Racial and ethnic minorities suffer disproportionately from HIV, which is a leading cause of U.S. mortality and morbidity. One innovative way to expand community-based prevention, testing, and linkage to care for HIV is through faith-based organizations, which previous research has shown can promote health and well-being- both within their congregations and through outreach to the community. However, despite the important contributions religious congregations make in health, few engage in HIV-related activities. Although we do not understand all the reasons for this lack of congregational HIV activities, several factors identified in the literature include lack of information about the disese, its history, and its consequences, as well as limited congregational resources. Stigma related to the disease, homosexuality, and drug use has also been identified as a particularly important barrier. Prior research has been limited because of a dearth of data on the specific types of programs congregations develop. However, new data collected in the 2012 National Congregations Study (NCS)-a nationally representative sample of U.S. religious organizations-differentiates among congregational programs that aim to support people living with HIV (PLWH), prevent HIV, generally raise awareness about HIV, and support other organizations in addressing HIV. The proposed quantitative study will draw on this new data to better understand how congregations specifically engage in HIV activities across the country and to determine the congregational and community characteristics associated with the existence of each type of HIV activity in congregations. Specifically, it will aim to (1) characterize the specific types of HIV activities in which congregations engage or participate;(2) examine the characteristics of congregations (and their communities) that predict involvement in these activities;and (3) assess whether these factors differ by the majority race of the congregation (i.e., African-American congregations compared with others). To accomplish these aims, we will draw on innovation and institutional theories to support a framework for conceptualizing the factors that influence congregational involvement in HIV. Such factors include congregational composition and community context (e.g., congregational and community demographic and health characteristics), congregational doctrine and policy, congregational resources (e.g., financial, physical, and human resources), and the relationships the congregation has with outside organizations and the impact of those on developing HIV programs in congregations. The findings from this research will make an important contribution to our understanding of how religious organizations address HIV disparities and, in particular, how they do so among institutions attended by African Americans, who are disproportionately affected by HIV. It may also help inform policy and practice related to community-based HIV prevention and care efforts by identifying factors that facilitate congregational involvement. This work will be of particular interest to public health professionals interested in building effective partnerships with congregations around HIV.
The proposed research will provide new insights about how religious congregations address HIV in their community. It will also identify the community and congregation characteristics that are associated with their participation in particular types of HI activities.