Metropolitan Community AIDS Network: Faith-Based Culturally Relevant Services for African American Substance Users at Risk of HIV

Abstract

Although representing 12 percent of the U.S. population, African Americans represent more than one-third of all cumulative AIDS cases and the majority of all new AIDS cases in the United States (Centers for Disease Control and Prevention, 2003). Despite this disproportionate representation by African Americans, traditional approaches to both substance abuse (Jones, 2004; Longshore, Hsieh, & Anglin, 1993; O'Connell & Langley, 1997) and HIV/AIDS (Cochran & Mays, 1993; Jones; Land, 2000) prevention and treatment continue to be problematic given unfavorable views of available treatments and distrust of mainstream social services (Wright, 1998). Furthermore, traditional middle-class European American intervention and treatment models do not consider the barriers to prevention and intervention facing African Americans and ignore the idea that individuals engage in behaviors that are functional for the environment in which they exist (McNair & Prather, 2004). Research has increasingly emphasized the need for promoting prosocial motives (that is, re-entry into a moral community, renewed spirituality, collective and individual self-esteem, as well as establishing/reestablishing role in family) to increase service use among African American clients (Longshore, Grills, Anglin, & Annon, 1997; O'Connell & Langley). The integration of a faith-based or spiritual component is important in the provision of culturally relevant services to African Americans. Spirituality has been a fundamental aspect of the African American experience (Constantine, Lewis, Conner, & Sanchez, 2000; Frames & Williams, 1996) and involves a relationship between the individual and some transcendent force or the representation of an integrative force in the individual's life providing meaning and core values (Van Hook, Hugen, & Aguilar, 2001). This concept is particularly important when working with African American clients in that as a group, African Americans' ethos is spiritual in nature. BACKGROUND Located in Nashville, Tennessee, Metropolitan Community AIDS Network (Metro CAN) was developed in response to the growing need to develop culturally relevant modes of service delivery specific to HIV/AIDS risk among substance users. The program is housed in the First Response Center of Metropolitan Interdenominational Church, a nonprofit faith-based organization founded as a ministry of inclusion in 1994. Believing that the church too often allows individuals to be excluded from active participation in a church on the basis of external characteristics, the congregation has used the central organizing theme of the single word whosoever, taken from John 3:16 in the Bible, as a mandate for inclusion and the basis of a mandate of service. This allows all individuals (regardless of past or current involvement in substance use or other similar circumstances) to participate in the social support system afforded through fellowship in a church. All programs are grounded using the principles of spirituality, love, and community to create a service-oriented environment where clients experience neither condemnation nor judgment. The program model is based on an enhancement of the strategies developed as part of the extensively evaluated National AIDS Demonstration Research (NADR) program and the National Institute on Drug Abuse (NIDA) Cooperative Agreement for AIDS Community-Based Outreach/Intervention Research Program, which is regarded as the best practice model for reaching out-of-treatment substance users (Needle & Coyle, 1997; Needle, Coyle, Normand, Lambert, & Cesari, 1998).The program combines elements of the NIDA/NADR Outreach model with extensive supportive case management. A faith-based noncoercive perspective is infused throughout all interventions. Specifically, this model is extended with the word whosoever. Recipients of services are not expected to accept, or even necessarily support, the religious faith of the service providers, but are viewed as co-equal participants in all interventions. …