Faith-based organisations and HIV prevention in Africa: A review

Background: Faith-based organisations (FBOs) are potentially an important role-player in HIV prevention, but there has been little systematic study of their potential strengths and weaknesses in this area. Objectives: To identify the strengths and weaknesses of FBOs in terms of HIV prevention. The questions posed were, (1) 'What is the influence of religion on sexual behaviour in Africa?', and (2) 'What are the factors that enable religion to have an influence on sexual behaviour?'. Method: A literature search of Medline, SABINET, Africa Wide NIPAD and Google Scholar was conducted. Results: The potential for Faith-based organisations to be important role-players in HIV prevention is undermined by the church's difficulties with discussing sexuality, avoiding stigma, gender issues and acceptance of condoms. It appears that, in contrast with high-income countries, religiosity does not have an overall positive impact on risky sexual behaviour in Africa. Churches may, however, have a positive impact on alcohol use and its associated risky behaviour, as well as self-efficacy. The influence of the church on sexual behaviour may also be associated with the degree of social engagement and control within the church culture. Conclusion: Faith-based organisations have the potential to be an important role player in terms of HIV prevention. However, in order to be more effective, the church needs to take up the challenge of empowering young women, recognising the need for their sexually-active youth to use protection, reducing judgemental attitudes and changing the didactical methods used.