Religious organizations are uniquely positioned to promote reduction of HIV stigma and to change social norms that discourage discussion of HIV among their formal memberships and in the larger community. Reducing stigma and changing such social norms are crucial precursors to conducting effective HIV prevention and testing programs and fostering acceptance of those living with HIV/AIDS. Yet, in many communities, religious organizations have been largely uninvolved in HIV prevention and support activities. The proposed study aims to analyze how social networks and religious beliefs facilitate or impede organizational change in religious institutions toward greater involvement in HIV. To control for the effects of ethnicity, religion and region, the study population has been narrowed to Chinese immigrant Buddhist and Christian religious organizations in New York City (NYC). Because of the choice of study population, the study's findings will be most relevant to Chinese and other Asian immigrant populations, which have recently had the largest increase in HIV/AIDS diagnosis rates in the US. In this light, the proposed study represents an opportunity to develop effective prevention efforts for US Asian populations before alarming indicators of increase translate into markedly higher HIV prevalence (as has occurred in other US communities and in the Asia/Pacific region), while also making a more general contribution to the theory and literature on religious organizations, social networks, organizational change, and HIV. The findings will be relevant to a wide range of communities, as increasing religious institutions'role in HIV has been generally under-studied. Because previous research indicates that barriers to religious organizations'involvement in HIV are largely social and religious, the study'specific aims are: (1) to determine how social network structures facilitate or impede organizational change with regard to involvement in HIV;(2) to identify and describe how leaders'and members'religious beliefs influence organizational involvement in HIV;and (3) to translate findings into strategies for overcoming barriers to involvement in HIV through a final working conference. To meet these aims, we propose a mixed methods study using qualitative interviews, quantitative surveys and social network methodologies to collect data on religious organization leaders'and members'social network characteristics, religious beliefs, HIV knowledge and attitudes, and innovativeness. Given the growing HIV epidemic in Asia and evidence of its impact on Asian American communities, increases in HIV/AIDS diagnosis rates, the central role of religious institutions in immigrant communities, and the formidable barriers to prevention education and care posed by high levels of HIV stigma, it is of critical importance to involve Asian immigrant religious organizations in efforts to reduce HIV stigma, prevent new infections, and ensure that Asian immigrants living with HIV receive proper care and support.
