Stigma as a Barrier to HIV-Related Activities Among African-American Churches in South Carolina

Abstract

South Carolina has one of the highest HIV/AIDS prevalence rates in the United States. More than 70% of those infected are African American. Traditionally, Black churches have been one of the primary sources of health outreach programs in Southern African-American communities. In this research, we explored the role of HIV-related stigma as a barrier to the acceptance of HIV-related activities in Black churches. A survey of African-American adults in South Carolina found that the overall level of stigma associated with HIV/AIDS was comparable to what has been found in a national probability sample of people in the United States. Consistent with the stigma-as-barrier hypothesis, the degree to which survey respondents endorsed HIV-related stigma was related to less positive attitudes concerning the involvement of Black churches in HIV-related activities.

KEYWORDS:

• HIV-related stigma
• Black churches

ACKNOWLEDGMENTS

The authors thank Eddie Clark, Karen Breejen, Aida Cajdric, Karen Johnston, Megan Markey, and Christine Rufener for their valuable comments on an earlier draft of this article.

Notes

The SCHAC and Herek’s original surveys contained the item: “Most people with HIV/AIDS don’t care if they infect other people with the AIDS virus.” Herek argued this item was related to the construct of responsibility (called blame here). However, the item was not correlated with the other two blame items in the SCHAC sample and it substantially lowered the reliability of the blame sub-scale and its correlations with other measures. So, we excluded this item from the blame measure analyses. Herek’s surveys and the SCHAC survey also included two items concerning symbolic contact—a desire to avoid things somehow associated with HIV/AIDS. One item was actually a difference between how people felt wearing a secondhand sweater worn by someone with HIV/AIDS and how people felt about wearing a secondhand sweater. The other item involved one’s comfort level in drinking from a glass in a restaurant that had been used by someone with HIV/AIDS some days earlier. These two items were not correlated in the current study. Principal components and reliability analyses showed that the drinking glass item fit well into the comfort construct (Table 1). So, the drinking glass was included in that construct and the contaminated sweater item was excluded altogether.

Analyses including and excluding these items from the avoidant intentions construct produced similar results.

Herek conceptualized the construct of support for coercive policies to include three facets: support for quarantines of PLWHA, support for publicly identifying PLWHA, and support for mandatory testing. Analyses of the interrelationships among these items in the SCHAC survey led us to condense these items to support for required testing in order to achieve an internally consistent measure.