Support versus stigma: How do African faith organisations in the UK respond to HIV-related issues?

Problem

African people in the UK bear a disproportionate amount of the national HIV burden, accounting for 32.3% of those affected despite only representing a tiny 1.7% of the population. The strong influence of faith organisations amongst African communities is a structural driver which cannot be ignored by the medical profession and needs to be understood in order for us to effectively and collaboratively respond to this situation. Whilst African faith organisations can and do provide great comfort and support to people living with HIV, they may also promote practices which negatively impact the health and wellbeing of those living with the disease. In the UK there has been limited research examining the responses of African faith leaders and their organisations towards HIV, nor how best to engage them in addressing issues related to it.

Approach

14 semi-structured interviews were conducted during 2014 with HIV-positive Africans who were members of a faith organisation and leaders of African faith organisations. Recruitment was undertaken using a selective sampling approach through a London-based non-governmental organisation which provides support for African people living with HIV. An inductive approach to preliminary analysis was conducted throughout data collection, to allow emerging ideas to influence the structure of subsequent interviews. Interviews were audio recorded and transcribed. A formal thematic analysis was then undertaken to identify key themes.

Findings

Stigma against issues relating to HIV was considered a major issue within faith organisations. Consequently some organisations do not view HIV as an issue which is relevant to them, and many people living with the disease feel they are unable to disclose their status to their faith community. Beliefs regarding miraculous healing and abstinence may create particular barriers to faith organisations addressing HIV and result in negative attitudes towards those living with the disease. However, many African faith leaders recognise the importance of their role in tackling the disease alongside medical treatment and want to proactively help those affected. There were examples of faith leaders being key providers of holistic support to those living with HIV, and of people affected using their faith organisations as arenas for HIV-related education and sexual health promotion. Strategies for engaging hard-to-reach faith organisations included involving both leaders and other members in long-term interventions.

Consequences

African faith organisations represent an under-utilised source of holistic support to people living with HIV, however organisations wishing to engage them must recognise that they face many barriers to doing so. Sustainable projects which work alongside local faith leaders and organisation members is essential to generate enduring changes in attitudes. Further research is needed to develop successful interventions which promote a positive relationship between African faith organisations and HIV issues in the UK.