Religious groups have done some good and some bad confronting AIDS in Africa, but several Western media criticisms of how religious groups are mishandling the epidemic are inaccurate and overstated. Through our research, my colleague Alexander Weinreb and I confirmed the importance of religious narratives and institutions in just about everything related to AIDS in Africa: religion matters for sexual behavior and how the disease is patterned within populations; it informs how people understand the disease; and it influences how people cope with effects of AIDS, for example, through providing care for the sick and for orphans.
Our team of researchers conducted extensive fieldwork in Malawi and made shorter visits to Kenya, Ghana, Mozambique and Tanzania. We visited more than 200 different congregations and conducted hundreds of interviews with religious leaders, lay people and parishioners. We also analyzed survey data from 30 African countries.
One topic where our research brings some much-needed clarity is the fierce debate over the relationship between religion and condoms. Many scholars and activists argue that religion is contributing to the spread of HIV by prohibiting condom use. But our analyses indicate that the persistently low levels of condom use in Africa can’t be attributed to religion at all. In interviews, lay people frequently complained that condoms diminish sexual pleasure, but almost never attributed any reluctance to use condoms to their religious beliefs or to any messages from their religious leaders. The vast majority of religious leaders also approach HIV prevention by prioritizing messages about abstinence and faithfulness, but their engagement with condoms is less moral than it is pragmatic. They were skeptical that their congregants would ever use condoms consistently. Such practical concerns are the real reason most religious leaders have not embraced condoms as anything other than a very partial solution to AIDS.
In another issue, the Western media frequently criticizes religious groups for condemning AIDS patients, but we found this story to be woefully incomplete. It is certainly true that in many parts of Africa, you can hear public messages and sermons arguing that AIDS was sent by God as some form of punishment. But these messages are almost always directed at the collective community. They do not reflect how individuals with HIV are, or should be, treated in their communities — probably because infected people are family members and friends. Messages about punishment and how “we are to blame” for the wrath of God, are intended to help people make sense of this difficult existential question: Why are so many good people are suffering and dying from this disease?
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In a sample of more than 3,500 people in almost 200 congregations, we found a handful of cases in which religion and medicine were at odds with one another. But most religious groups are actively promoting medical solutions, some in combination with faith healing practices, others not.
For example, one religious leader from a rural community took parishioners on a field trip to a medical clinic to have the whole congregation tested for HIV. This was in 2004, before testing facilities had been established in more than a handful of rural facilities in Malawi. Other religious leaders use every possible opportunity — weekly sermons, bible-study classes and funerals — to push a combination of moral and biomedical approaches that, together, reduce the spread of HIV.
A key contribution of religious groups in Africa that has been largely overlooked by the Western media is their critical role as care-giving organizations. This is among the most important findings in our study. Governments and volunteer programs across Africa are incapable of meeting the demand to provide care for the millions of people living with AIDS, even in relatively wealthy African countries like South Africa and Botswana. This leaves the extended family network and religious communities as the most effective providers of care for the sick and their families.
Much of this important care work is undertaken by women, including weekly collections during services and home visits after services; and rosters to organize cooking and cleaning. Because most African communities lack the state-supported infrastructure we enjoy in the West, this religiously-based (primarily Christian) organization of care is essential for easing the suffering of people living with HIV and for maintaining community well-being.
Our study of local Africa communities challenges the assumption that religion is a villain in the story of AIDS in Africa. The findings suggest that religion needs to be a key part of efforts to understand the African AIDS epidemic and to implement real solutions. If anything, without religion, the toll of AIDS on communities in sub-Saharan Africa would be infinitely worse than it has been to date.