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Christian Communities and Prevention of HIV among Youth in KwaZulu-Natal, South Africa
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Young people in South Africa, particularly females, are at great risk of acquiring HIV, and heterosexual sex is the predominant mode of HIV transmission. In order to curb the epidemic the Department of Health encourages all sectors in the society, including religious institutions, to respond effectively.

The present thesis seeks to increase the understanding of the role of Christian communities in prevention of HIV for young people. Three denominations in KwaZulu-Natal were selected to reflect the diversity of Christian churches in South Africa: the Roman Catholic Church, the Evangelical Lutheran Church in Southern Africa, and the Assemblies of God.

Using qualitative interviews the first paper explores how religious leaders (n=16) deal with the conflict between the values of the church and young people’s sexuality. Study II reports on attitudes to HIV prevention for young people among religious leaders (n=215) using questionnaire survey data. Study III investigates how young people (n=62) reflect on messages received from their churches regarding premarital sex by analysing nine focus group discussions. In the fourth paper, based on questionnaire survey data, we report on young people’s (n=811) experiences of relationships with the opposite sex and their perceived risk of HIV infection.

The view that young people in churches are sexually active before marriage was common among religious leadership. The majority of religious leaders also reported that they are responsible for educating young people about HIV prevention. Religious leaders who had received training on HIV were more likely to run a life skills programme for young people, however they were ambivalent about prevention messages. Young people reported premarital sexual abstinence as the main HIV prevention message from their churches. The majority responded that they had received information about HIV in church. To be in a relationship was common, more so for males for whom multiple relationships also were viewed more acceptable. To perceive themselves at risk of HIV infection was common.

Further training for religious leaders is needed to enable them to manage the conflict between the doctrine of the church and their willingness to assist young people in the transition into adulthood.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2011. , 69 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 684
Keyword [en]
HIV prevention, Young people, Religion, Religious leaders, Sexuality, HIV risk, South Africa
National Category
Medical and Health Sciences
Research subject
International Health
Identifiers
URN: urn:nbn:se:uu:diva-155097ISBN: 978-91-554-8113-1 (print)OAI: oai:DiVA.org:uu-155097DiVA: diva2:432721
Public defence
2011-09-23, Room IX, Universiteteshuset, Biskopsgatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Note
Faculty of MedicineAvailable from: 2011-08-30 Created: 2011-06-16 Last updated: 2011-09-08Bibliographically approved
List of papers
1. Ambivalence, silence and gender differences in church leaders' HIV-prevention messages to young people in KwaZulu-Natal, South Africa
Open this publication in new window or tab >>Ambivalence, silence and gender differences in church leaders' HIV-prevention messages to young people in KwaZulu-Natal, South Africa
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2010 (English)In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351, Vol. 12, no 1, 103-114 p.Article in journal (Refereed) Published
Abstract [en]

A series of semi-structured interviews on HIV prevention were conducted with South African clergy with pastoral and liturgical responsibilities from the Roman Catholic Church, the Lutheran Church and the Assemblies of God. The interviews were tape-recorded, transcribed verbatim and analysed by interpretive descriptive analysis. Three themes indicative of church leaders' approach to HIV prevention among youth emerged: dilemmas in breaking the silence on HIV and AIDS; ambivalent HIV-prevention messages from church leaders to young people; and gender differences in HIV-prevention messages. While church leaders had taken steps to overcome the stigma, the dilemmas of balancing theological understanding with resistance from their congregations presented a complex scenario. Ambivalence to HIV prevention concerned whose responsibility it was to educate young people about HIV; talking about sexuality in public; pre-marital abstinence and condom use; and resistance from congregation members towards HIV prevention. Finally, findings indicated a discrepancy between church leaders' belief in gender equality and the HIV-prevention messages they verbalised, which appears to burden girls.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-111816 (URN)10.1080/13691050903141192 (DOI)000277519300008 ()19675963 (PubMedID)
Available from: 2009-12-22 Created: 2009-12-22 Last updated: 2017-12-12Bibliographically approved
2. Involvement of religious leaders in HIV prevention, South Africa
Open this publication in new window or tab >>Involvement of religious leaders in HIV prevention, South Africa
2011 (English)In: Svensk Missionstidsskrift, ISSN 0346-217X, Vol. 99, no 2, 119-135 p.Article in journal (Refereed) Published
Abstract [en]

Religious leaders do not easily get involved in HIV prevention for young people since discussing sexuality publicly is taboo. A self-administrated questionnaire survey was conducted among local religious leaders (n=215) August-October 2008, when they convened at regional meetings in KwaZulu-Natal, South Africa. The questionnaire included socio-demographic data, previous HIV education and attitudes to HIV prevention for young people, policy issues, and questions on stigma. The participants (186 males, 29females) were affiliated to the Catholic Church (66), Lutheran church (82),and the Assemblies of God (67). Religious leaders regarded themselves as responsible for educating young people about HIV, and were interested in topics concerning young people’s sexuality. However, only 39% reported that their church had run a life-skill programme for youth in the last six months. The results indicated that religious leaders who had participated in HIV training were more likely to have arranged a life-skill programme for young people and also more likely to have taken an HIV test.

Religious leaders were positive about further training on HIV- related issues, and if learning opportunities are offered to them, this might increase their involvement in HIV prevention among young people.

Keyword
Religious leaders, HIV prevention, young people, South Africa
National Category
Medical and Health Sciences
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-156560 (URN)
Available from: 2011-08-03 Created: 2011-08-03 Last updated: 2017-12-08Bibliographically approved
3. Faith, Premarital Sex and Relationships: Are Church Messages in Accordance with the Perceived Realities of the Youth?: A Qualitative Study in KwaZulu–Natal, South Africa
Open this publication in new window or tab >>Faith, Premarital Sex and Relationships: Are Church Messages in Accordance with the Perceived Realities of the Youth?: A Qualitative Study in KwaZulu–Natal, South Africa
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2013 (English)In: Journal of religion and health, ISSN 0022-4197, E-ISSN 1573-6571, Vol. 52, no 2, 454-466 p.Article in journal (Refereed) Published
Abstract [en]

Since religious messages on life style have a strong impact in South Africa, it is important to assess how they relate to the situation for young people at risk of HIV infection. Nine focus group discussions were conducted with youth (n=62), aged 13–20 years, from the Roman Catholic Church, the Lutheran Church, and the Assemblies of God. Young people were ambivalent toward sexual contacts since these generally were expected to be part of a relationship even though the church condemns premarital sex. Girls perceived the moral norms to concern them more than the boys for whom sexual needs were more accepted. These moral barriers lead to lack of information about protection and may increase the risk of HIV. The realities young people facing should be a major concern for the faith communities.

Keyword
Adolescents, Faith communities, HIV prevention, Religion, Sexuality, Sub-Saharan Africa
National Category
Medical and Health Sciences
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-155280 (URN)10.1007/s10943-011-9491-7 (DOI)000317625500010 ()
Available from: 2011-06-20 Created: 2011-06-20 Last updated: 2017-12-11Bibliographically approved
4. Sexuality and HIV prevention: concerns of young people within faith communities in KwaZulu–Natal, South Africa:  
Open this publication in new window or tab >>Sexuality and HIV prevention: concerns of young people within faith communities in KwaZulu–Natal, South Africa:  
(English)Manuscript (preprint) (Other academic)
Abstract [en]

This paper explores HIV prevention messages reported by young people, and their perceived risk of HIV infection in faith communities. A questionnaire survey was conducted, including young people (n=1102) affiliated to the Roman Catholic Church, the Lutheran Church and the Assemblies of God. The questionnaire included: sociodemographic characteristics, the teachings of the churches on sexuality and HIV prevention, experiences of relationships, and the perceived risk of HIV infection. Participants were also encouraged to write questions on sexuality and HIV/AIDS. Unmarried individuals aged 15-24 years (n=811) were included in the analysis. The majority (83%) participated in youth groups and considered themselves as religious (80%). Premarital sexual abstinence was the most frequent (88%) reported prevention message from the church, followed by: faithfulness (23%), HIV testing (18%), and condom use (17%). The majority (83%) had experience of a relationship and perceived themselves at risk of HIV infection (53%); 29% of the respondents had been tested.  Using binary logistic regression analysis, we found that religious affiliation was associated with education on sexuality and HIV in youth groups, suggesting better information for members in the Lutheran and Catholic churches. Lutheran youth were more likely to be tested for HIV. The personal questions illustrated that young people in churches have serious questions about their sexuality, relationships, and HIV transmission.

In conclusion, faith communities focus on abstinence messages, while the information on sexuality and relationships appear to be less frequent. Faith communities need to strengthen their capacity to educate young people about sexuality, relationships and HIV prevention. 

Keyword
Religion; education; HIV; AIDS; youth; church; South Africa
National Category
Medical and Health Sciences
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-155278 (URN)
Available from: 2011-06-20 Created: 2011-06-20 Last updated: 2011-09-08

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