Fulfilling Sacred Work – A Call to Action to Invest in Faith-Based HIV/AIDS Initiatives

For National Faith HIV/AIDS Awareness Day in 2019, I challenged religious and faith communities to radically affirm their LGBTQIA+ congregants as a means of actualizing faith in action but also as a robust HIV prevention strategy. I questioned whether we could place our faith in religious institutions to address HIV stigma within their public witness. The challenge to faith communities that remains is to repair the immeasurable harm that some of these institutions have caused their LGBTQIA+ parishioners and those living with or at risk for HIV. Equally salient, there is an abundance of demographic and scholarly evidence that supports that faith and spirituality are protective and resiliency factors for those most at-risk for HIV.

Also important is a fundamental commitment by state and local departments of health and private funders to continue to prioritize and advocate for faith-based outreach programs that seek to repair the harm and unequivocally engender an atmosphere of care for all people – which is a critical aspect of health and wellness. As states throughout the country face an unprecedented crisis in plunging state revenues prompted by COVID-19, today I  emphatically call that we minimize cuts to public health funding that delivers grants and aid to community-based organizations that have burned the midnight oil over the decades to repair harm and strengthen ties between religious institutions and the most marginalized within our communities.

The COVID-19 pandemic represents just the latest stark nexus point in the economic landscape of state public health funding. There has been a troubling decline in state public health funding for over a decade, and this phenomenon is not unique or particular to a specific state. Thirty-one states made cuts to their public health budgets over one year from fiscal year 2015-2016 through fiscal year 2016-2017. Local health departments have also experienced significant cuts that hinder their ability to continue longstanding collaborative partnerships with community-based organizations, including religious and faith-based communities. In many cases, these religious institutions are actively engaged and committed to unlearning and learning to fully recognize the humanity of those they serve, including people living with HIV.

Some individuals question the efficacy of faith-based outreach or contend that this outreach is no longer effective given the concomitant decline of religiosity among the youngest cohort of millennials. We know that HIV disproportionately impacts Black and Brown communities, and this has been the case since the mid-1990s. Among these communities, religion and faith remain a fixture of strength even if their allegiance to organized religion has waned. Sixty-one percent of Black millennials claim that religion is very important to them, according to a 2014 Pew Research Center poll. Nonetheless, there is a discernible difference between religiosity among Black millennials and Generation X and Baby Boomers, where upwards of 80% of individuals believe religion to be very important for their lives. It is undeniable that the adverse experiences of LGBTQIA+ individuals and those living with or at-risk for HIV within religious settings are among a plethora of reasons for this decline in religiosity. However, to say that faith institutions are a lost cause for effective allyship, seemingly not worthy of the redemption their core tenets demand, is to undermine our efforts to end the HIV epidemic. Further, there is emerging scholarly evidence that elucidates that spirituality is a protective factor in maintaining HIV negative status for those disproportionately impacted by HIV, namely Black gay men. A 2018 study found that spiritual and religious beliefs among Black gay men is a protective factor in how individuals negotiate their sexual health.

State and local funding of public health and, in particular, public health funded community-based partnerships with faith-based institutions must continue unabated. The latitude that the Ending the HIV Epidemic (EHE) plan gives communities in tailoring community engagement for their specific community needs provides space for engaging interfaith communities. Health departments can utilize different web meeting platforms and social media to engage religious institutions and individuals living with and at risk for HIV. This will allow for increased engagement with individuals who might not otherwise engage in in-person faith-based discussions. Partnerships between health departments, religious institutions, and community-based organizations are often two and three decades in the making. These efforts should continue as a community engagement strategy to end the epidemic. New York State represents a model of effective HIV faith-based programming — fostering abiding relationships with a focus on interfaith outreach and by facilitating frank discussions with emerging seminarians and physicians, who will undoubtedly encounter people living with or at risk for HIV during their careers. The NYS DOH’s Faith Communities Project understands and appreciates that HIV prevention is sacred work. Our charge as public health practitioners is to understand that our roles are sacred too. The landscape of HIV prevention and treatment has been transformed by the delivery of biomedical and biobehavioral interventions. These interventions represent just one ingredient of what it takes to end the HIV epidemic. Our sacred work of advocating for and funding faith-based HIV outreach is the much more difficult task. It requires us to appreciate the lived experiences of those most at-risk for HIV. It necessitates an open mind and heart to collaboratively partner with religious institutions with the intention of creating transformative healing.