The role of religious organizations in HIV/AIDS prevention and care is poorly understood within the broader African context of syncretistic cultural and behavioral practices. Sub-Saharan African family and community life are heavily intertwined with religious life, therefore religious groups, syncretistic or not, influence HIV- related beliefs and practices. In response to PA-04-115, the proposed project in the Republic of Malawi will partner with and utilize the resources of the Global AIDS Interfaith Alliance (GAIA), an international organization working primarily in Malawi to reduce stigma and enhance HIV prevention and care through churches and mosques. GAIA's long-standing ties to numerous faith-based organizations (FBOs) will allow an examination of four religious groups: Baptist (BACOMA), Muslim (MUWO), Living Waters (LW), and Anglican (ANG) to determine the extent and nature of their involvement in HIV-related activities. The study aims are to: 1. To describe BACOMA, LW, ANG, and MUWO strategies to prevent HIV infection and to care for people living with HIV/AIDS (PLWHA). 2. To describe the perceived power and influence exerted by four Malawi religious groups on risk-taking and HIV mitigation behaviors of their members from the perspectives of central leadership, local level leadership, and members at local levels. 3. To test the contribution of knowledge, attitudes to risk-taking behavior, subjective norms (religious group membership), perceived behavior control and behavioral intentions to the outcome behaviors (risk-taking and care/mitigation behaviors) using multilevel regression. Theoretical underpinnings include the Theory of Diffusion of Innovation which will guide the investigation of how ideas and innovations move through the religious bodies' hierarchy and the Theory of Planned Behavior to understand how individual behavior choices are related to religious organizations. The design is cross-sectional, with mixed methods, utilizing both qualitative and quantitative inquiry techniques in sampling, data collection and analysis. A purposive sample of 20 religious leaders at the central leadership level, 60 leaders as the local entity level, and 508 individual members of local religious groups, and 32 PLWHA will be included. In addition, data will be collected from a total of 24 focus groups, 8 groups consisting of leaders operating at the local level (2 each from BACOMA, LW, ANG, MUWO) and 16 groups consisting of individual members of the local entities. ? ? ?
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