HIV/AIDS testing and Antiretroviral Treatment have been scaled up in Mozambique over the last several years in Mozambique through the National Health System. However, health systems data from the central provinces of Manica and Sofala, where HIV prevalence is 20-30 percent, reveal that loss to follow-up is considerable along the treatment cascade. In the process from HIV-testing to initiation of anti-retroviral treatment, over 40 percent of those who test positive are lost to follow-up. The problem is especially severe among pregnant women and youth; nearly 70 percent who test HIV-positive do not register at treatment clinics. These same peri-urban communities with clinics have also witnessed a dramatic expansion and proliferation of Pentecostal and African Independent Churches over the last 15 years. Census and research data suggest that in some areas over 50 percent of the adult population may have become church members. To date, most of these churches have had only minor involvement in HIV/AIDS outreach programs. Very little is known about how membership in churches may influence utilization of HIV/AIDS health services or how church expansion in the community may impact community attitudes toward services and AIDS stigma. This exploratory research will center on in-depth qualitative interviews with church member samples at each stages in the treatment process to determine church influence on treatment choices at four treatment clinics. HIV- positive church members who have abandoned treatment will be identified where possible and interviewed. Pastors, women's group leaders, and youth leaders will be interviewed to identify attitudes toward testing and treatment. This project is designed to provide insight into how Pentecostal and African Independent Churches are influencing utilization of HIV/AIDS testing and treatment services in Mozambique. The findings will be useful for developing health education and community mobilization programs designed to enhance service utilization and adherence to anti-retroviral treatment. This exploratory research will also provide evidence for how church expansion is making an impact on AID stigma and is affecting behavior change for HIV/AIDS prevention. ? ? ?
