Faith-based organisations have been successful in delivering HIV services, African studies show

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Faith communities and leaders in rural Zambia and Nigeria helped provide HIV testing, treatment, and prevention services, including PrEP. This approach also increased HIV literacy and decreased stigma in local communities, according to studies presented at the INTEREST 2023 conference in Maputo, Mozambique last week.

The uptake of HIV testing is lower among men in African countries. The Faith Community Initiative in Zambia targeted men in religious settings to encourage HIV testing. James Sikanyika from Ciheb Zambia said that of 3401 men reached by the initiative, 1926 men were tested. Two hundred and forty seven men (13%) received a positive diagnosis and were linked to treatment. Out of the 1679 men who tested negative, 44% started PrEP.

The initiative also collaborated with Zambia Interfaith Networking Group to educate 607 faith leaders in three provinces on ‘Messages of Hope’ and the benefits of HIV testing and treatment. These messages were disseminated during homilies, sermons, and Christian radio programmes.

Glossary

stigma

Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.

capacity

In discussions of consent for medical treatment, the ability of a person to make a decision for themselves and understand its implications. Young children, people who are unconscious and some people with mental health problems may lack capacity. In the context of health services, the staff and resources that are available for patient care.

representative sample

Studies aim to give information that will be applicable to a large group of people (e.g. adults with diagnosed HIV in the UK). Because it is impractical to conduct a study with such a large group, only a sub-group (a sample) takes part in a study. This isn’t a problem as long as the characteristics of the sample are similar to those of the wider group (e.g. in terms of age, gender, CD4 count and years since diagnosis).

control group

A group of participants in a trial who receive standard treatment, or no treatment at all, rather than the experimental treatment which is being tested. Also known as a control arm.

linkage to care

Refers to an individual’s entry into specialist HIV care after being diagnosed with HIV. 

Also, 87 faith community members were trained in psychosocial counselling and HIV testing. They offered HIV testing with linkage to treatment or prevention, depending on the test result.

In Nigeria, a faith-based model was developed with the aim of mitigating HIV-related stigma in the community. The project, 'Strengthening Faith-based HIV Response', was implemented in Benue and Kaduna states between 2017 and 2019. The intervention leveraged the moral authority of faith leaders to shape opinions, address stigmatising narratives, and improve HIV literacy in faith congregations.

A simplified version of the country’s HIV Anti-Discrimination Act was developed using verses from the Bible and Quran, and a sermon guide was also produced.

The team conducted three-day capacity building for selected religious leaders on HIV-related stigma mitigation through sermons, HIV literacy, and messaging. The faith leaders were supported to hold dialogues with different groups in their congregations. They facilitated HIV testing and set up confidential support groups for people living with HIV in their congregations.

The study compared data from a representative survey of 510 congregants in 20 intervention congregations and 500 congregants in 20 control congregations in the same locations. At follow-up, there was a 27% increase in willingness to accept HIV results if tested positive at the follow-up stage and an 18% increase in the control group at follow-up. There was a significant increase in willingness to receive communion with people living with HIV in the intervention group, and improvements in HIV knowledge.

The intervention in Nigeria was able to achieve a positive attitudinal shift and improvements in HIV literacy, while the intervention in Zambia reached both young and older men with HIV testing, treatment, and prevention services, including PrEP. This suggests that partnering with faith-based organisations may offer unique opportunities for HIV prevention and treatment interventions.

References

Nyirongo N et al (presenter Sikanyika J). Empowered by Faith to Leave No One Behind: Collaborating with Faith-Based Organisations to Deliver HIV Services to Men in Zambia. INTEREST, Maputo, abstract 30, 2023.

Nwakamma I et al. Efficacy of a Faith-Based Model for HIV-Related Stigma Mitigation. INTEREST, Maputo, abstract 355, 2023.

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