ABSTRACT
The extent of the HIV pandemic - particularly in the hardest-hit countries; including South Africa - has prompted a call for greater engagement of all groups; including faith-based organisations (FBOs). Although FBOs are known to play a substantial role in providing care and support to those affected by HIV and AIDS; empirical evidence in regard to their actions in the broader context of stigma is limited. A qualitative; key-informant survey was conducted in South Africa as part of a six-country international study to examine perceptions of how FBOs have contributed to reduction in HIV risk; vulnerability and related impacts. The special emphasis of this paper is the influence of FBOs on stigma and discrimination. In-depth interviews were held with 34 senior-level key informants who act as key decision-makers in the response to HIV and AIDS in South Africa. Secular and faith-based respondents shared their perceptions of the faith-based response; including FBOs' actions in relation to HIV/AIDS stigma and discrimination. Our study revealed that while FBOs were perceived as taking some action to address stigma in South Africa; FBOs were also thought to contribute to HIV/AIDS- discrimination through conflating issues of sexuality and morality; and through associating HIV and AIDS with sin. The interviewees indicated a number of internal and external challenges faced by FBOs to deal effectively with stigma; including lack of information and skills; the difficulty of maintaining confidentiality in health services; and self-stigmatisation which prevents HIV-infected persons from revealing their status. Findings from this study may help both faith-based and secular groups capitalise on the perceived strengths of FBOs as well as to elucidate their perceived weaknesses so that these areas of concern can be further explored and addressed
Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Organizations , Social EnvironmentABSTRACT
Background: Stigma and discrimination are widely recognized as factors that fuel the HIV/AIDS epidemic. Uganda's success in combating HIV/AIDS has been attributed to a number of factors; including political; religious and societal engagement and openness - actors that combat stigma and assist prevention efforts. Objectives: Our study aimed to explore perceptions of Uganda-based key decision-makers about the past; present and optimal future roles of FBOs in HIV/AIDS work; including actions to promote or dissuade stigma and discrimination. Methods:We analyzed FBO contributions in relation to priorities established in the Global Strategy Framework on HIV/AIDS; a consensus-based strategy developed by United Nations Member States.Thirty expert key informants from 11 different sectors including faith-based organizations participated in a structured interview on their perceptions of the role that FBOs have played and could most usefully play in HIV/AIDS prevention; care and support. Results: Early on; FBOs were perceived by key informants to foster HIV/AIDS-related stigma and discrimination. Respondents attributed this to inadequate knowledge; moralistic perspectives; and fear relating to the sensitive issues surrounding sexuality and death. More recent FBO efforts are perceived to dissuade HIV/AIDS-related stigma and discrimination through increased openness about HIV status among both clergy and congregation members; and the leadership of persons living with HIV/AIDS. Conclusions: Uganda's program continues to face challenges; including perceptions among the general population that HIV/AIDS is a cause for secrecy. By virtue of their networks and influence; respondents believe that FBOs are well-positioned to contribute to breaking the silence about HIV/AIDS which undermines prevention; care and treatment efforts