Barber looks at the way religion shapes HIV transmission, treatment, and prevention
Darius (not his real name) grew up African American and gay in the socially conservative American South. Life wasn’t easy, but his mother loved and sheltered him. He enjoyed going to church with her and developed a strong faith—one he took with him when he enlisted in the United States Marine Corps.
When Darius returned home, his mother invited him to join her for services at a new church she’d started to attend. He did and, when called, joined the rest of the congregation and approached the altar to be anointed. When Darius reached the front of the church, the minister wrapped an arm around him and told the others to step back. As Darius’s mother and the rest of the church looked on, the pastor spoke into her microphone and prayed that God would remove the “demon of homosexuality” from him.
In the ensuing months, Darius was plagued by depression and anxiety. He said that the God that had been so central in his life was “gone, gone, gone.” To cope, he turned to drugs and became addicted to cocaine. He also engaged in risky sexual behavior. Eventually, he contracted the human immunodeficiency virus (HIV).
Charles Barber, MTS ’14, studies the way religion shapes the health of Darius and other African American men who have sex with men (MSM). His research, in which Darius participated, is a knowledge base from which healthcare providers can draw to understand religion’s role in HIV transmission—and its potential to support treatment and prevention efforts.
“In the South, we have some of the country’s highest rates of HIV infection and transmission,” says Barber. “The South also has the highest rates of membership in Black Protestant churches. When providers assess the health of patients, they often don’t address the role of religion and spirituality. As a result, they overlook influences that not only put men at greater risk for contracting HIV but also actually improve health and decrease rates of transmission.”
Barber, who earned his PhD in American Religious Cultures from Emory University and did field work in Nairobi, Kenya, spent most of the last year as a principal investigator at Grady Health System’s Ponce De Leon Center in Atlanta, Ga. His study, which was the basis of Barber’s doctoral dissertation at Emory, identified a group of Christian African American MSM who were HIV positive. He says that one of the goals of his research was to give healthcare and community organizations a more nuanced understanding of religion—one in which faith traditions are seen as an important factor in the social constellation of health.
“Religion is often a ‘both and,’” he says. “It can have a negative and positive impact at the same time. With HIV, there’s a long history of black Protestant institutions having to confront the epidemic among MSM in a larger social context that’s mediated by conservative white Protestant evangelicals. There are extra layers to be aware of.”
Through a combination of qualitative and quantitative research, Barber explored the ways that religion interacted with gender and sexuality to shape the formation of the men’s identities, the ways in which they contracted the virus, and their response to regimes of treatment and prevention. Like Darius, many of Barber’s interviewees were struggling with sexual and gender identity because of the cultural and religious contexts in which they lived—struggles that led to addiction, suicidality, depression, and other risk factors for HIV contraction.
“The men I worked with were burdened by so many social determinants of health,” he says. “They were confronted by political and economic challenges as well as racism, homophobia, and a highly stigmatized illness. The research enables healthcare providers to account for the way that religion interacts with those factors to impact health both domestically and globally.”
At the same time, Barber found that most of the men he studied had reconciled their sexuality and gender identities with their religion—so much so that their faith played a critical and positive role in their health.
“For many of the men I interviewed, religion helped them stick to their treatment regime,” Barber says. “It provided motivation and a sense of self-worth that enabled them to remain in care.”
Darius’s road back to religion began when he got into recovery and joined a 12-step program to deal with his addiction.
“The program gave him the tools he needed to reconfigure his notion of God,” Barber says. “He told me ‘I wish this had happened years ago. To know that God can love me where I am.’”
Having reconnected with his spirituality in recovery, Darius decided to attend a church service with his sister. Afterwards the pastor approached him to apologize for the ministers who, in the past, had disparaged Darius’s sexuality in the name of God. Religion again became a positive force in his life—and his health.
Barber says that the next step for his research is to develop assessment tools that will enable health care and community organizations to quantify the role of religion in the complex web of behaviors that impact health. Then, they can allocate resources more effectively to combat the epidemic.
“In terms of public health, we need to use what we learn to structure more culturally competent resources that are not necessarily located in clinical setting,” he explains. “There needs to be greater awareness and relationships between communal resources and those in healthcare.”
As for Darius, Barber says that today he is healthy, sober, and an advocate for men like him with HIV.
“He has a renewed sense of God’s power in his life that allows him to stay healthy and help others,” he says. “There’s so much we can learn from Darius about the positive dimensions of religious and spiritual beliefs. If we do, we can help people follow his example to overcome the stigma of HIV, stay in treatment, and prevent transmission. It’s a win, win, win.”
-Paul Massari