Dr. Meredith Long of World Relief Speaks on Stigma of HIV/AIDS

As World AIDS Day approaches this week, Dr. Meredith Long, director of International Health at World Relief, described some of the common trends in misunderstandings within the Christian community and how the churches are beginning to step away from the stigma of HIV/AIDS.

What are some of the most common misunderstandings on AIDS within the Christian community?

Because AIDS is transmitted through sexual relationships often outside or before marriage and is also associated with homosexuality and intravenous drug use, there was a perception that it's only a sinner’s disease. And for a long time, particularly in Africa, there was even a denial that Christians would even get AIDS. I think that there is also a sense that to accept and to love people with AIDS, even though many of them get it without any behavior that we would call sinful, is to condone the behavior itself, and therefore it's better to choose holiness from the church's perspective than reach out to those people. Finally, in some cases, it was associated with some curse from God or some direct punishment for sin and the hesitancy to become involved in relationships to people they thought were cursed or uniquely set aside for punishment

What critical facts or other information do people not know of concerning the pandemic?

Originally, there was very little knowledge as to how AIDS was transmitted and therefore a great deal of fear. That knowledge is very high now in many countries. There's been a lot of education to go on. I think the really key question and the false question that many churches deal with is first of all a pharisaical question - the one that the Pharisees put with the woman caught in adultery. Will you choose holiness or will you choose compassion and acceptance? And to the Pharisees, they were unable to see how you could choose both but Jesus confounded them by choosing both. The woman was brought to Jesus, who was the only one with any moral authority to condemn her, but he failed to condemn her and after the Pharisees had been defeated and went away, he corrected her behavior.

I think often churches feels that they are faced with a choice when actually they are able to choose both acceptance and love and also are able to intervene in teaching and behavior change. That is beside the point that for many people who get AIDS – for many women – the only risk behavior they undertake is having a sexual relationship to their husband. Particularly, you can see that in the fact that for young women, being married young increases their risk of AIDS rather than decreases it even though they're faithful to their husbands.

Can you describe the change you've seen among Christians and churches in dealing with the AIDS crisis? What are you seeing more often now?

Certainly much more involvement. Churches still range across the spectrum from acceptance and involvement to continued rejection, but more and more are responding in Christ-like ways both in reinforcing the traditional teaching on abstinence and faithfulness and also in terms of reaching out in care and compassion to families affected by AIDS - providing for home care, providing for orphans and widows and then increasingly being able to provide linkages to treatment and voluntary counseling and testing. Churches, particularly many churches in Africa, have awakened to the need to demonstrate compassion and involvement in addressing the HIV/AIDS epidemic.

How exactly are the stigma barriers being broken? What are people beginning to realize?

The stigma barriers are those that I had mentioned before. As we work with churches, our strategy is to first of all give them accurate information about HIV/AIDS so that they know how it is transmitted and how it is not transmitted, and then to challenge them ethically and biblically with questions regarding HIV/AIDS. I know that as we work in China with churches and even outside churches, we use the story of the prodigal son. The point - what they respond as to the father, the elder brother or the friends of those who rejected the son once he ran out of money. We also help them recognize that many people become affected with AIDS without any behavior that the church would regard as sinful. We help them understand how to protect themselves and others in their congregation

What do you encourage among churches and the general public in this battle against AIDS?

First of all to become informed about the extent of the epidemic itself. In 2003, there were 37.5 million people approximately infected with aids. And in 2005 it's gone up to 40.3 million people. It’s a battle that is still devastating much of sub-Saharan Africa where 64 percent of the new infections are. But it's also increasing in Eastern Europe particularly and East Asia and the church is active in many of these places and needs to help address this epidemic. I think the other side of it besides becoming informed about HIV/AIDS is to seriously look at the biblical teachings that apply to the churches' response and then to be able to respond effectively.

What we try to do at World Relief is build convergence between the compassion and willingness of the church to respond with responses that are themselves effective, whether it be in changing behavior to prevent AIDS or providing home care of good quality that helps the person affected by AIDS as well as the members who are providing care. Finding this convergence between Christian compassion and technically “right response” so that their activities are effective in actually changing the scope and nature of the epidemic.

The United Nations, World Vision and World Relief have all joined in the effort on an international level to spread awareness and help prevent the disease. Do you feel this stigma breaking trend will continue even more and that HIV/AIDS will finally be assessed at the grassroots level?

Certainly not only churches, but many organizations have been working to break the silence on HIV/AIDS. Certainly that has been effective through the years. You can see that in the extent of not only church programs but the programs of civil society and the government and the international community in response to HIV/AIDS. But this work is not over. The AIDS epidemic still carries great stigma. Again in our work in china, we ran into a situation where some of those who were receiving the lab report of a test did not want to receive one in their hands that was a positive test. When I was working with a translator and was making a point that you can't tell by looking at someone who has HIV/AIDS and that I might have HIV/AIDS, she actually refused to translate that statement because of the stigma that is attached even to the suggestion that someone as respected as a teacher, particularly a foreign teacher, is affected with the disease. There is a lot of work to be done still in reducing stigma, but there has been a lot of work that has been done and done effectively

William Meredith Long received a Bachelor of Arts and a Master’s from Wheaton College. He pursued further studies in journalism and adult education, and received a Dr.P.H. in Public Health, Health Behavior and Education from the University of North Carolina in 1992. Long has extensive experience in health organizations. Beginning with Medical Assistance Program (MAP) International, Long served as regional representative for South Asia, project director and program consultant, and in several director positions in International Health Programs in East and Southern Africa. Currently, Long serves as director of International Health Programs at World Relief. World Relief Programs are distinguished by their strong community base, integration with faith communities, and technical excellence. Long’s work reflects his dedication to HIV/AIDS prevention, holistic health and healing. He has published several articles and presented on AIDS education. Long’s book, a contribution to the Billy Graham Center monographs entitled Health, Healing and God’s Kingdom: New Pathways to Christian Health Ministry in Africa, was reviewed as "both a scholarly treatise and an insightful practical manual for health practitioners ... significant for understanding health and healing in a more widely non-Western context."