Engaging religious leaders to support HIV prevention and care for gays, bisexual men, and other men who have sex with men in coastal Kenya

Abstract

In Kenyan communities, religious leaders are important gatekeepers in matters of health and public morality. In a context that is generally homophobic, religious leaders may aggravate or reduce stigmatization of sexual minorities such as gay and bisexual men, and other men who have sex with men (GBMSM). Literature indicates mixed results in efforts to encourage religious leaders to work effectively and sensitively with issues regarding HIV and sexuality. This paper describes the implementation of an engagement intervention with religious leaders from different denominations, which took place following a homophobic hate attack that was led by local religious leaders, at an HIV research clinic for GBMSM on the Kenyan coast. After the homophobic attack, tailored engagement activities, including a comprehensive four-day online sensitivity training course took place between June 2015 and October 2016 in the Kenyan coast. HIV researchers, together with trained GBMSM activists, organized the series of engagement activities for religious leaders which unfolded iteratively, with each subsequent activity informed by the results of the previous one. Facilitated conversations were used to explore differences and disagreements in relation to questions of scripture, mission, HIV, and human sexuality. As a result, researchers noted that many religious leaders, who initially expressed exceedingly negative attitudes towards GBMSM, started to express far more accepting and supportive views of sexuality, sexual identities, and same-sex relations. This paper describes the changes in religious leaders’ discourses relating to GBMSM, and highlights the possibility of using engagement interventions to build trust between research institutes, religious leaders, and GBMSM.

The role of context in shaping HIV testing and prevention engagement among urban refugee and displaced adolescents and youth in Kampala, Uganda: findings from a qualitative study

“…Religion maintained a connection to home communities and cultures; hence, participants noted that churches could be harnessed as a platform to share HIV information once religious leaders were trained. Prior work in Kenya documented that facilitated engagement of religious leaders contributed to supportive views of sexual health [32]. Medical mistrust emerged; in other contexts, medical mistrust among refugees has been linked with past and current experiences of being 'Most times we can't go for an outreach without a counsellor who we attach to an interpreter, because sometimes they trust that person who speaks their language who explains very well in their own language'.…”

A realist systematic review of stigma reduction interventions for HIV prevention and care continuum outcomes among men who have sex with men

“…Religious leaders also showed that they were able to gradually apply more humanistic, caring discourse, indicating that one can interrupt the cycle of socialization and stand up for change. 43…”

Achieving inclusive research priority-setting: what do people with lived experience and the public think is essential?

“…This implies shared decision-making throughout projects and the greatest community empowerment [ 37 ]. It entails involving individuals with lived experience, members of the public, and/or organisations representing them as decision-makers not only when conducting data collection and analysis and disseminating findings but also when setting research projects’ topics and questions and shaping projects’ design [ 13 , 36 , 43 ]. In this paper, the terms ‘people with lived experience’ and ‘members of the public’ are primarily used rather than patient, community, or community member.…”