Barriers and Inroads to AIDS Dialogue in African American Religious Contexts. K. A. Swain, Texas A&M University, College Station, TX 77840
Despite the religious stigma surrounding AIDS, the African American church has potential for community HIV prevention because it is a touchstone for extended families that can help educate a population disproportionately infected with HIV. This exploratory study organizes and adapts health behavior theory, develops culturally specific, church-based HIV prevention strategies, and reveals factors that block or empower constructive AIDS dialogue in these settings. Ten focus groups with 85 adolescents and women and 13 in-depth interviews with clergy, church members, and AIDS organization leaders highlighted norms of AIDS knowledge and attitudes, health beliefs, religiosity, sexual behaviors and scripting, substance use, and source credibility. Teens collaboratively developed skits and "#34 for a photo comic book for use as an HIV prevention tool and as a device for exploring how women and teens talk about AIDS. Outcomes included dialogue initiation, enthusiasm, momentum, ownership, self-efficacy, and intent to maintain healthy behaviors. An organizing framework consisted of eight domains: predisposing and environmental factors, message design and delivery, cognitive and normative processes, enabling factors, potential barriers, and outcomes. Interpersonal risk interventions should be tailored to address condom use, stigma, homosexual behaviors and other taboos, while utilizing Christian principles such as evangelism, prayer, behavioral accountability, and divine guidance.
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