Battling Stigma and Silence: Using CFSC to Fight HIV/AIDS in African American Communities

This article explains the work of Nashville, Tennessee (United States)-based Metropolitan Interdenominational Church Technical Assistance Network (MICTAN), which uses communication for social change (CFSC) to remove the barriers of silence and stigma associated with HIV/AIDS in African-American communities. Specifically, MICTAN uses CFSC to help clergy address the HIV/AIDS crisis in African American communities.


Statistics, based upon the United States population, as stated here, show a high incidence of HIV/AIDS among African American people, for example: 1) African American men account for 42 percent of HIV/AIDS cases among all American men; 2) Women who are African American account for 66 percent of all diagnoses among all American women, 20 times the rate for white American women; and 3) AIDS is the No. 1 killer among African American women between the ages of 25 and 34. "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."

The MICTAN ministry provides capacity building and technical assistance to other faith-based organisations, community organisations, and community coalition development projects to strengthen capacity for providing access to and utilisation of HIV prevention services. It connects with organisations, in part, through conference presentations, such as the National Baptist Convention. Churches with some level of HIV awareness can begin training after a needs assessment involving "key players in the organisation - leaders, pastors, etc."


The MICTAN programme focuses on four CFSC concepts:

1. Catalyst
2. Dialogue
3. Collective action
4. Impact/outcome

The involvement and training of church leaders in developing plans for a sustainable community programme begins with understanding the myths, perceptions, and misconceptions that contribute to the HIV/AIDS crisis in African American communities. Peer-to-peer dialogue is seen as a way for ministers to talk to each other about the HIV/AIDS crisis and collectively come up with a solution. It includes gaining the cultural sensitivity to convey "information so as to not offend churchgoers, while focusing on the issues in the most relevant manner possible... [B]ottom-up, community-level dialogue and ownership of the problem become critical elements of MICTAN’s use of communication for social change. 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."

Another way MICTAN uses CFSC is through what they call peer-to-peer dialogue between ministers because, as stated here, "Ministers have a language all their own”. Through peer-to-peer dialogue, ministers use their own words to express the importance of action to other ministers, which gives them affirmation from other pastors.

According to pastors who use CFSC, the dialogue is not always limited to HIV/AIDS prevention, but also includes underlying factors, such as youth violence, poverty, lack of education, or other issues affecting the community. As stated here: "By involving all stakeholder concerns, organizations are in a better position to address the AIDS problem directly....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....The goal is to encourage mobility as well as sustainability." MICTAN does not try 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."

One example of an action-related outcome comes from MICTAN's emphasis on the importance of normalising HIV testing. At church-run health fairs, clergy act as change agents by stepping up to be tested as an act of encouragement for HIV testing that includes both congregation and community members. On the theory that a single individual can influence others to move from inaction to action by being what social scientists call “positive deviants”, MICTAN emphasises that the action of only one community member can lead to many others changing their behaviours.

By the final training session, MICTAN finds that impact should already have begun and should broaden so that one community influences surrounding communities. One church, for example, moved from talk to care with a programme called LifeHelp that provides and encourages others to be a support system for those living with HIV/AIDS. Once action has been established, MICTAN encourages organisations to achieve sustainability for themselves. Their training is designed to empower faith communities to address issues in a way that people take charge of the change-making process through speaking in "first person voices" and to give community members a safe place so they can tell their stories, and then spreading support through action, one community at a time.