Community and Church/Organization Context
Introduction
A matter of life-or-death surrounding the HIV/AIDS crisis within the African American community warrants intervention and assistance from the African American churches; education is vital. The Centers for Disease Control (CDC) states that an estimated 1 in 16 African American men and 1 in 32 African American women will be diagnosed with HIV infection at some point in their lifetimes. Also, over 40% of African Americans are living with HIV in the United States. As an extension of the preceding discussion, the chapter will discuss pertinent in the Community of Savannah, Georgia, the causes that can increase the likelihood of high HIV transmission rate, the stigmas, the ministry site the chosen project will be examining and guiding in becoming HIV/AIDS competent, the realities of sex, the tolerant and holistic approaches. There is a way you can make this difficult and complex set of variables sound less stressful? Meaning, make the sentence shorter or you make it sound like a complete thought.) Addressing this complex set of variables will be a challenge while simultaneously being a reason for the church taking the journey to becoming HIV competent. (Be careful with contradicting yourself and your objectives when writing. You do not want to open up for more questions when your position in this topic should be as an authority and expert in it.)
Section One
The Community Context; Savannah, Georgia (GA)
There are pertinent facts about the Community in Savannah, GA. According to the Census Bureau, in 2019, there were 1.5 times more Black or African (Non-Hispanic) residents (77.5K people) in Savannah, GA than any other race or ethnicity. The were 51.5k White (Non-Hispanic) and 5.01k White (Hispanic) residents, the second and third most common ethnic groups. Also, in 2019 there were universities in Savannah, GA that awarded 9,222 degrees. The student population is skew towards women, with 9,124 male students and 20,638 female students. Most students graduating from Universities in Savannah, GA are White (3, 912 and 46.9%), followed by African American (2,841 and 34.1%), Hispanic or Latino (807 and 98.7%), and Asian (349 and 419%). Lastly, in 2019, employed populations (185, 066) had a 2.83% 1-year decline. The most common job groups, by the number of people living in Savannah, GA are Sales & Related Occupations 8,066 (people) Office & Administrative Support Occupations (7,182) people and Food Preparation & Serving Related Occupation (7, 083).
Socio-economic Factor/Status Savannah, GA
The socioeconomic status of Savannah, GA community stands a fundamental factor in living standards. The U.S. Census Bureau estimates that 26.5 percent of Savannah residents are living in poverty. According to the Census Bureau’s statistics (APPENDIX 1), the poverty rate is 41 percent for Savannah residents under the age of 18.
The Census Bureau uses a set of money income thresholds that vary by family size and composition to determine who classifies as impoverished. For example, the most common racial or ethnic group living below the poverty line in Savannah, Ga is Black (19,081+ 1,007), followed by White (8,183+658) and Hispanic (2,115+370). Adams et al. (2018), contend that poverty can also increase the likelihood of a high HIV transmission rate amongst African Americans. Living in poverty involves poor quality health care, unsafe neighborhoods, and risky sexual behavior to survive. Poverty and lack are also factors associated with the use of transaction-based sex to ensure needed resources. Not only do these factors contribute to the spread of HIV, but they also reduce the quality of life for the infected individuals and their ability to access treatment. For example, CDC officials also say income inequality, discrimination, and poorer health outcomes are more widespread in the South of Georgia has the top rate of new diagnoses among states. According to the study from Health Testing Centers, the state ranks No. 3 in HIV risk in the nation, trailing only Ohio and Nevada, which used data from the CDC. According to the Georgia Department of Public Health, Chatham County had 1,890 persons living with HIV; Bryan County, 42; and Effingham, 77. The numbers are from 2017, the most recent available. Daniel Griffin, 32, co-founded Thrive SS, a nonprofit that provides support services to 900 African American men in Georgia who have HIV, said earlier this year that Southern states have an access-to-care problem linked to high uninsured people. ‘Access to care can be a problem for black and brown people in the Deep South,’ said Driffin, who has HIV. ‘Many people often go without meds.’
According to the American Psychological Association (APA), the rate of HIV infection directly relates with Social Economic Status (SES). The current increase in riskier health behaviours is attributable to the insufficiency of socioeconomic resources. These trends play a fundamental role in elevating HIV contraction rate. Some of the major immoral behaviours leading to the latter include substance use, which reduces the likelihood of using condoms. In parallel, APA also suggests that the high rate of unemployment and homelessness contribute to HIV infection significantly. Notably, these conditions often prompt individuals to engage in risky conduct such as prostitution. Food insufficiency poses a major challenge to HIV victims. Notably, these patients find it difficult to maintain a balance diet increasing the probability of severity. On that note, APA suggests that contrary to low-income areas, urban centers has a higher prevalence rate.
According to APA, scholars, such as Godley et al. (2020), urge that urban health incurs barriers from unemployment and poverty. The duo often sparks high crime rates and prostitution, aspects key in the spread of HIV. However, studies reveal that these aspect correlate, making it challenging to derive mechanisms that promote the latter. Even though HIV is predominately located in major urban areas, trends over the years suggest an increasing impact of the disease on women, minorities, older adults, rural residents, and those living in the South.
According to APA, the risk of infection is attributable to SES indicators. For instance, male and females have different elements that lead that increase infection. Notably, men tend to be at risk if exposed to income inequality. On the other hand, women may encounter the risk factors in the event of poverty, homelessness, and health issues. Despite the distinction, both gender encounter survival barriers upon HIV diagnosis if exposed to increase unemployment and poverty. Scholars also add illiteracy as a key SES indicator. The APA shows through these factors how transmission of HIV at a high rate is occurring because of socioeconomic status. All these aspects of poverty influence the prevalence of HIV/AIDS. Therefore, the black churches need to be more involved in the community.
Lastly, the rapid spread of HIV among African Americans is an essential pertinent fact about the Savannah, GA community. Percentages may not add up to 100% due to rounding. The rounding includes Asian, Pacific Islander, Native Hawaiian, American Indian, Alaska Native, and Multiple races (Appendix 2). The participants will review the HIV statistics in Savannah at the HIV/AIDS awareness workshops to determine the best way to shape the programs since there is a rise in transmissions in African Americans.
Racism and Ethnic Makeup
As seen in Table/Figure 1, people of color are disproportionately affected by the HIV epidemic. An unfortunate result of this statistic is racial discrimination. Unfortunately, the reality is that there is racial discrimination that exists in America. The Center for HIV Law and Policy “challenges barriers to the rights and health of people affected by HIV through legal advocacy, high-impact policy initiatives, and creation of cross-issue partnerships, networks, and resources.” They state, “As people of color disproportionately suffer the brunt of the HIV epidemic in the United States, HIV is a racial justice issue as well as a public health issue. For example, in 2010, African Americans accounted for an estimated 44% of all new HIV infections among adults and adolescents despite representing only 12% of the national population.” This shows how racial discrimination exists. These factors affect and increase health discrepancies in Black communities, impacting the lack of access to the prevention, care, and treatment of HIV and quality health care. In addition, the media and health give the least amount of attention to the risks and losses related to HIV.
Mass Incarceration
Mass incarceration also can increase the likelihood of a high HIV transmission rate amongst African Americans. In addition, mass incarceration is a contributing factor because of sexual interactions between inmates after incarceration. Link and Phelan stated that “approximately 1 in 15 Black adults aged 18 and older is currently incarcerated, as is 1 in 9 black men between the ages of 20 and 34. Data shows that Black men are disproportionately incarcerated compared to their White counterparts.” The CDC has discovered that most Black men have contracted HIV before incarceration. The suggestion is that the social and economic challenges these men face upon release could compromise the possibility of transmission. The CDC also asserts that “women who have an incarcerated partner are more likely to become sexually active with other men during their main partner’s incarceration.” This outcome shows the lowered ratio of available men because they are fewer men. This might raise the transmission of HIV.
Relevant Lifestyle and Behavioural Characteristics
Underestimation of Personal Risk
Then, there is the underestimation of personal risk. Many communities believe they are not at risk for HIV because of the lack of knowledge, myths, and misconceptions about HIV. For example, Magic Johnson’s thoughts were clearly expressed in a news conference:
On November 7, 1991, basketball legend Earvin Magic Johnson disclosed to an astonished world at a surprise news conference that he had contracted HIV and would retire immediately from the Los Angeles Lakers. Nevertheless, Johnson vowed to ‘battle this deadly disease’ and established the Magic Johnson Foundation to help educate people about HIV and AIDS.
This shows how over 25 years ago, a person who thought that contracting HIV could never happen to him because he was a basketball superstar could still contract the virus. He dared to tell his story during a news conference to warn others that it could happen to them, and HIV/AIDS is not a gay disease. Misconceptions about our risk can lead us to engage in unprotected acts increases a higher risk for contracting HIV. Dr. Mervyn Silverman asserts that the announcement is a crucial moment in the history of HIV/AIDS in America. He acknowledges how Magic Johnson was an invincible basketballer. However, despite the greatness, the player was vulnerable to HIV infection. This vulnerability created a significant public stigma . This reference displays why the announcement was such a critical moment in history. After the information, they realized that people could still live long and happy, fulfilled lives after receiving a diagnosis of HIV or AIDS.
Sense of Community
Stigma
Stigmas can increase the likelihood of a high HIV transmission rate amongst African Americans. Corrigan stated that patterns of behavior, thinking, and feeling are being noticed. Whether they are described in moral, psychosocial, or medical terms is influenced by societal discourse and usually varies over time. This statement emphasizes the complicated nature of stigma because it is not always easily identifiable or consistent throughout society. Therefore, managing stigma is an additional burden of living with a stigmatized condition.
Further, stigma defined as HIV and AIDS are considered the most stigmatized illnesses in the world according to Bauer: (1) A widely used definition of stigma is ―an attribute that is deeply discrediting. Society deems this attribute unacceptable. (2) The stigmatized condition may be rejected. (3) Stigma is the combination of labels, stereotypes, discrimination, categories, status, or lack thereof, guided by those with access to power. (4) Stigma appears at the intersection of culture, power, and difference. It is something that society disdains at such a level that it removes any credibility the individual once had Herek. People distinguish and label human differences:
Dominant cultural beliefs link labeled persons to undesirable characteristics…
Labeled persons are placed in distinct categories.
Labeled persons experience status loss and discrimination
Entirely dependent on access to social, economic, and political power allows the construction of stereotypes, separating labeled persons into distinct categories, and the full implementation of disapproval, rejection, exclusion, and discrimination.
Alternatively, stigmatization begins with signals or labels that signal subsequent prejudices and discrimination. Thus, stigma can become attached to an individual to become the defining characteristic by which a person is identified. This identification is a way of separating individuals and is guided by the beliefs attached to the characteristic or Stigmatization is perpetuated through communication, Especially within health contexts because societal understandings of health conditions are influenced by how they are discussed. For example, AIDS used to be referred to by the medical community as the Gay-Related Immune Deficiency Syndrome, which communicated that AIDS only affected gays, stigmatizing the community. This example illustrates how the powerful can spread stigmas. Their access to the public, combined with their believability, allows the powerful to establish and promote their ideas on a larger platform. Unfortunately, society supported these messages by stigmatizing these individuals.
Causes of Stigma
The leading causes of stigma are incomplete knowledge, fears of death and disease, sexual norms, and a lack of recognition of the existence of stigma. Insufficient and inaccurate knowledge combines with fears of death and illness to perpetuate beliefs in casual transmission and, thereby, avoidance of those with HIV. The knowledge that HIV can be transmitted sexually combines with an association of HIV with socially “improper” sex, such that people with HIV are stigmatized for their perceived immoral behavior. Finally, people often do not recognize that their words or actions are stigmatizing. The effects of the stigma that are related to HIV/AIDS according to Link and Phelan:
Associated with deviant behavior, both as a product and as a producer of abnormal behavior
He is viewed as the responsibility of the individual.
It is tainted by religious belief as to its immorality.
Thought to be contracted via a morally sanctionable behavior … and therefore considered to represent a character blemish.
They are perceived as contagious and threatening to the community.
Associated with an undesirable and an unaesthetic form of death.
Not well understood by the lay community and viewed negatively by health care providers.
Stigma towards Families living in the community
Isolation and rejection towards families suspected to have HIV.
Name-calling, finger-pointing, gossip, rumors, backbiting, jealousy.
Rumors about HIV and AIDS are used as a weapon to denounce families.
Suspicion/speculation about other people based on observed symptoms.
Stigma triggered by visits/food provided by home-based care workers.
Shame or loss of family honor – “You have discredited/shamed our family.”
Snooping – people visit to see the condition of the person living with HIV.
Separation of personal household items like utensils
They are burning or discarding clothing and other things used by a person(s) living with HIV.
Physical isolation (i.e., being forced to sleep alone or in a separate room)
Minimum physical contact
Being hidden from neighbors
Being treated as a burden
Minimized input regarding family decision-making.
Judging, blaming, condemning – made to feel they have disgraced the family.
Family members are not being honest about their feelings toward the individual(s) living with HIV.
Partners/spouses of a person(s) living with HIV assumed to be HIV-positive
Stigma and Communities
Evictions
Halted visits but continued concern about being criticized for not visiting.
No exchange of food, gifts, or time for outings
Fear of infection through sharing or using household items owned by a person living with HIV.
Fear of stigmatization through association
Fear of children being infected through contact with the HIV-affected family
Stigmatization of Homosexuality
Some people may have negative attitudes toward homosexuals. The CDC states, “These attitudes can lead to rejection by friends and family, discriminatory acts and violence, and laws and policies with negative consequences. If you are gay, bisexual, or a man who has sex with other men, homophobia, stigma, and discrimination can affect physical and mental health.” The CDC also contends that the attitudes tend impact an individual’s income, employability, and securing health insurance. In parallel, the institution adds that the stigmatization may hinder access to quality care, stimulate poor mental health, substance abuse, and increase sexual behavior. CDC suggests that homosexuality stigmatization reduces the chance of having long term relationships. This barrier increases the possibility of acquiring HIV and STDs. Most importantly, the attitude discourages one from disclosing their sexual orientation hence reducing the possibility of social support. Stigmas can be especially hard for people to deal with who are attracted to the same sex. These negative attitudes increase their chance of experiencing violence. Other than violence, there are bullying, teasing, harassment, physical assault, and suicide-related behaviors.
Intimacy with sexually active partners continues to play a vital role in the spread of HIV/AIDS. This increased their risk of having sex with someone who is already HIV positive. According to the National Library of Medicine, “HIV/AIDS has been blamed on promiscuity and the promiscuous, and a major goal of many HIV-prevention programs has been to induce people to reduce the number of their sexual partners.” The authors also state, “Despite the salience of this concept in the AIDS discourse of scientists, policymakers, the media, religious leaders, and the gay community, critical analysis of the role of promiscuity in this epidemic has been lacking. This affects their ability to access treatment and creates an environment that discourages people from getting tested for HIV. This includes discussing their status with family, intimate partners, and their spiritual leaders. The silence about HIV has played a significant part in the lack of awareness in Black populations all over the United States.
An example of the silent community comes from the researcher’s experience with a family member who died of AIDS. The researcher can recount an unforgettable experience with HIV/AIDS in her family over thirty years ago. The researcher suddenly developed a closer friendship with her friendly yet private female cousin, often visiting her family home. Unfortunately, her cousin never disclosed anything much about herself. Her guarded nature caused a growing concern, which eventually created distance between them. During this same period, the researcher’s cousin became ill, and her visits stopped. A couple of years later, she passed away. Her death brought great emotions of sadness. It also revealed to the researcher her ignorance concerning what life looks like for individuals dealing with HIV/AIDS diagnoses. This realization led to anxiety and eventually a new perspective and appreciation for individuals affected by HIV/AIDS. During this time, the researcher desired that the church would have spread HIV/AIDS awareness, so she could have been more cautious and gained the necessary knowledge to have been more compassionate.
Yet, historically, conservative churches have been mostly silent, whereas those with lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) persons in their congregation have been more active. An active voice in the community on a topic increases compassion and decreases stigmas on an issue. Thus, the church influences its congregation and community. Restoration Praise and Worship Family Ministry (RPFWM) church in Savannah, GA, can increase compassion and decrease stigmas through the awareness of HIV/AIDS. The researcher has been attending RPFWM for over 20 years. During that time, the researcher has observed a lack of understanding regarding HIV/AIDS. Therefore, the researcher has passionately moved toward guiding RPWFC to becoming an HIV/AIDS competent church. The definition of an HIV/AIDS capable church is a religious institution that operates on inner competence. The church achieves the latter by internalizing the impacts, risks, and consequences and acknowledges the need to respond compassionately and appropriately. On that note, such religious institutions acquire competence by seeking knowledge, leadership, and resources. On the same note, creating external competence requires establishing institutional and theological capacity. The duo should relevant socially, inclusive, collaborative, and sustainable with the aim of reducing HIV infection.
An HIV/AIDS competent church defines inner capable as a socially supportive religious organization that enables members to cope by increasing people’s awareness and knowledge. This suggests that the researcher would guide participants to create a non-judgmental environment that is compassionate to ensure that the participants collaborate with the researcher and experience the love of God, even if some of the participants are not Christians. The experience of being HIV competent in education will measure the level of competency through surveys. The outer competence is by showing compassion and responding to those who have contracted HIV, which helps restore hope and dignity to those suffering from the deadly disease. Due to the seriousness of HIV/AIDS and how it affects individuals in so many ways, churches in the community need to be an active voice and not silent.
The post Community and Church/Organization Context Introduction A matter of life-or-death surrounding the HIV/AIDS appeared first on PapersSpot.
