The Role of Churches in HIV Prevention

As part of the recently passed 2004/05 budget, the City Council City Council awarded just over $500,000 in HIV prevention to 46 black and Latino faith communities and a similar amount to the Latino Commission on AIDS and the National Black Leadership Commission on AIDS to work with these particular faith communities.

The funds are slated to continue existing or initiate new HIV prevention programs targeting the extended social networks that interact with these faith communities. In particular, the funding will target heterosexual women and young people and, in some faith communities, black and Latino men who identify as gay or who act on the “down low” or as “bugarones”—a Spanish term which very generally describes a similar phenomenon in the Latino community.

This decision by the City Council and the broad range of advocates that urged inclusion of the faith initiative in the City budget has raised some concerns. Given the Bush administration’s push for a controversial faith initiative to mobilize its conservative base, some advocates have expressed concerns about the use of city tax dollars “to promote religious agendas” or to underwrite “homophobic” institutions. There are also concerns about whether such funding violates the constitutional mandate requiring the separation of church and state.

As a gay Latino man living with HIV, I understand these concerns. I appreciate the fact that for many in LGBT community, including some journalists, what the advocates have sought and the City Council has done on the surface seems incongruous. Why give money to churches, when religious institutions in the city have taken extreme positions including opposition to the inclusion of sexual orientation in the Human Rights Law, opposition to the “Children of the Rainbow” curriculum, opposition to the Harvey Milk School and opposition to gay marriage? Many in the lesbian, gay, bisexual and transgender community have been deeply wounded by their experiences with faith communities.

I would like to help readers of Gay City News understand the public health rationale for including faith communities in HIV prevention and care, very generally address concerns about the separation of church and state, and talk about the particular projects that the City Council has funded.

For better or worse (depending on your perspective), black and Latino churches are critical institutions in the lives of the respective communities. For many Latinos, the churches have been the institutions that have eased their entry into American society, advocated for their interests and provided leadership. Black and Latino churches reach populations that would otherwise have little access to information and support. As public health professionals, we would be derelict to not enlist their involvement in fight to prevent HIV. As a means of reaching high-risk heterosexual non-drug using women and young people, the Latino church is an invaluable venue. In fact, some of the major barriers to prevention have their roots in the attitudes of those in faith communities unable to separate public health from religion—which is precisely why this initiative is so important.

The work of the National Black Leadership Commission on AIDS, the Latino Commission on AIDS, Balm in Gilead, Harlem Congregations for Community Improvement and hundreds of other groups around the country reaches populations that most AIDS service providers can never touch. We try and change attitudes that form barriers to prevention, such as the notion that AIDS is a punishment from God and that only bad people get AIDS. We access the extended families that emanate that social networks involved in faith communities with HIV testing and education. We enlist ministers as “gatekeepers” to large segments of the black and Latino communities to raise awareness and to use their leadership to separate the public health concerns from the moral, values-driven debate.

Working with faith communities requires a long-term commitment. An organization cannot just drop in, hand out some flyers and walk away. You need to build trust and relationships. This is a very slow and difficult process that uses the basic harm reduction principle of meeting the client “where he or she is” and not imposing your judgment on them. The church leadership needs to be satisfied that you respect their organization and way of operating and the leadership must also appreciate and buy into our public health mandate. In order to work with us, a faith community must agree to be trained on HIV prevention and support education. We do not pay for homilies or other religious activities—that, in fact, would be an insult to most ministers—or insist they change their basic moral beliefs. We develop work plans with each church that are science based HIV prevention interventions.

The Latino Commission on AIDS and the National Black Leadership Commission on AIDS have been doing this work for many years. We have worked with these particular congregation for years. Our work is especially important because the federal Centers for Disease Control and Prevention has all but abandoned its work with faith communities in high-risk communities and only wants to prevent people who are already positive from infecting others.

We believe that this strategy will ultimately increase the number of infections. The City Council has stepped up to plate to support a community-based intervention that has proven effective and for that we are grateful. We are grateful for the leadership of Council Speaker Gifford Miller and Councilmembers Christine Quinn, Marguerita Lopez, Al Van, Hiram Monserrate, Bill Perkins and many others. It took guts to make such an award and they deserve our gratitude.

Dennis deLeon is the president of the Latino Commission on AIDS.

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