Jan 7
Religious Beliefs Hinder HIV Care Access for Positive Ugandans, Study Reveals
READ TIME: 3 MIN.
In Uganda, where HIV prevalence remains a significant public health challenge, religious beliefs are increasingly recognized as a key barrier preventing people living with HIV from accessing essential care. A scoping review protocol published by the National Institutes of Health examines how traditional and religious frameworks shape health behaviors, noting that high trust in religious leaders influences community attitudes toward testing and treatment. These leaders' statements can either reduce or reinforce stigma, directly affecting willingness to seek services.
The review details specific examples from Uganda, where some patients discontinue antiretroviral therapy due to beliefs in spiritual healing, viewing medication as a lack of faith in divine intervention. This mirrors findings in Pentecostal communities across sub-Saharan Africa, including Uganda, where faith leaders sometimes advise relying solely on prayer, leading to treatment abandonment. A pilot study by the Meros Center in Uganda further reveals HIV stigma among clergy as a driver of discrimination, with HIV-positive church leaders facing isolation and judgment from peers and superiors who link the virus to sexual immorality.
Key drivers of this stigma include hyper-spirituality, ignorance about HIV transmission, and socio-cultural norms, as identified in the Meros Center's research on Ugandan clergy. Disclosure of an HIV-positive status leaves leaders vulnerable, with fears of spreading the virus through touch deterring interaction with congregants. The study quotes clergy concerns: “… some clergy fear to mix with other congregants because of the thinking that they are sick and can spread the virus if touched.” This internal church stigma extends to communities, hindering testing and follow-up care, which threatens overall public health.
For LGBTQ+ Ugandans living with HIV, these barriers compound existing challenges. The Uganda Christian Advocates Association impact report emphasizes that access to HIV services for LGBTQ+ people must address not only stigma and cultural norms but also faith-based obstacles. Religious institutions often establish moral frameworks that discourage preventive measures like condom use and perpetuate stigma viewing HIV as divine punishment.
Ugandan LGBTQ+ networks highlight the need for inclusive programs amid broader funding disruptions. Richard Lusimbo, founder of Uganda Key Populations Consortium, stresses community-led efforts by LGBTQ+ groups in delivering HIV clinics and peer support in remote areas, urging governments to resource these initiatives. “We are not there to patch holes... Our leadership must be recognized, resourced, and embedded within national systems,” Lusimbo stated.
In response to U.S. PEPFAR funding pauses, Uganda increased its health budget to 8.1% this financial year, praised by groups like CEHURD Uganda for bolstering sexual and reproductive health rights and community involvement. Physicians for Human Rights reports disruptions to HIV services in Uganda but notes potential for recovery through domestic efforts.
Transgender and nonbinary Ugandans face amplified risks, with limited gender-affirming care intertwined with HIV services. Advocacy from groups like GALCK+ in neighboring Kenya underscores the impact of funding cuts on LGBTQ+ HIV testing clinics and safe spaces, a pattern echoed in Uganda.
Experts advocate integrating religious leaders into interventions. The NIH review calls for mapping evidence on their roles to develop contextually relevant strategies that respect local beliefs while promoting biomedical care. Successful models include faith-based pre-marital HIV testing and pastoral counseling that endorse prevention.
The Meros Center concludes that addressing clergy stigma requires multi-sector involvement, while UCAA urges holistic approaches for LGBTQ+ access. Uganda's health dialogues signal progress, but sustained domestic funding and inclusive leadership are essential to counter religious barriers and ensure equitable care for all, including transgender people, gay men, and other LGBTQ+ individuals living with HIV.
