Can interfaith research partnerships develop new paradigms for condom use and HIV prevention? The implementation of conceptual events in Malawi results in a 'spiritualised condom'.

OBJECTIVES: The aim of this intervention research study was to engage senior leaders of faith-based organisations (FBOs) in Malawi in a participatory process to construct an interfaith theology of HIV/AIDS. This process was designed to enhance the capacity of faith leaders to respond more effectively to the HIV/AIDS pandemic. METHODS: An evidence-driven combination of ethnographic and participatory action research methodologies was utilised. Conceptual events-innovative participatory action research processes-were held over the 4-year project and brought together health service providers, policy makers and a non-governmental organisation in partnership with FBOs and grassroots faith-based communities. RESULTS: Through facilitated dialogue, an interfaith theology of HIV/AIDS emerged, resulting in the proposition that a 'spiritualised condom' endorses a 'theology of protecting life'. This proposition was based on the following convictions: (1) life is sacred and to be protected, (2) to kill or murder is a 'greater sin' than the 'lesser sin of infidelity', (3) protection of the innocent is a moral and religious requirement, (4) condoms have the potential to prevent the death of an innocent person and (5) condoms need to be encouraged, even in the context of marriage. CONCLUSIONS: Clinicians, non-governmental organisations, health service providers and policy makers, assisted by health social scientists, can successfully partner with FBOs and their leaders to (1) modify and transform faith-based understandings of HIV risk and (2) bring about attitudinal and behaviour changes that help to address the challenges associated with HIV/AIDS.

Experiences and benefits of volunteering in a community AIDS organization.

This qualitative study examines the AIDS service organization-volunteer relationship from the volunteer's point of view. Factors that led to a relationship with an AIDS service organization included personal values and individual characteristics and needs. Volunteers reported many rewards from the work itself and the responses of others. Volunteers also encountered challenges that included role demands, role-ability fit, and stress/burnout concerns as well as limited organizational resources and structural obstacles. These results suggest that care must be taken to ensure that the volunteer role meets the needs, skills, and abilities of the individual volunteering. The need to ameliorate challenges is clear for AIDS service organizations seeking to retain volunteers. Some of the preventive strategies include goal-setting and feedback, individual-sensitive role redesign, opportunity to participate in decisions, and increased communication.

Vaccine preparedness: lessons from Lyantonde, Uganda.

To explore how to better educate rural Africans about preventive HIV/AIDS vaccine trials, 15 semi-structured, open-ended interviews were conducted with villagers in Lyantonde, Rakai District, Uganda. This study reports on the findings by focusing on the attitudes, knowledge and questions the rural villagers had about HIV/AIDS-preventive vaccine testing. While several interviewees confused preventive vaccines with therapeutic vaccines, most were clear about the distinction and about key questions to ask about vaccine testing. In addition, some subjects manifested high levels of trust in the likely effectiveness of preventive vaccines, even in the testing stages, most subjects demonstrated the potential to be intelligently inquisitive about the likely effects. In sum, these villagers show the potential to be reliable subjects, motivated for appropriate reasons, and willing to play a role in advancing the progress of HIV/AIDS vaccine development in Africa.

Community-based HIV education and prevention workers respond to a changing environment.

The purpose of this study was to understand the culture, values, skills and activities of staff involved in education and prevention activities in community-based AIDS Service Organizations (ASOs) in Ontario, Canada, and to understand the role of evaluation research in their prevention programming. In this qualitative study, 33 staff members from 11 ASOs participated in semi-structured interviews that were analyzed using the grounded theory approach. ASO staff experience tension between a historical grassroots organizational culture characterized by responsiveness and relevance and a more recent culture of professionalization. Target populations have changed from being primarily gay men to an almost unlimited variety of communities. Program emphasis has shifted from education and knowledge dissemination to a broadly based mandate of health promotion, community development, and harm reduction. Integration of evidence of effectiveness, social-behavioral theory, or systematic evaluation is uncommon. Understanding these points of tension is important for the nursing profession when it is engaged with ASOs in programming or evaluation research.

Vaccines in the public eye.

Preventive vaccines are widely acknowledged as the best hope for protection against infectious pathogens such as avian flu, HIV and SARS. As a result, they have received much recent attention in the media that has exposed some of the challenges involved in optimally using vaccine technology.

Malawi faith communities responding to HIV/AIDS: preliminary findings of a knowledge translation and Participatory-Action Research (PAR) project.

This paper reports on the preliminary findings (year one) of a four-year intervention and Participatory-Action Research (PAR) project in Malawi. Project goals are to enhance the response capacity and effectiveness of Faith Community (FC) leaders to the problem of HIV/AIDS. Ethnographic interviews with FC leaders were conducted. Intercultural training sessions and theological events were also held using a participatory method called conceptual events. Preliminary results indicate a commitment on the part of faith community leaders to enter into a dialogue with other sectors and faith traditions in addressing the common, critical concern of HIV/AIDS. All FC leaders share a common feeling that they are a small moral voice in this fight against HIV/AIDS, drowned out by a 'big voice' promoting condom use by donors and government. FC leaders are expected to present themselves as having an authoritative voice with respect to protecting the soul, but at the same time are sincerely searching for ways to speak about HIV/AIDS in more practical ways. Condoms become a metaphor for resistance. For example, FC leaders wish to know how the message of condom promotion (a behavioural and technical argument) might be grafted onto what they would posit as a moral message of care, prevention and support. This challenge is made even more complex by the quiet assumption to incorporate the truths of African traditional religion (ATR) in the construction of an ecumenical theology of faith, hope and compassion.