Effects of a Faith-Based, Multilevel Intervention on HIV-Related Stigma and HIV Knowledge Among African American Church-Affiliated Populations

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BACKGROUND: HIV-related stigmas contribute to HIV disparities, which faith-based organizations could address, but few studies have measured faith-based HIV intervention effects on HIV-related stigmas. METHODS: Taking It to the Pews (TIPS) is a multilevel, religiously tailored HIV prevention intervention developed and implemented with faith leaders. Over 12 months, trained church health liaisons implemented the TIPS Toolkit (e.g., HIV sermon guides and responsive readings, testimonials) with the primary aim of increasing HIV testing. A cluster randomized controlled trial with 14 predominantly African American churches in Kansas City, MO, compared TIPS to a non-tailored, multilevel HIV education intervention; both intervention and comparison groups offered church-based HIV testing events with the local health department. We examined whether TIPS affected HIV stigma among congregants and community members, specifically, HIV discomfort (5-item scale), anticipated HIV stigma (4-item scale), and overall HIV stigma (11-item scale), while controlling for known correlates of HIV stigma. RESULTS: We recruited 1491 church and community members at 14 churches. Compared to standard HIV education, TIPS did not decrease HIV discomfort or overall HIV stigma and did increase anticipated HIV stigma. A secondary analysis found that among intervention participants, intervention exposure was associated lower stigma and higher HIV knowledge, with HIV testing events and information from health professionals or HIV + people being particularly influential. CONCLUSION: Direct contact with health professionals and HIV + people can help reduce stigma among church-affiliated populations, but broader exposure and strategies are needed for congregation-level stigma. Stigma reduction and HIV testing may have synergistic effects in faith-based settings.

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