How Faith Based Organizations’ Doctrines Regarding Sexuality Affect Their Participation in the Public Health Response to HIV in the Eastern Caribbean

Abstract

Faith-based organizations (FBOs) are influential in the Eastern Caribbean. To understand their role in HIV-related health programs, we conducted a cross-section of surveys and interviews with representatives from FBOs in four countries: Antigua and Barbuda, Barbados, St. Kitts and Nevis, and St. Vincent and Grenadines. We examined HIV-related and sexual health activities, capacity to provide programs, and attitudinal influences, such as stigma. We found that although some FBOs are engaged in sexual health and HIV-related work, many are limited by formal church doctrines and parishioner perceptions about HIV. HIV prevention messages, for example, were centered on abstinence and monogamy. Promoting condom use was considered incompatible with church doctrine. HIV-related stigma and discrimination were considerable, primarily because attitudes toward men who have sex with men and sex workers were conditioned by views that these people engaged in “sinful” activities that should be renounced. Nevertheless, FBO leaders were motivated by compassion and wanted to provide care and psychosocial and spiritual support to HIV-infected people, and were willing to be part of the public health response to HIV, within the limits of their doctrines. FBOs may serve an important role in de-stigmatizing HIV among parishioners, emphasizing compassion and reframing HIV as a chronic health condition. However, for many sexuality-related issues and interventions, collaborations with outside organizations may be required.