Not Preaching to the Choir: Using Sermons as an HIV Prevention Tool in the Black Church

Background: Churches are a major force in the lives of African Americans and potential ally in HIV prevention. Sermons, the focal point of Black church services, reach many people – including some not reached by traditional HIV interventions. Few studies have examined the feasibility of using sermons as an HIV prevention strategy. This study worked with pastors of Black churches to develop culturally appropriate sermon messages that address heterosexual risk behaviors.

Methods: We recruited 35 pastors from Black churches in NC, interviewed them to assess their perception of barriers to incorporating HIV prevention messages into sermons, and formed working groups where we conducted capacity building workshops that addressed the epidemiological, clinical, and social aspects of HIV infection. Pastors generated a list of sermon topics with supporting Scriptures and developed sermons individually or in groups.

Results: Interviews indicated that before the working groups few pastors addressed HIV or sexual behaviors in their sermons due to their perception of a lack of Scriptural support for these discussions and concern that some topics were incompatible with their theology. Nevertheless, all pastors thought sermons should discuss HIV prevention. During the workgroup meetings pastors developed 20 sermons that addressed heterosexual risk behaviors. Sermons incorporated topics that were culturally appropriate and compatible with existing church doctrine, including marriage, partner selection, monogamy, teen pregnancy, and dating behavior.

Conclusion: Sermons are an affordable HIV prevention strategy for reaching many people, including those who are at-risk of acquiring HIV but would not be targeted by conventional HIV interventions.