Barriers to HIV/AIDS-related health promotion interventions in African-American, faith-based communities: Addressing truth, lies, and conspiracy theory

This study examined factors believed to influence African-American Christians' motivation to participate in individual and congregational forms of church-based HIV/AIDS health ministry in Metropolitan Washington, DC. Two unexpected outcomes resulted from being asked to complete a self-administered survey instrument, the Black Christians' HIV/AIDS Survey-Revised. First, congregants began a dialogue contingent on the depth of their HIV/AIDS knowledge and the African-American epidemic. Second, congregants discussed their own HIV/AIDS ministry involvement or lack thereof. These conversations highlighted significant cultural barriers related to HIV/AIDS ministry and attitudes about research in the Black community. In addition to the legacy of distrust and belief that HIV/AIDS is genocidal weapon against African Americans, resulting from the Tuskegee Syphilis Study, additional beliefs and rumors emerged. Congregants spoke about the presence and withholding of a cure/vaccine for HIV/AIDS in Africa for the benefit of the pharmaceutical establishment. These African Americans also linked Biblical scripture, stating that “people are destroyed [infected with and affected by HIV/AIDS] for lack of knowledge” (Hosea 4:6, KJV) and belief that HIV/AIDS programming in the church is inappropriate. Finally, a new observation and conversation emerged with many African-American Christian men's' perception of being on the ‘down low' if involved in HIV/AIDS ministry efforts. Williams (2003) stated that “myths, misconceptions, apathy, and inadequate knowledge” may be “contributing factors to the AIDS epidemic among African Americans” (p. 296). Regardless of the age, education, or denomination, observations and feedback from congregants supported this statement. Confronting these beliefs and changing these attitudes remain a challenge for public health educators when planning HIV/AIDS prevention interventions in the Black church. How then do public health educators counter these myths and misconceptions? Jemmott, Jemmott, and Hutchinson (2001) offer an answer, “…future HIV/AIDS preventions programs must be innovative, anticipating the myriad of social and historical influences that may act as barriers to effective intervention efforts, and must involve the community members and leaders in program development from early planning stages” (p. 298). Additionally, suggestions for methods to respectfully address these issues to work toward successful in program planning and engage the African-American faith communities are possible and will be shared and discussed.