Despite the disproportionately high rates of heterosexually transmitted HIV infection among African Americans and ongoing need for effective inexpensive behavioral interventions, no published research has examined the use of sermons as an HIV prevention tool in black churches. Recently published data that underscore the importance of sexual network patterns and social context in the epidemiology of heterosexual HIV infection among African Americans have broadened the range of potentially effective HIV prevention messages. We propose to use the faith-based research network of black Christian churches in North Carolina convened by the Carolina Shaw Partnership to form a pastor work group that will use principles of community-based participatory research to develop sermon-based messages to decrease heterosexual risk behaviors. We will: 1) conduct in-depth qualitative interviews among the network pastors to determine the extent and nature of comments concerning sexual behavior in their sermons at baseline and assess their perception of barriers to their incorporating prevention messages into their sermons; 2) work with the pastors to develop culturally appropriate HIV prevention messages for pastors to use in their sermons that are consonant with the pastors' religious beliefs, are consistent with current public health research findings, and draw upon the pastors' insights; and 3) conduct additional qualitative interviews among the work group pastors as well as pastors of other black churches to test the acceptability and feasibility of pastors' incorporating into their sermons the messages they develop. This project builds on our previous research concerning the epidemiology of heterosexual HIV transmission among African Americans in the South - and also builds on the existing infrastructure of the Carolina-Shaw Partnership for the Elimination of Health Disparities (Project EXPORT). A future study will prospectively evaluate how often pastors actually do incorporate these messages and will ultimately evaluate their effect on rates of HIV and other STIs in black communities. Thus, the propose research constitutes a critical first step in the development of an inexpensive, cost-effective HIV intervention that will use the strengths of the black church to decrease sexual risk behaviors among African Americans.
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