Barriers to and facilitators of HIV involvement among Chinese immigrant religious institutions in New York City

Background: Religious institutions have significant influence and reach in US Asian and Pacific Islander immigrant communities and, therefore, have the potential to address growing concerns around HIV. However, few Asian immigrant religious organizations are engaged in HIV-related educational or stigma-reduction activities even though a high proportion are involved in other health-related activities (as we have previously reported). Methods: Using a stratified sampling approach, we selected 21 Chinese immigrant Buddhist and Christian religious institutions in NYC and within each institution conducted 9 in-depth qualitative interviews (total n=189) and 40 quantitative interviews (total n=840), focusing on attitudes and experiences relevant to their faith, their institution and HIV.

Results: Our data suggest that religious imperatives to demonstrate compassion, prior involvement in providing non-religious community services, organizational conflict that allows minority or unpopular views to surface, and presence of “innovators” among the membership are facilitators of organizational involvement in HIV. HIV stigma and concern about organizational reputation, lack of congruence with organizational mission, lack of capacity and resources, perception that HIV is not a relevant problem in the community or among their constituents, and lack of “innovators” among the membership are barriers to organizational involvement.

Conclusions: Religious institutions in Asian immigrant communities continue to play an important role in supporting the health of the communities they serve. Understanding barriers to and facilitators of their involvement can help extend that role to include HIV education and HIV stigma-reduction activities as well programming addressing other important but stigmatized health issues.