Religious organizations have the potential to be either partners in or obstacles to combating the HIV/AIDS epidemic. On the one hand, research in Western countries has demonstrated empirical associations between religion, mortality and health, including HIV infection, and there is some evidence that these associations may hold for sub-Saharan Africa as well. In addition, religious organizations encourage some behaviors and forbid others, and as the most common formal organizations in rural Africa they could play a key role in mitigating the consequences of AIDS. On the other hand, anecdotal evidence suggests that some religious organizations consider one key approach of international HIV prevention programs, condom use, to be illicit, and that some stigmatize rather than support those with AIDS. Given the magnitude of the epidemic in SSA and the widespread participation of Africans in religious organizations, it is surprising that there has been no systematic assessment of the extent to which, and the mechanisms by which, religious organizations in SSA facilitate or impede effective responses to the epidemic. Thus, the principal aim of this proposed study is to collect new data on religious organizations in order to examine how these organizations and their """"""""moral communities"""""""" influence responses to the epidemic in a sub-Saharan African country with a major HIV/AIDS epidemic. The proposed project would add new, comprehensive data to an NIH-funded longitudinal study in rural Malawi, thus enhancing the value both of the proposed new data as well as the existing data. In particular, we propose to: (1) collect and analyze new data that would permit a rich description of the characteristics of religious organizations that are relevant for assessing their roles in combating the AIDS epidemic; (2) integrate the new data with an unusual ongoing longitudinal study and (3) conduct individual, village, and multilevel analyses using the integrated data set to examine the influence of religious organizations on individual and community-level HIV status and risk practices.
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