Spiritual Agency as a framework for HIV prevention in African American gay men

Purpose: Spiritual agency is derived from a previous study exploring the utility of spirituality in the lives of African American gay men living with AIDS (Miller, 2005 and 2007). Using Bandura's (2002) conceptual framework of human agency, this study constructs an empirically based definition of spiritual agency to determine its relevance for African American gay men in relation to substance use and HIV prevention efforts.

Methods: Following Seidman's (1998) approach to in-depth interviewing, the 32 informants participated in three, ninety minute interviews. The data were analyzed using discourse, thematic and content analysis.

Results: The data analysis of 14 informants revealed a mixed understanding of spiritual agency in relation to their desired outcomes. The informants defined spiritual agency as the ability to integrate spirituality and their own efforts to achieve their desired outcomes. Six HIV positive men describe the significance of spiritual agency in reframing the effects of societal and religious homophobic and heterosexist messaging. Two HIV positive men report spirituality agency as a salient factor in their sobriety. Four of the HIV negative men suggest spiritual agency helps them maintain their sero-status. Two HIV negative men report no spiritual agency. They attribute this lack of salience due to the traumatic rejection by their family and their religious congregation.

Implications for Practice: The men who expressed salience for spiritual agency indicate that current HIV prevention efforts should include a dimension of spirituality. The preliminary findings suggest additional services should be developed to assess the extent of the trauma due to rejection from religious organizations experienced by African American gay men.