“That's the Devil's Work”: Rural African-Americans describe the role of the church in addressing HIV

While academic-church partnerships have resulted in significant impacts on various health behaviors within the African American community, Blacks continue to be disproportionately affected by HIV/AIDS in the U.S. We explore rural African Americans' perceptions of how Black Churches can address HIV in the South through a church-based health promotion (CBHP) model. We report data from eleven focus groups with rural African Americans aged 16-45 years (n=94) conducted as part of a community-based participatory research project designed to develop a multi-level HIV risk reduction intervention. Thematic analysis of focus group data was performed by three independent coders using principles of grounded theory. Participants felt the Church's involvement in prevention efforts could significantly reduce the spread of HIV but did not feel that pastors were the appropriate persons within the Church to lead these efforts. Participants expressed a desire for the Church to mobilize around the disproportionate impact of HIV/AIDS on African Americans but felt the Church's reluctance to address this issue stemmed from the “old beliefs” about the cause of HIV (i.e, punishment for sin). Participants felt that researchers should make a greater effort to educate Church leaders about HIV so that pastors would feel more comfortable approaching the topic from the pulpit. Reconciling the Church's traditional beliefs with medicine's biological model of disease is a challenge to researchers seeking church partnerships. However, the integral role of Black Church in the lives of the African American communities it serves emphasizes the advantage of using CBHP model to address HIV.