Perceptions and social constructions of HIV prevention in the Black Baptist church Public Deposited

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  • March 21, 2019
  • Roman Isler, Malika Dawn
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Introduction. Although the Black church (i.e., the Black Baptist church) has long exerted incomparable influence upon the health behaviors of African American communities, few have engaged in evidence-based interventions for HIV/AIDS prevention or collaborated with public health professionals on implementation. Because no research has examined the compatibility of these innovations with theological and socio-behavioral perspectives of Black church clergy and congregations, this study: 1) examines social constructions of HIV/AIDS and efforts to prevent HIV by rural and urban black Baptist churches in North Carolina; 2) identifies, compares, and contrasts key considerations about introducing 5 evidence-based HIV prevention innovations (abstinence, monogamy, condom use, voluntary counseling and testing, and prevention with positives) to Black Baptist churches; and 3) explores relevant, participant-driven HIV prevention models. Methods. This study used an exploratory qualitative design and methodological orientations of grounded theory and interpretive description. Data were collected using individual interviews and focus groups of respondents from 8 Black Baptist churches in North Carolina. A total of 1,117 interview minutes were audio-recorded and transcribed verbatim; the 638 resulting pages of text were managed using Atlas.ti 5.2. Analytic tools included open coding, memo writing, case-level comparisons, model development, and validation of the theoretical schema. Results. Case-level comparisons by church and by respondent segments revealed minimal distinctions. Respondents described social constructions of HIV/AIDS and its prevention in terms of 2 distinct worldviews, socio-behavioral and theological. Typical church responses to HIV/AIDS included silence, judgment, or maltreatment of persons living with HIV/AIDS. A combination of theological concepts, sin avoidance, and the socio-behavioral concept of avoidance of disease inform and enhance both the adaptability and acceptance of current evidence-based innovations. Participants also proposed non-evidence-based interventions. Conclusions. Findings offered insights into: expanding the utility of evidence-based HIV prevention models within Black Baptist church contexts; specific modifications to those models to increase compatibility; and additional Black church-based models that will require additional research. Further research is needed to reconcile socio-behavioral interpretations of homosexuality, accountability, and the consequences of sin within church-based contexts.
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  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Gillings School of Global Public Health (Department of Health Behavior and Health Education). "
  • Eng, Eugenia
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  • Chapel Hill, NC
  • Open access

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