In 2006, it was recognized that rural African Americans with HIV were part of an overlooked population that was in need of culturally contextualized interventions aimed at improving their quality of life and period of survival. This is where Project FAITHH comes in. According to the Centers for Disease Control, in 2014 in the U.S., African Americans are disproportionally affected by HIV/AIDS and account for higher proportions of HIV infections in all stages of the disease.
Alabama’s statistics mirror the US but are even more disproportionate.
These numbers are alarming. There are many factors related to living in the South which is vital to understanding the current HIV/AIDS epidemic; some of which include racism, lack of trust or suspicion, religious beliefs, poverty, and homophobia. Not only is rural culture more conservative than urban areas, rural residents are often more likely to lack access to health care and health care insurance preventing them from practicing primary prevention measures. Therefore, it is critical that theory-based, culturally sensitive and methodologically sound studies be conducted to develop interventions aimed at decreasing the incidence of HIV infection and improve the lives of those infected.
People living with HIV/AIDS (PLWHA) have been targets of stigma since the beginning of the pandemic. Even though HIV/AIDS has evolved from an acute, fatal disease to a chronic, treatable one, stigma continues to be a problem and is one reason that people are reluctant to seek testing and treatment. Stigmatization leads to feelings of shame, guilt, self-loathing and depression and results in low self-esteem and decreased social interactions. HIV/AIDS related stigma has been implicated in rejection by family members and friends, loss of employment, and housing evictions. Therefore, it is easy to see how stigma is contributing to the expansion of the epidemic. Therefore, Project FAITHH aims to decrease HIV/AIDS related stigma in rural Alabama by implementing a faith-based HIV/AIDS anti-stigma curriculum among African American congregations in order to decrease stigma individually and congregationally.
We aim to accomplish this goal through the pilot testing of an adapted 7 week anti-stigma curriculum designed for African American churches in rural Alabama. Our program consists of a conceptual framework that addresses HIV/AIDS stigma, fear, and denial (SFD). In this framework, SFD are targeted and potentially decreased through community empowerment, cultural competence skill development and social action. In addition, we aim to increase HIV/AIDS knowledge of Pastors and church members as well as increase their HIV prevention activities and their interactions with people living with HIV/AIDS (PLWHA).
Project FAITHH will have great significance in public health for a number of reasons. First, it addresses a major health disparity in the United States where Southern rural African Americans are disproportionately affected by HIV/AIDS. It is also relevant because it targets the Black church, which could play an influential role in decreasing multiple levels of HIV/AIDS related stigma: interpersonal, organizational/institutional and community. Additionally, the study is designed to empower PLWHA and to enhance their quality of life.
The Faith-Based Approach to Hiv/AIDS
The Black Church has substantiated itself as a foundational support for the African American community not only for its spiritual needs, but also for educational, political, and economic support. African American churches have become increasingly involved in battling health disparities, particularly in the areas of cancer, diabetes, and cardiovascular prevention. However, the Black Church has not embraced the HIV/AIDS epidemic as readily because of the difficult and complex issues attached to risk behaviors that are associated with the disease. However, the increasing disparity of HIV/AIDS in the Black community has demanded the engagement of faith based leaders in the epidemic.
For example, in 2006, the Centers for Disease Control convened a meeting for Black faith based leaders to elicit their help in increasing awareness of the disease in their communities and support for prevention activities such as testing. Additionally, strategies such as the Week of Prayer for HIV/AIDS have been a way to increase awareness among faith leaders in the African American community. Local involvement is critical not only for community support and culturally appropriate interventions, but also for sustained, relevant outcomes.