{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:56:12Z","timestamp":1791428172932,"version":"4.3.3"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Center for the Study of Community Health, University of Alabama at Birmingham","award":["U48\/DP006404"],"award-info":[{"award-number":["U48\/DP006404"]}]},{"DOI":"10.13039\/100019610","name":"Center for AIDS Research, University of Alabama at Birmingham","doi-asserted-by":"publisher","award":["P30 AI027767"],"award-info":[{"award-number":["P30 AI027767"]}],"id":[{"id":"10.13039\/100019610","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U54MD008620"],"award-info":[{"award-number":["U54MD008620"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. Racial and Ethnic Health Disparities"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract\u00a0 \u00a0\u00a0<\/jats:title>\n          <jats:p>The Deep South is the epicenter of the HIV-epidemic in the United States, with rural AAs bearing the greatest burden. Traditional efforts to improve testing efforts have been largely unsuccessful due to their failure to recognize and leverage the sociopolitical and cultural factors that affect the uptake of HIV-screening interventions at the community level. The purpose of this study was to gain a deeper understanding of the socio-cultural contexts impacting HIV-testing in the rural South, and to assess strategies to increase testing in rural, Southern communities. Focus groups (<jats:italic>n<\/jats:italic>\u2009=\u20098) and semi-structured interviews (<jats:italic>n<\/jats:italic>\u2009=\u200931) were conducted among community and faith-based leaders in Alabama and Mississippi, to inform our understanding of local perceptions of HIV infection, barriers and facilitators impacting HIV-testing, and best strategies for improving testing efforts at the local level. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed to extract major themes. While both faith-based and community leaders reported at least some stigmatizing attitudes towards HIV infection, faith-based leaders were more likely to report discomfort being around someone with HIV and were more likely to link the spread of HIV to immoral behaviors. The combination of the cultural importance of the Church, deep-seated religiosity among community members, and faith-based messages associating HIV infection with immorality directly impacted HIV stigma within the community-in turn, decreasing willingness to participate in HIV-testing, disclose positive HIV serostatus, or openly discuss transmission protection behaviors. The Church was identified as crucial to include to improve HIV-testing efforts in the rural South, due to their prominent sociopolitical roles within communities and ability to influence community members\u2019 perceptions of HIV stigma. Faith-based leaderships should be included in initiatives to increase improve HIV-testing and awareness of status and reduce HIV disparities in the Deep South.<\/jats:p>","DOI":"10.1007\/s40615-024-02122-w","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T08:41:07Z","timestamp":1726648867000},"page":"3177-3183","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Faith-based Community Engagement in HIV-Testing and Awareness of HIV Status in Southern, Rural, African American Communities"],"prefix":"10.1007","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3325-0335","authenticated-orcid":false,"given":"J. M.","family":"Wise","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"Kempf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Ott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. P.","family":"Footman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Hardy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Y.","family":"Araya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Latham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Stockett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. L.","family":"Daniels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. G.","family":"Lanzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"2122_CR1","unstructured":"Prevention CfDCa. HIV in the Southern United States. Updated May, 2016. 2018. https:\/\/www.cdc.gov\/hiv\/pdf\/policies\/cdc-hiv-in-the-south-issue-brief.pdf. Accessed 18 Jan 2018"},{"issue":"5","key":"2122_CR2","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1016\/j.jana.2012.08.007","volume":"24","author":"J Pellowski","year":"2013","unstructured":"Pellowski J. Barriers to care for rural people living with HIV: a review of domestic research and health care models. J Assoc Nurses AIDS Care. 2013;24(5):422\u201337. https:\/\/doi.org\/10.1016\/j.jana.2012.08.007.","journal-title":"J Assoc Nurses AIDS Care"},{"issue":"6","key":"2122_CR3","doi-asserted-by":"publisher","first-page":"1968","DOI":"10.1007\/s10943-016-0193-z","volume":"55","author":"TM Aholou","year":"2016","unstructured":"Aholou TM, Cooks E, Murray A, et al. \u201cWake up! HIV is at your door\u201d: AA faith leaders in the rural South and HIV perceptions: a qualitative analysis. J Relig Health. 2016;55(6):1968\u201379. https:\/\/doi.org\/10.1007\/s10943-016-0193-z.","journal-title":"J Relig Health"},{"issue":"3 Suppl 1","key":"2122_CR4","first-page":"S108","volume":"14","author":"WW Darrow","year":"2004","unstructured":"Darrow WW, Montanea JE, Fernandez PB, Zucker UF, Stephens DP, Gladwin H. Eliminating disparities in HIV disease: community mobilization to prevent HIV transmission among Black and Hispanic young adults in Broward County, Florida. Ethn Dis Summer. 2004;14(3 Suppl 1):S108\u201316.","journal-title":"Ethn Dis Summer"},{"issue":"11","key":"2122_CR5","doi-asserted-by":"publisher","first-page":"e0202389","DOI":"10.1371\/journal.pone.0202389","volume":"13","author":"A Perez-Brumer","year":"2018","unstructured":"Perez-Brumer A, Nunn A, Hsiang E, et al. \u201cWe don\u2019t treat your kind\u201d: Assessing HIV health needs holistically among transgender people in Jackson, Mississippi. PLoS ONE. 2018;13(11):e0202389. https:\/\/doi.org\/10.1371\/journal.pone.0202389.","journal-title":"PLoS ONE"},{"key":"2122_CR6","unstructured":"Prevention CfDCa. HIV among AAs. 2018. https:\/\/www.cdc.gov\/hiv\/group\/racialethnic\/africanamericans\/index.html. Accessed 18 Jan 2018"},{"key":"2122_CR7","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1186\/1471-2458-13-482","volume":"13","author":"S Baral","year":"2013","unstructured":"Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health. 2013;13:482. https:\/\/doi.org\/10.1186\/1471-2458-13-482.","journal-title":"BMC Public Health"},{"issue":"3","key":"2122_CR8","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1007\/s11524-017-0147-0","volume":"94","author":"WI Jeffries","year":"2017","unstructured":"Jeffries WI, Sutton MY, Eke AN. On the battlefield: the black church, public health, and the fight against HIV among AA gay and bisexual men. J Urban Health\u202f: Bull N Y Acad Med. 2017;94(3):384\u201398. https:\/\/doi.org\/10.1007\/s11524-017-0147-0.","journal-title":"J Urban Health : Bull N Y Acad Med"},{"issue":"12","key":"2122_CR9","first-page":"1682","volume":"97","author":"J Smith","year":"2005","unstructured":"Smith J, Simmons E, Mayer KH. HIV\/AIDS and the Black Church: what are the barriers to prevention services? J Natl Med Assoc. 2005;97(12):1682.","journal-title":"J Natl Med Assoc"},{"issue":"3","key":"2122_CR10","doi-asserted-by":"publisher","first-page":"492","DOI":"10.2105\/AJPH.2015.302985","volume":"106","author":"JD Coleman","year":"2016","unstructured":"Coleman JD, Tate AD, Gaddist B, White J. Social determinants of HIV-related stigma in faith-based organizations. Am J Public Health. 2016;106(3):492\u20136.","journal-title":"Am J Public Health"},{"issue":"6","key":"2122_CR11","doi-asserted-by":"publisher","first-page":"2005","DOI":"10.1128\/jcm.00185-12","volume":"50","author":"LA Cosentino","year":"2012","unstructured":"Cosentino LA, Campbell T, Jett A, et al. Use of nucleic acid amplification testing for diagnosis of anorectal sexually transmitted infections. J Clin Microbiol. 2012;50(6):2005\u20138. https:\/\/doi.org\/10.1128\/jcm.00185-12.","journal-title":"J Clin Microbiol"},{"issue":"1_suppl","key":"2122_CR12","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1177\/00333549101250S102","volume":"125","author":"DM Griffith","year":"2010","unstructured":"Griffith DM, Campbell B, Allen JO, Robinson KJ, Stewart SK. YOUR Blessed Health: an HIV-prevention program bridging faith and public health communities. Public Health Rep. 2010;125(1_suppl):4\u201311.","journal-title":"Public Health Rep"},{"issue":"2","key":"2122_CR13","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1177\/1049731506296826","volume":"17","author":"SA MacMaster","year":"2007","unstructured":"MacMaster SA, Jones JL, Rasch RF, Crawford SL, Thompson S, Sanders EC. Evaluation of a faith-based culturally relevant program for AA substance users at risk for HIV in the southern United States. Res Soc Work Pract. 2007;17(2):229\u201338.","journal-title":"Res Soc Work Pract"},{"issue":"2","key":"2122_CR14","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1089\/apc.2014.0160","volume":"29","author":"JM Stewart","year":"2015","unstructured":"Stewart JM. A multi-level approach for promoting HIV testing within AA church settings. AIDS Patient Care STDS. 2015;29(2):69\u201376. https:\/\/doi.org\/10.1089\/apc.2014.0160.","journal-title":"AIDS Patient Care STDS"},{"issue":"2","key":"2122_CR15","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1111\/j.1748-0361.2006.00021.x","volume":"22","author":"BD Heckman","year":"2006","unstructured":"Heckman BD. Psychosocial differences between whites and AAs living with HIV\/AIDS in rural areas of 13 US states. J Rural Health. 2006;22(2):131\u20139. https:\/\/doi.org\/10.1111\/j.1748-0361.2006.00021.x.","journal-title":"J Rural Health"},{"key":"2122_CR16","unstructured":"Centers for disease control and prevention. HIV Surveillance Report, 2017. Vol. 29. 2018. https:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv-surveillance.html. Accessed Mar 2019"},{"issue":"5","key":"2122_CR17","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.ypmed.2011.08.021","volume":"55","author":"GE Wyatt","year":"2012","unstructured":"Wyatt GE, Williams JK, Gupta A, Malebranche D. Are cultural values and beliefs included in US based HIV interventions? Prev Med. 2012;55(5):362\u201370. https:\/\/doi.org\/10.1016\/j.ypmed.2011.08.021.","journal-title":"Prev Med"},{"issue":"5s1","key":"2122_CR18","doi-asserted-by":"publisher","first-page":"S112","DOI":"10.1016\/j.amepre.2018.05.015","volume":"55","author":"MC Kempf","year":"2018","unstructured":"Kempf MC, Ott C, Wise JM, et al. Universal screening for HIV and hepatitis C infection: a community-based pilot project. Am J Prev Med. 2018;55(5s1):S112-s121. https:\/\/doi.org\/10.1016\/j.amepre.2018.05.015.","journal-title":"Am J Prev Med"},{"issue":"1","key":"2122_CR19","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1097\/00003727-200501000-00006","volume":"28","author":"CM Hardy","year":"2005","unstructured":"Hardy CM, Wynn TA, Huckaby F, Lisovicz N, White-Johnson F. AA community health advisors trained as research partners: recruitment and training. Fam Commun Health. 2005;28(1):28\u201340. https:\/\/doi.org\/10.1097\/00003727-200501000-00006.","journal-title":"Fam Commun Health"},{"issue":"8 Suppl","key":"2122_CR20","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1002\/cncr.22151","volume":"107","author":"N Lisovicz","year":"2006","unstructured":"Lisovicz N, Johnson RE, Higginbotham J, et al. The Deep South Network for cancer control. Building a community infrastructure to reduce cancer health disparities. Cancer. 2006;107(8 Suppl):1971\u20139. https:\/\/doi.org\/10.1002\/cncr.22151.","journal-title":"Cancer"},{"issue":"1","key":"2122_CR21","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/00003727-200501000-00006","volume":"28","author":"CM Hardy","year":"2005","unstructured":"Hardy CM, Wynn TA, Huckaby F, Lisovicz N, White-Johnson F. AA Community health advisors trained as research partners: recruitment and training. Fam Commun Health. 2005;28(1):41\u201350.","journal-title":"Fam Commun Health"},{"key":"2122_CR22","doi-asserted-by":"publisher","first-page":"2936","DOI":"10.1007\/s10461-019-02604-7","volume":"23","author":"RG Lanzi","year":"2019","unstructured":"Lanzi RG, Footman AP, Jackson E, et al. Love with No Exceptions: a statewide faith-based, university-community partnership for faith-based HIV training and assessment of needs in the Deep South. AIDS Behav. 2019;23:2936\u201345. https:\/\/doi.org\/10.1007\/s10461-019-02604-7.","journal-title":"AIDS Behav"},{"issue":"5","key":"2122_CR23","doi-asserted-by":"publisher","first-page":"e36172","DOI":"10.1371\/journal.pone.0036172","volume":"7","author":"A Nunn","year":"2012","unstructured":"Nunn A, Cornwall A, Chute N, et al. Keeping the faith: AA faith leaders\u2019 perspectives and recommendations for reducing racial disparities in HIV\/AIDS infection. PLoS ONE. 2012;7(5):e36172. https:\/\/doi.org\/10.1371\/journal.pone.0036172.","journal-title":"PLoS ONE"},{"issue":"8","key":"2122_CR24","doi-asserted-by":"publisher","first-page":"1692","DOI":"10.1007\/s10461-015-1280-y","volume":"20","author":"KP Derose","year":"2016","unstructured":"Derose KP, Griffin BA, Kanouse DE, et al. Effects of a pilot church-based intervention to reduce HIV stigma and promote HIV testing among AAs and Latinos. AIDS Behav. 2016;20(8):1692\u2013705. https:\/\/doi.org\/10.1007\/s10461-015-1280-y.","journal-title":"AIDS Behav"},{"issue":"5","key":"2122_CR25","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1037\/0022-3514.90.5.751","volume":"90","author":"TF Pettigrew","year":"2006","unstructured":"Pettigrew TF, Tropp LR. A meta-analytic test of intergroup contact theory. J Pers Soc Psychol. 2006;90(5):751\u201383. https:\/\/doi.org\/10.1037\/0022-3514.90.5.751.","journal-title":"J Pers Soc Psychol"},{"issue":"3","key":"2122_CR26","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1521\/aeap.2010.22.3.218","volume":"22","author":"J Berkley-Patton","year":"2010","unstructured":"Berkley-Patton J, Bowe-Thompson C, Bradley-Ewing A, et al. Taking it to the pews: a CBPR-guided HIV awareness and screening project with black churches. AIDS Educ Prev. 2010;22(3):218\u201337.","journal-title":"AIDS Educ Prev"},{"issue":"5","key":"2122_CR27","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1177\/1524839917754044","volume":"19","author":"ELP Bradley","year":"2018","unstructured":"Bradley ELP, Sutton MY, Cooks E, et al. Developing FAITHH: methods to develop a faith-based HIV stigma-reduction intervention in the Rural South. Health Promot Pract. 2018;19(5):730\u201340. https:\/\/doi.org\/10.1177\/1524839917754044.","journal-title":"Health Promot Pract"},{"issue":"1","key":"2122_CR28","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1521\/aeap.2014.26.1.28","volume":"26","author":"KP Derose","year":"2014","unstructured":"Derose KP, Bogart LM, Kanouse DE, et al. An intervention to reduce HIV-related stigma in partnership with AA and Latino churches. AIDS Educ Prev. 2014;26(1):28\u201342. https:\/\/doi.org\/10.1521\/aeap.2014.26.1.28.","journal-title":"AIDS Educ Prev"},{"issue":"2","key":"2122_CR29","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1177\/1524839909348766","volume":"12","author":"G Corbie-Smith","year":"2011","unstructured":"Corbie-Smith G, Adimora AA, Youmans S, et al. Project GRACE: a staged approach to development of a community-academic partnership to address HIV in rural AA communities. Health Promot Pract. 2011;12(2):293\u2013302. https:\/\/doi.org\/10.1177\/1524839909348766.","journal-title":"Health Promot Pract"},{"issue":"4","key":"2122_CR30","first-page":"323","volume":"103","author":"PP Foster","year":"2011","unstructured":"Foster PP, Cooper K, Parton JM, Meeks JO. Assessment of HIV\/AIDS prevention of rural AA Baptist leaders: implications for effective partnerships for capacity building in American communities. J Natl Med Assoc. 2011;103(4):323\u201331.","journal-title":"J Natl Med Assoc"}],"container-title":["Journal of Racial and Ethnic Health Disparities"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40615-024-02122-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40615-024-02122-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40615-024-02122-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T13:55:58Z","timestamp":1758203758000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40615-024-02122-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,16]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["2122"],"URL":"https:\/\/doi.org\/10.1007\/s40615-024-02122-w","relation":{},"ISSN":["2197-3792","2196-8837"],"issn-type":[{"value":"2197-3792","type":"print"},{"value":"2196-8837","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,16]]},"assertion":[{"value":"20 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 July 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}