HIV Testing, Stigma, and Risk: A Comparison of Church Leaders and Their Congregants

Area of Science:

• Public Health
• Community Health
• Epidemiology

Background:

• African American churches are vital community hubs for HIV testing and prevention.
• Beliefs and attitudes within congregations can significantly hinder HIV intervention implementation.
• Understanding differences between leaders and congregants is crucial for effective strategy development.

Purpose of the Study:

• To compare HIV testing behaviors, stigma, knowledge, and perceived risk between church leaders and congregants.
• To identify specific barriers within church settings that affect HIV prevention efforts.
• To inform targeted interventions for improving HIV testing uptake and reducing stigma.

Main Methods:

• A comparative, cross-sectional study design was employed.
• Self-reporting questionnaires were administered to participants in six churches in Baltimore, Maryland.
• Data were collected from 173 participants, including 68 leaders and 105 congregants.

Main Results:

• Leaders and congregants demonstrated similar high levels of HIV knowledge and low levels of HIV-related stigma.
• Church leaders exhibited higher levels of homosexuality stigma compared to congregants (p = .039).
• Congregants reported higher perceived HIV risk (p < .001) and were more likely to undergo annual HIV testing (p = .002) than leaders.

Conclusions:

• While HIV knowledge is high, specific stigmas and differing risk perceptions exist between leaders and congregants.
• Interventions should prioritize educating and engaging church leadership to foster greater support for HIV testing and prevention.
• Addressing leadership beliefs and behaviors is essential for overcoming barriers and enhancing the effectiveness of community-based HIV strategies.