Black PRAISE is a congregation-based intervention (a program of activities designed to achieve a specific outcome) developed to build knowledge about HIV and reduce HIV-related stigma among Black Canadian congregations across Ontario.
In 2004-2006 a team of researchers, service providers and community members conducted a research study on HIV stigma affecting Black Canadian communities in Toronto (the Stigma Study). The study highlighted that stigma was multi-faceted and pervasive, and originated both outside of Black Canadian communities (e.g., associated with racism, anti-immigrant sentiments, etc.), and within those communities (negative judgements and assumptions about who gets HIV). Participants in community forums suggested that Black faith leaders should be engaged in efforts to address stigma. The team engaged pastors in a series of consultations and forums to discuss possibilities of collaborating to address stigma. In 2012, participants agreed to collaborate on designing and testing an intervention to reduce HIV-related stigma among Black Canadian congregations.
HIV disproportionately affects Black Canadian communities in Ontario. In 2015 and 2016 combined, Black Canadians accounted for 23% of new HIV diagnoses in Ontario despite making up only 5% of the province’s population.[1] The pattern is similar for Black people nationally.[2] Stigma contributes to poor health outcomes for people living with HIV (PLWHIV). It may also help to drive new HIV infections by making people reluctant to get tested for HIV and adopt HIV prevention practices. [3, 4] Black Canadian faith leaders and their congregations are a valuable avenue to address HIV-related stigma given their wider reach and the historical contribution of Black faith leaders in promoting health for the Black community.[5]
The research team developed the intervention items in collaboration with pastors and key individuals from the participating churches. The pastors reviewed and provided feedback on the content, timing and delivery of all aspects of the intervention. In addition, community-based agencies and key individuals collaborated on the development and implementation of Black PRAISE.
The Black PRAISE team included researchers and service providers who work on HIV-related issues with Black Canadian communities. The team worked collaboratively with pastors, policy makers, service providers and community advocates to develop and test Black PRAISE.
Black PRAISE comprised: i) development and distribution of a booklet with validated knowledge on HIV transmission and testing, how HIV affects Black Canadian communities, the factors that make people vulnerable to HIV, and links to resources and services; ii) a sermon on compassion and social justice delivered by the pastors to their respective congregations; and iii) a video of Black Canadians sharing their experiences with HIV-related stigma, its impact on the Black Canadian community, and the role of Black Canadian churches in combatting HIV stigma. These were delivered at six participating churches during or after the main Saturday or Sunday service according to an agreed upon schedule.
The team implemented Black PRAISE in October to November 2016. Leaders from the respective congregations delivered the intervention: distributing the Black PRAISE booklet among their fellow congregants; the pastors delivered a sermon on compassion and social justice (based on a template developed by the team); and screening the video featuring community members speaking about stigma. Each church received a subsidy to support their participation. Church liaisons, community collaborators and volunteers received honoraria.
The team evaluated Back PRAISE by surveying the congregations as follows: at baseline (in October 2016, before the intervention activities) to establish existing levels of HIV knowledge and HIV-related stigma; post-intervention (i.e., in November/December 2016 following the intervention); and 3 months after the intervention (February/March 2017). The surveys assessed whether congregants increased their knowledge about HIV and decreased their level of stigma after exposure to the intervention. In addition, the team interviewed one pastor and two congregants from each church about their experience participating in Black PRAISE.
Results showed that participants’ levels of HIV knowledge increased and their stigma scores reduced significantly after exposure to the intervention. The more interventions a respondent participated in, the better the outcome. Also, participants in the in-depth interviews reported feeling more invested with the wellbeing of PLWHIV and enthusiasm for efforts to address HIV in Black Canadian churches and communities.
The Canadian Institutes of Health Research (CIHR) and the Canadian HIV Trials Network (CTN) funded Black PRAISE.
As of March 2019, the team has produced a report, two fact sheets (available here and here) and a conference report about Black PRAISE. The team will also develop manuscripts for publication in research journals.
Winston Husbands, PhD., Senior Scientist, Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON, M4T 1X3 ¨ T: 416.642.6486 X 2212 ¨ F: 416-640-4245 E: [email protected]
References
[1]Ontario Community HIV and AIDS Reporting Tool (OCHART). (2017). View from the Front Lines: Annual Summary and Analysis of Data Provided by Community-Based HIV/AIDS Services in Ontario. Toronto: Ontario HIV Treatment Network. Retrieved from http://www.ohtn.on.ca/view-from-the-front-lines-2017/
[2]Bourgeois AC, Edmunds M., Awan A., Jonah L., Varsaneux, O., Siu W. (2017). HIV in Canada—Surveillance Report, 2016. Can Commun Dis Rep. 43(12): 248-56. https://doi.org/10.14745/ccdr.v43i12a01
[3]Sengupta, S., et al., (2011). HIV Interventions to reduce HIV/AIDS stigma: A systematic review. AIDS and Behavior, 15(6), 1075-1087. doi: 10.1007/s10461-010-9847-0
[4]Brown, Macintyre, L. k. and Trujillo, L. (2001). Interventions to reduce HIV/AIDS stigma: What have we learned? The Population Council Inc. doi=10.1.1.175.9660
[5]Derose, K. P., Mendel, P. J., Palar, K., Kanouse, D. e., Bluthenal, R. N., Castaneda, L. W. . . . Oden, C. W. (2011). Religious congregations’ involvement in HIV: A case study approach. Aids and Behavior, 15(6): 1220 – 1232. doi: 10.1007/s10461-010-9827-4