“If I wasn’t a pastor, I would be telling them about condoms, contraceptives and PrEP”—conflicts, dilemmas and credibility
Qualitative insights from religious leaders and the promotion of pre-exposure prophylaxis (PrEP) in Eswatini
Bibliographic Data
| ID | 21879972 |
|---|---|
| Authors | Hannah Goymann (0000-0003-1290-1220, Heidelberg University), Astrid Berner-Rodoreda (0000-0002-5484-890X, Heidelberg University), Mxolisi Mavuso (Clinton Health Access Initiative (CHAI), Mbabane, Eswatini), Shannon A Mcmahon (0000-0002-8634-9283, Heidelberg University), Sindy Matse (Ministry of Health), Andreas Jahn (0000-0001-8181-9795, Heidelberg University), Albrecht Jahn (Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany), Kate Bärnighausen (0000-0002-4466-8921, University of the Witwatersrand) |
| Year | 2025 |
| Volume | 10 |
| Issue | 4 |
| Pages | e018174 |
| Publication date | 2025-04-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2024-018174 |
| PMID | 40306730 |
| OpenAlex | W4410016916 |
| Language | EN |
| References cited | 43 |
BACKGROUND: Religious leaders (RLs) form an influential group in Eswatini. This study explores their understanding and acceptance of pre-exposure prophylaxis (PrEP), with a view to improve PrEP service delivery for those who would benefit from PrEP the most. METHODS: We conducted online and in-person in-depth interviews with (n=26) purposefully selected RLs (n=12 female and n=14 male) from Eswatini. Data were managed using NVivo V.12 and coded inductively. We used thematic analysis to analyse our data and structure our findings across the individual, interpersonal, community and institutional levels of an ecological framework. RESULTS: RLs have the willingness, potential and influence to promote PrEP in their church communities. They are aware of the community need for HIV prevention, but describe a conflict between their professional role as a pastor and their personal commitment to the well-being of their church community. Participants expressed a dilemma between their pastoral ethics- which oppose sex outside of marriage-and the conflicting challenges of HIV stigma and evidence-based health promotion among church members. Discussing PrEP could compromise their credibility and expose them to potential censure from religious authorities and the church community. CONCLUSION: RLs can play an important role in the community acceptance and implementation of PrEP but are conflicted between community health and their professional role. Addressing the sources of this conflict and offering tailored training about HIV prevention and PrEP is essential to reduce stigma and benefit from RLs' influence in the church community
Credibility · Dilemma · Interpersonal communication · Political science · Public relations · Qualitative research · Social science · Sociology · Thematic analysis · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Law · Medicine · Psychology · Religion, Society, and Development · Social Psychology
NVivo
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| Citation velocity | historical |
|---|---|
| Highly cited | No |