Dear HIFA colleagues,
Citation, abstract, extract and comment from me below.
CITATION: Beliefs of Pentecostal pastors concerning the use of antiretroviral treatment among Pentecostal Christians living with HIV in a suburb of Cape Town-South Africa: a community health systems lens
Ivo Nchendia Azia, Anam Nyembezi, Shernaaz Carelse, Ferdinand C Mukumbang
Health Policy and Planning, https://doi.org/10.1093/heapol/czae089
Published: 11 September 2024
ABSTRACT
The global public health community accepts antiretroviral therapy (ART) for controlling and managing HIV. However, within some communities, claims of faith or miraculous healing of HIV and AIDS by Pentecostal pastors continue to spark controversies. This paper reports on an exploratory qualitative study to explore the beliefs held by Pentecostal pastors regarding the use of ART among Pentecostal Christians who are living with HIV (PCLH). Twenty Pentecostal pastors from two informal settlements in Cape Town, South Africa, were purposefully selected. Open-ended, semi-structured, in-depth individual interviews were conducted on their religious beliefs concerning ART adherence. Interviews were conducted in English, audiotaped, and transcribed verbatim before being imported to the Atlas—ti 2023 software program for thematic data analysis. Since our study was guided by the relational community health system (CHS) model a hybrid deductive-inductive thematic analysis was used. Two contrasting themes about the influence of the religious beliefs of Pentecostal pastors were identified: The first theme and its associated subthemes highlight the lack of basic HIV and ART knowledge among pastors. Consequently, these pastors tend to nudge their Christians to rely more on faith and spiritual healing at the expense of adherence to ART. The second theme and the associated sub-themes suggest that some pastors possess some basic HIV knowledge and understand the role of ART and how it works. This group of pastors advise their congregants to use ART and other healthcare services in tandem with spiritual rituals, faith, and prayers. Our findings highlight the need for functional community-based structures, such as community health committees (CHCs) and health facility management committees (HFMCs), in settings where complex interaction within the belief systems, practices, and norms of some stakeholders can influence people’s health-seeking behaviours such as adhering to chronic medications like ART.
The conclsion of the full text reads:
'Many pastors of Pentecostal churches in the two selected informal settlements are still sceptical about the efficacy of optimally adhering to ART in the treatment of HIV considering that they believe that turning to God, rather than using ART, offers a superior
approach to addressing HIV. Although some pastors also believe that ART can work well when complemented with spiritual rituals like prayers, several pastors still lack the necessary knowledge about HIV and ART. This limited knowledge about HIV/AIDS and the use of
ART to cure PLH highlights their challenges while providing pastoral care to PCLH. Since pastors can promote adherence to ART among PCLH through their teachings, doctrines, and belief systems, we need collaborations between Pentecostal churches and healthcare workers
through CHCs and HFMCs to augment ART adherence outcomes among PCLH within the Pentecostal communities and PLH in general.'
COMMENT: The role of faith leaders in the global evidence ecosystem - how they influence the availability and use of reliable healthcare information among the general public in different settings - is a potential topic for a new HIFA Project [ www.hifa.org/projects ]. If anyone is interested to explore this, please email the forum hifa@hifaforums.org or contact me: neil@hifa.org
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
