Christian Communities and Prevention of HIV among Youth in KwaZulu-Natal, South Africa

Young people in South Africa, particularly females, are at great risk of acquiring HIV, and heterosexual sex is the predominant mode of HIV transmission. In order to curb the epidemic the Department of Health encourages all sectors in the society, including religious institutions, to respond effectively. The present thesis seeks to increase the understanding of the role of Christian communities in prevention of HIV for young people. Three denominations in KwaZulu-Natal were selected to reflect the diversity of Christian churches in South Africa: the Roman Catholic Church, the Evangelical Lutheran Church in Southern Africa, and the Assemblies of God. Using qualitative interviews the first paper explores how religious leaders (n=16) deal with the conflict between the values of the church and young people’s sexuality. Study II reports on attitudes to HIV prevention for young people among religious leaders (n=215) using questionnaire survey data. Study III investigates how young people (n=62) reflect on messages received from their churches regarding premarital sex by analysing nine focus group discussions. In the fourth paper, based on questionnaire survey data, we report on young people’s (n=811) experiences of relationships with the opposite sex and their perceived risk of HIV infection. The view that young people in churches are sexually active before marriage was common among religious leadership. The majority of religious leaders also reported that they are responsible for educating young people about HIV prevention. Religious leaders who had received training on HIV were more likely to run a life skills programme for young people, however they were ambivalent about prevention messages. Young people reported premarital sexual abstinence as the main HIV prevention message from their churches. The majority responded that they had received information about HIV in church. To be in a relationship was common, more so for males for whom multiple relationships also were viewed more acceptable. To perceive themselves at risk of HIV infection was common. Further training for religious leaders is needed to enable them to manage the conflict between the doctrine of the church and their willingness to assist young people in the transition into adulthood.Faculty of Medicin