An article in NAM aidsmap reported on a study of church attendance and HIV diagnosis in men who have sex with men (MSM) in Alabama. Researchers at the 1917 Clinic in Birmingham, Ala., conducted a cross-sectional study with people newly diagnosed with HIV after 2007. The 508 participants (62 percent African-American) consisted of 60 percent MSM, 21 percent men who have sex with women (MSW), and 18 percent women who have sex with men (WSM). Participants completed a questionnaire about HIV testing history and sexual behavior, including a question on whether they attended church.
Most participants reported church attendance, including 53 percent of MSM, 59 percent of MSW, and 64 percent of WSM. One-third (32 percent) of the participants had a CD4 cell count below 200 cells per cubic millimeter when they began treatment and were classified as diagnosed late. Findings indicated a significant interaction between church attendance and late presentation to care. MSM church attendees were significantly more likely to have a CD4 cell count less than 200 cells per cubic millimeter at diagnosis than MSM who were non-church attendees. When the researchers adjusted for other factors associated with late diagnosis, church attendance was associated with a more than two-fold increase in risk of late diagnosis among MSM.
Results for MSW and WSM showed no association between church attendance and late diagnosis. Researchers also found a significant interaction between church attendance and sexual behavior and testing history. Women who did not attend church were more likely to report no previous HIV test compared to church attendees (59 versus 32 percent). Also, MSM church attendees were more likely to report no previous test compared to MSM non-church attendees.
Researchers suggested possible explanations for the relationship between church attendance and late diagnosis among MSM and urged caution in interpreting their findings.
The full report, “Church Attendance in Men Who Have Sex with Men Diagnosed with HIV is Associated with Later Presentation for HIV Care,” was published online in the journal Clinical Infectious Diseases (2013; doi: 10.1093/cid/cit689).