Faith-based HIV Prevention for African American MSM

Susan Kegeles, UC-San Francisco; Vera Owens & Haqumai Sharpe, Unity Fellowship Church Movement
Social and Behavioral

Background: Young Black men who have sex with men (YBMSM) are at extremely high risk for HIV both in California and throughout the U. S. Our previous research indicated that religion and spirituality are very important in the lives of YBMSM--most were raised in the church and many remain connected to it--yet few HIV prevention interventions have incorporated faith-based approaches into their prevention strategies. In this project, the Unity Fellowship Church Movement (UFCM) and the UCSF Center for AIDS Prevention Studies (CAPS) will collaborate to develop an innovative HIV prevention approach, positioned within a faith-based organization, that will mobilize YBMSM ages 18-29 to reach into the Black community to encourage their peers to have safer sex, obtain HIV testing when needed and, for their HIV-positive peers, to access appropriate medical treatment, if necessary. This project will build on our previous UARP-funded work focusing on developing a community-level prevention model for use in BlackAIDS service organizations.

Methods: First, we will conduct 30 semi-structured telephone interviews with representatives of "Open and Affirming" (OA) Black Churches in California that publicly welcome and fully include people of all sexual orientations and identities into their programs, leadership, and ministries. Data from these interviews will assess the capacity, interest and attitudes of OA churches towards HIV prevention. Second, we will conduct 2 focus groups with YBMSM who do not attend church to discuss their attitudes towards OA churches running HIV prevention programs and their beliefs about barriers and facilitators to men who are not affiliated with churches participating in such interventions. Third, UFCM, CAPS, community experts, and consultants will collaborate to develop an HIV prevention intervention for Black faith-based organizations. This third step will involve gaining a better understanding about barriers and facilitators for YBMSM obtaining HIV testing and seeking treatment if they test HIV positive. We will conduct four focus groups: two with HIV-negative men to examine barriers and facilitators to testing and to mobilizing men to encourage their friends to get tested, and two with HIV-positive men to examine concerns about seeking treatment as well as other practical barriers they perceive to accessing health care. Additionally, we will convene two Boards of Cultural Experts, one comprised of YBMSM and the other of older BMSM (i. e., over the age of 30), to provide input on how the intervention should be designed, what components it should have to ensure cultural sensitivity and appropriateness forYBMSM and suitability for use by OA Black churches.

Expected Results: We anticipate that this study will inform our understanding about YBMSM's spiritual lives that may be complicated by ambivalent relationships with traditional Black churches. Optimally, this spirituality may provide a distinctive leverage point to motivate care-taking both of oneself and of others. Conversely, homophobic messages taught in traditional Black churches may fuel sexual risk taking and dissuade YBMSM from participating in a faith-based program. Thus, we need to better understand Black men's relationships with spirituality and the church before we can effectively integrate prevention into their faith communities.