness to social issues. J Sci Study Relig. 2011;50(3):617–30.PubMedCrossRef
73.
Centers for Disease Control and Prevention. Structural interventions; 2017.
74.
Bush S, Magnuson D, Rawlings MK, et al. Racial characteristics of ftc/tdf for pre-exposure prophylaxis (PrEP) users in the US. ASM Microbe/ICAAC; 2016.
75.
National HIV/AIDS strategy for the United States: Updated to 2020. In: Policy WHOoNA, ed; 2015.
Metadata
Title
Reducing the African American HIV Disease Burden in the Deep South: Addressing the Role of Faith and Spirituality
Authors
Amy Nunn
William L. Jeffries IV
Pamela Foster
Katryna McCoy
Cassandra Sutten-Coats
Tiara C. Willie
Yusuf Ransome
Robin Gaines Lanzi
Edward Jackson
Jannette Berkley-Patton
Michael Keefer
Jason D. Coleman
Publication date
01-10-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue Special Issue 3/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02631-4

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