Religion and HIV/AIDS

It was my first time in a church in South Africa. I didn't know what to expect.

A trangendered woman stepped up to the pulpit and read an opening scripture from the Bible.

The worship leader walked to the front and said "If you're a lesbian,if you're gay, if you're bisexual, if you're transgender, you're welcome here! If you have HIV or AIDS you are welcome here! Everyone is welcome here."

That was when I began to start feeling like I could make this my home church.

I've already illustrated the damage that extremist and right-wing Christianity can do to when highly funded (and often foreign) religious groups attempt to influence state policies. But the fact remains that in the Majority world, religion-- whether Christianity, Islam, or Buddhism-- is adhered to at least in name by the majority of the population. In other words, interventions to combat HIV/AIDS will not be succesful if they are running contrary to widely held and respected religious norms of the country in which they are operating.

In fact, in the majority world it may well be that the broad-based popularity of religious institutions, the social and physical infrastructure, and the capability for both mass education and mass health outreaches make religious institutions uniquely capable of comnatting HIV/AIDS in locations where the road ends and hospitals, clinics, and educated social workers don't exist.

Examples of such alliances do exist. In Papua New Guinea, non profit initiatives educate and work with pastors and other church leaders to spread the word on HIV prevention through the social networks that only the church has. And they have been succesful in spreading accurate information and stemming the spread of the virus through this method. While unusual, this example may be one that can pave the road for using the extensive networks that religion have in order to combat the spread of HIV/AIDS.

I found in my time at Metro Evangelical Services in Johannesburg that religion is capable of expanding into non-traditional roles to help prevent HIV. M.E.S. might be one of the only organisations I know of where you can get preached to on the street about Christianity on one hand, and about the importance of wearing condoms on the other-- and all under the umbrella of one organisation, M.E.S. The pastors that were sent to buildings and networks in churches knew where they could refer people who were concerned about their status and to get accurate information.

There is much to learn about religious-health alliances. But without using the networks that already exist in countries to combat HIV/AIDS, and assuming their moral authority, it will be much more costly, expensive, and ineffective to try and combat HIV/AIDS.

Choices choices?

"HIV/AIDS can be prevented with the proper lifestyle"
"If you are faithful or abstinent, you won't get HIV"

Do these messages sound familiar? Pop culture-- funded and abetted by USAID's so called ABC funding criteria that only gives money to organisations that encourage Abstinence, Being faithful and Condoms (in that order)-- puppet these sayings again and again as if they have legitimacy for women's lives across incredeibly diverse cultures and countries all over the world.

When I heard Dr. Carr asking us at the OHTN conference if people from various cultures really have the choices this kind of message implies, I immediately thought of some of my friends in South Africa. My friend "Karabo," as we'll call her, confided in me that she wasn't certain if her fiance was being faithful to her.

"Karabo!" I said, immediately concerned, "If you're not sure that he's being faithful to you, you have to use condoms."

"Girl," she sighed, "I can't. I've dated him since we were both in high school. If I start asking him to use condoms now he will wonder why. He'll think I'm not being faithful."

This kind of situation is exactly what Dr. Carr is referring to.

The spread of the HIV/AIDS virus is more than a series of bad "lifestyle choices" by people across the globe. Rather, HIV/AIDS reveals people's vulnerability and their lack of power much more than it does their personal choices.

Take the example of the countless women who are victims of rape in conflict zones. HIV/AIDS in this situation can hardly be seen as a consequence of lifestyle. Instead, it shows the lack of respect for women's rights that soldiers and indeed the entire institution of revolutionary groups have. The spread of HIV/AIDS through rape also highlights the vulnerability of certain women more than others; those women that can not escape conflict zones when war breaks out often have less money, and most certainly lack the protection of a strong state system that could protect them.

The issues surrounding HIV/AIDS are complex. It is not fair to blame people who have the virus with poor lifestyle choices. More relevant is to examine the factors that have created such a vulnerability to contracting the virus, and to work on destroying these disempowering structures.

OHTN conference 2009

The Ontario HIV Treatment Network conference on "research at the front lines" served up more new possibilities for moving forward and hope against the many interrelated oppressions surrounding the virus than I had imagined. I don't know if I can quite properly describe the feeling of seeing a man dressed in a suit, introduced as a PhD, presenting a plenary piece on the latest research in HIV/AIDS and referring to the gay community as "we" and "ours". It was one of those moments that sends a beautiful wave of shock through your body, as you realise that suddenly the margins aren't quite as marginalised as you always deeply felt.

That was Dr. Ron Stall, and his work was a beautiful breakthrough into the interconnected psycho-social health issues gay men face. His research outlined how childhood abuse, depression, substance abuse, and intimate partner violence all increase the likelihood of acquiring HIV. More, if one of those problems is present in a man's life, there is a greater chance that any of the other problems will also occur; which is common sense when you think about it. Basically it means if you've been abused as a child you may end up in an abusive relationship; and an abusive partner is not one who is willing to be faithful and wear condoms if you ask him to. Sorting out exactly why each of these connections occur is complex; but each vulnerability factor serves to increase the likelihood that at least one other will be present.

Listening to Dr. Stall was one of those light-bulb moments for me. Not only because he tied together the deep wounds of homophobia so many of us have experienced as children, but also because it inspired me in what I want to do for my master's thesis. I had been interested in looking at refugee women from conflict zones, how service providers are treating them for trauma (or not), and intimate partner violence. Now I realise it is obvious I have to add HIV to that and see what connections arise. Many presenters at the conference illustrated that immigrants tend to seroconvert after arriving in Canada; I want to know if the same trend exists for refugees, and what role conflict and violence play into HIV. More importantly, I want to emphasise what service providers can do to meet refugees' needs, and how to prevent intimate partner violence and HIV acquisition.

I had to book two days off work to go to the conference, and I did so over the phone. My Mom, sitting next to me overheard me as I explained to my employer that I was going to a conference on HIV.

"They might think you have it, Mary Ann" my Mom worried.

"Then I just made one small step towards destroying that stigma" I replied.

And indeed, the research and the community surrounding this conference proved to do that in more ways than just my own small and inadvertent action.