Battling Stigma and Silence: Using CFSC to Fight HIV/AIDS in African American Communities
by Lenora Kukome
“We use dialogue, ministry and compassion,” explains Jacqueline Fleming Hampton, curriculum and evaluation coordinator of the Nashville, Tenn.-based Metropolitan Interdenominational Church Technical Assistance Network (MICTAN). MICTAN uses CFSC to attack the barriers of silence and stigma associated with HIV/AIDS in African American communities.
MICTAN’s work provides an interesting example of CFSC in action. The communication for social change approach fosters dialogue in local communities: People tell their stories, empower themselves, decide what the issues are and then address them as a community. CFSC fosters collective action, which influences individual change.
The alarmingly high incidence of HIV/AIDS among African American people has created a crisis. The statistics tell the story:
- While African Americans account for 13 percent of the United States population, each year they account for 49 percent of the estimated 38,096 new HIV/AIDS diagnoses;
- African American adults lead the rate for HIV diagnosis;
- Of all American children affected by HIV, African American children are the largest group. In 2005, 104 (63 percent) of the 166 children under the age of 13 diagnosed with HIV/AIDS in 33 states were black.
- African American men account for 42 percent of HIV/AIDS cases among all American men;
- Women who are African American account for 66 percent of all diagnoses among all American women, 20 times the rate for white American women;
- AIDS is the No. 1 killer among African American women between the ages of 25 and 34; and
- Each year, of 68 new cases among children under 13 years old, 46 are African Americans.
Factors contributing to the rapid rise of African Americans with HIV/AIDS are socio-economic issues, including lack of educational opportunities, plus delays in early detection, treatment, prevention and insufficient access to affordable care and medications.
Most urgently for MICTAN, eight of the ten states with high HIV-prevalence rates are in the U.S. South.
MICTAN was founded in February 1981. The group’s HIV/AIDS ministry began after one of its founders died from AIDS-related complications. It is one of the nine ministries comprising the organisation’s First Response Centre.
The other eight ministries of the First Response Centre are:
- The Wellness Centre, which addresses HIV/AIDS issues;
- Dina Project, which responds to sexual violence;
- Parents Assisting Children to Achieve, a child advocacy programme;
- Davidson County Harm Reduction Program, an outreach programme for intravenous drug abusers;
- Men of Faith, Men of Colour, an HIV outreach to gay and bisexual men;
- The Alcohol and Drug ministry;
- Imani Coalition, which is an HIV-linked network service;
- MetroCan, an outreach programme focused on prevention.
MICTAN targets community stakeholders, community organizations and local public health departments that have special interest, programmes or interventions that increase access and use of HIV prevention services for African Americans.
The MICTAN ministry provides capacity building and technical assistance to other faith-based organizations, community organizations and community coalition development projects. The ministry’s mission is: “Strengthening community capacity for providing access to, and utilization of HIV prevention services.”
To help spread the word about MICTAN’s work, Hampton, who works on HIV prevention capacity building, often speaks at conferences of faith-based organizations, such as the National Baptist Convention. After the initial introduction has been made—whether through conferences, mass mailings or other contacts—leaders of faith-based organisations are encouraged to contact MICTAN to determine the type of capacity building implementation that aligns with the specific needs of their communities.
Any church interested in using MICTAN’s approach needs to have some level of awareness among its leadership. “The MICTAN training is not HIV 101,” Hampton says. “But it [is designed] for organisations at an intermediate level of awareness who want to set up a programme.” Once this has been determined the capacity building can take place.
Before any training can begin, a needs assessment, conducted by a skilled person, is necessary to develop the trainings and workshops the organisation wants and needs. Even at this preliminary level, key players in the organization—leaders, pastors, etc.—are involved in the process. At this point, training sessions and workshops can be organized and trained specialists can be sent to the interested organizations.
MICTAN uses the CFSC approach as the primary tool for capacity building and AIDS programming.
The MICTAN programme focuses on four concepts:
- Collective action
Individual change begins among the church leaders as they get involved in the training process and develop plans, together, as a community, for a sustainable programme. The process begins with a community’s recognition that the HIV/AIDS problem must be addressed.
MICTAN’s training helps organizations understand how the myths, perceptions, and misconceptions contribute to the HIV/AIDS crisis in African American communities. Cultural sensitivity is essential when conveying information so as to not offend churchgoers while focusing on the issues in the most relevant manner possible
Dr. John Meeks of the Greater Nazarene Baptist Church of Evergreen, Ala., has been involved with MICTAN for several years and still uses the organisation’s expertise in faith-based initiatives. Meeks first encountered MICTAN through an HIV/AIDS conference in Nashville. Through the information MICTAN provided, Meeks realized the seriousness of the AIDS epidemic and asked training specialists to come educate key leaders in his community.
For his community, Dr. Meeks became the catalyst, the first stage of the communication for social change process.
In Greater Nazarene Church, and in many others throughout the United States, bottom-up, community-level dialogue and ownership of the problem become critical elements of MICTAN’s use of communication for social change. “Central to the training dynamic are communication and collaboration,” says Hampton. As part of the training, church leaders are encouraged to facilitate dialogues among the community.
Dialogue can be in the form of individual, first-person testimony, small-group conversations and facilitated dialogues. It begins when clergy and community members speak to each other about their concerns in addressing AIDS issues. Through this process, they are better able to understand others’ viewpoints—and develop an action plan.
Without dialogue, people with HIV/AIDS can feel marginalised. For example, in Huntsville, Ala., a young man, a member of a church, was HIV/AIDS positive. But his church had no place for him; he had no one to talk to, no one he could relate to on how he felt. The church rejected him. Members of his church community did not know what to do, so they simply brushed him aside.
The dialogue MICTAN encourages helps such situations. The organisation opens communication channels that may otherwise be closed. The organisation gives voice to the voiceless.
And dialogue may not only be about AIDS, according to Pastor Walter W. Matthews of Chicago, Ill. Sometimes, he says, underlying factors such as youth violence, poverty, lack of education or other issues affecting the community emerge. By involving all stakeholder concerns, organizations are in a better position to address the AIDS problem directly.
Another way MICTAN uses CFSC is through what they call peer-to-peer dialogue. “Ministers have a language all their own”, explains Hampton. Through peer-to-peer dialogue, ministers use their own words to express the importance of action to other ministers in a way other people cannot. The technique, she says, gives them affirmation from other pastors.
Pastor Matthews credits MICTAN with creating a place for such conversation to take place. “There were people in our community who accused ministers of not being active in addressing the AIDS issue. Through MICTAN’s training, we were able to bring both sides to the table. [The training] provided a space for pastors to tell their stories about involvement, encouraging other [pastors] to do the same.”
The Reverend James W. Hill, Jr. of Clarksville, Tenn., sees peer-to-peer dialogue as a way for ministers to talk to each other about the HIV/AIDS crisis and collectively come up with a solution. Such dialogue highlights the need for social change and a call for action. Using the information gathered from dialogues, organisation leaders conceptualise a plan for the future. They are asked a series of questions so that the capacity-building programme can be tailored to suit the specific needs of their communities. The leaders are also provided with a list of programmes and strategies implemented by other communities so they can draw ideas from them.
“I will not leave until I know the information and the strategies have been understood by the people I am training,” says Hampton.“ They must have a plan of action in place before I can confidently say they have been trained.” Both the trainer and the trainee must be able to communicate ideas to each other so that the needs of the community are satisfied. “Skills cannot be imparted if the key leaders are not involved with the process,” she says.
Not only is the training developed to suit the specific needs of the community, but it’s also designed so both the trainer and the trainee leave with more knowledge than what they came with. Hampton says: “The training is reciprocal…and varies and evolves over time. We are always looking for new ideas and for feedback.”
As with all communication for social change programmes, MICTAN’s goal is not to dictate how various organizations should increase awareness of, and access to, HIV/AIDS care. The goal is to encourage mobility as well as sustainability. MICTAN does not attempt to change any church’s belief system: It wants to change the way religious beliefs are actualised. MICTAN encourages organizations to focus on the infrastructures of ministry and compassion and use these establishments as venues for AIDS conversation and action. “We can find existing systems that can be enhanced,” Hampton says. “They need some changes, but they can still work.”
The organisation also emphasizes the importance of normalizing HIV testing among not only the members of the community but clergy members as well. As influential members of the community, the clergy act as change agents: Their individual actions impact the actions of their congregation. The Reverend Roosevelt Williams of Birmingham, Ala., describes a health fair held by his church: “During the [HIV] testing, a 95 year old woman got tested, encouraging other, more at-risk groups, to get tested as well.”
Another pastor, who wishes to remain anonymous, explains a similar result of individual action that became collective action:
The community I was a member of was suffering from a high prevalence of HIV/AIDS but did not want to address it. As a community leader, however, I saw that there was indeed a need to address this issue, as sensitive as it may be. After being introduced to MICTAN, we were able to develop a programme through the church that helped those with the virus get access to care. A young mother and member of the church, through an HIV/AIDS assistance program, was able to support another young mother with HIV/AIDS, helping her get access to the care available in the community. The telling of this story to the community encouraged others also to become a support system to those suffering from the disease. I saw the impact that one person could have on a community and decided to get HIV/AIDS tested and tell my congregation about it, in hopes that it would encourage others to do the same.
The action of only one community member led to many others changing their behaviours. A single individual can influence others to move from inaction to action by being what social scientists call “positive deviants.”
By the time the final training session has taken place, impact should already have begun and should continue. The impact should affect not only one community: It should also affect surrounding communities. A member of the African-American Pastors Consortium, and a key individual involved with MICTAN, the Rev. Ernest Hargrove of Grenada, Miss., Life Christian Fellowship Church, explains how communication for social change helps him sustain his church’s AIDS work and impacts people living in surrounding communities.
His church, the Rev. Hargrove says, “moved from talk to actual care with a new program called LifeHelp.” The programme provides and encourages others to be a support system for those living with HIV/AIDS. “We have also encouraged other groups to begin similar programs to get people active in the HIV/AIDS issue. In Greenwood [a town 20 miles from Grenada], a youth group initially involved with LifeHelp started their own HIV project by sharing information and finding information on grants they could apply for to educate their community about risks.”
Once action has been established, MICTAN encourages organisations to achieve sustainability for themselves. As Hampton says, “Health educators don’t believe in one-shot deals. We want organisations to operate on their own, but if it is necessary and possible, we will do more workshops with them.” MICTAN encourages all participants to keep in close contact if further assistance is needed.
The importance of “first person voices,” as Hampton refers to them, is embedded in MICTAN’s purpose, encouraging “people with HIV to tell their story…Social change means empowerment,” she says, “and that can only be achieved if their voices are heard.”
Hampton knows communication for social change is not an abstract theory. The CFSC approach is a way of thinking, a means to address issues and a way for people to take charge of the change-making process. It is essential that members of a community be given a voice and a safe place so they can tell their stories. The individual stories result in individual change, which in turn leads to social change. “We give people a safe place to tell their story, says Hampton. “It is our hope that we continue to get better at what we do so other organisations are just as involved in reducing AIDS not only in the African American community but in all communities.”
Editor’s note: Special thanks to the African American Pastors Consortium, members of MICTAN, Jacqueline Fleming Hampton and Ross Fleming.