CDC's HIV screening guidelines encourage routine screening of all individuals aged 13 to 64 in medical settings. However, many African Americans (AAs) have limited access to health care and barriers to HIV services may prohibit some from seeking HIV screening. The African American church is an institution with extensive influence in Black communities and may be an ideal setting for increasing reach of HIV screening beyond traditional medical settings;yet, no controlled studies exist on HIV interventions in AA churches. The primary aim of this study is to fully test a culturally/religiously-tailored, church-based HIV screening intervention against a standard HIV information intervention on HIV screening rates at 6 and 12 months with adult AA church members and community members who use church outreach services. In this two-arm clustered, randomized community trial, churches will be matched on SES, membership size, and denomination, then randomized to treatment condition. It is projected that 14 churches (7 churches per arm;110 church and community members per church;1,540 participants total) will be required to detect significant increases in HIV screening in the intervention arm. Intervention content is guided by the Theory of Planned Behavior (TPB). Intervention delivery will be guided by a Community Engagement and Social-Ecological approach. This approach includes church leaders delivering culturally/religiously-appropriate HIV education and screening materials (e.g., sermon guides, HIV screening testimonials, church bulletins) and activities (e.g., pastors modeling receipt of HIV screening, HIV screening events) from a church-based HIV Tool Kit through multilevel church outlets (community-wide, church-wide services, ministry and outreach groups, individual) to increase intervention reach and dosage. It was hypothesized that this church-based HIV screening intervention will significantly increase HIV screening rates vs a standard HIV information intervention in AA church-populations at 6 and 12 months. The role of potential mediators and moderators related to receipt of HIV screening will be evaluated and a process evaluation to determine modifiable implementation fidelity, facilitators, barriers, and costs related to increasing church-based HIV testing rates will be conducted. This intervention study could provide an effective, scalable model for HIV screening interventions in AA churches.
This novel study is the first to test an HIV screening intervention in African American churches. It could provide a theory-based, faith community engagement model for implementing scalable, wide-reaching HIV screening interventions by supporting African American faith leaders with a religiously and culturally-appropriate, church- based HIV Tool Kit. This model could have a significant public health impact on increasing routine HIV screening rates in African American communities.