On the battlefield: Black churches, public health, and the fight against HIV among black men who have sex with men

Issues: In 2010, black men who have sex with men (MSM) accounted for 28% of new HIV infections in the United States and 64% of new infections among African Americans. However, these men represented less than one percent of the U.S. population. Since the 1990s, HIV incidence has increased among black MSM. Description: Black churches, which are mainstays for black community engagement and well-being, historically have embodied public health's core value of care for vulnerable persons. These entities are instrumental in addressing many health problems that face black Americans. However, black MSM, who report substantial church involvement, often experience anti-gay treatment within black churches. Such treatment may make black MSM vulnerable to HIV infection by decreasing their self-esteem and restricting their abilities to acquire church-based HIV prevention services. Lessons Learned: Our comprehensive literature review suggests that black churches have been slow to respond to HIV among black MSM. Some church-based interventions for black MSM have promoted HIV testing and provided support services to HIV-infected men. Two effective behavioral interventions address the importance of religion among black MSM, but few churches use these interventions with their parishioners. Two national black organizations have encouraged churches to provide non-judgmental HIV prevention services to black MSM. Recommendation: Public health efforts that engage black churches to address HIV among black MSM might recognize the (1) work of churches currently conducting HIV prevention with black MSM; (2) opportunity for more church-based HIV prevention activities; and (3) harmful effects of anti-gay religious sentiment.