Centre for Population Studies, Department of Epidemiology and Population Health, 49-51 Bedford Square, London School of Hygiene and Tropical Medicine, London, WC 1B 3DP, UK.
BMC Public Health. 2010 Jul 20;10:427. doi: 10.1186/1471-2458-10-427.
The role of religious beliefs in the prevention of HIV and attitudes towards the infected has received considerable attention. However, little research has been conducted on Faith Leaders' (FLs) perceptions of antiretroviral therapy (ART) in the developing world. This study investigated FLs' attitudes towards different HIV treatment options (traditional, medical and spiritual) available in a rural Tanzanian ward.
Qualitative interviews were conducted with 25 FLs purposively selected to account for all the denominations present in the area. Data was organised into themes using the software package NVIVO-7. The field work guidelines were tailored as new topics emerged and additional codes progressively added to the coding frame.
Traditional healers (THs) and FLs were often reported as antagonists but duality prevailed and many FLs simultaneously believed in traditional healing. Inter-denomination mobility was high and guided by pragmatism.Praying for the sick was a common practice and over one third of respondents said that prayer could cure HIV. Being HIV-positive was often seen as "a punishment from God" and a consequence of sin. As sinning could result from "the work of Satan", forgiveness was possible, and a "reconciliation with God" deemed as essential for a favourable remission of the disease. Several FLs believed that "evil spirits" inflicted through witchcraft could cause the disease and claimed that they could cast "demons" away.While prayers could potentially cure HIV "completely", ART use was generally not discouraged because God had "only a part to play". The perceived potential superiority of spiritual options could however lead some users to interrupt treatment.
The roll-out of ART is taking place in a context in which the new drugs are competing with a diversity of existing options. As long as the complementarities of prayers and ART are not clearly and explicitly stated by FLs, spiritual options may be interpreted as a superior alternative and contribute to hampering adherence to ART. In contexts where ambivalent attitudes towards the new drugs prevail, enhancing FLs understanding of ART's strengths and pitfalls is an essential step to engage them as active partners in ART scale-up programs.
宗教信仰在预防 HIV 以及感染者态度方面的作用受到了广泛关注。然而，在发展中国家，很少有研究关注信仰领袖对艾滋病逆转录病毒疗法（ART）的看法。本研究调查了坦桑尼亚农村病房中信仰领袖对不同 HIV 治疗选择（传统、医学和精神）的态度。
采用目的抽样法选择了 25 名信仰领袖进行定性访谈，以涵盖该地区的所有教派。使用 NVIVO-7 软件包对数据进行主题组织。随着新主题的出现，现场工作指南进行了调整，并逐步向编码框架中添加了额外的代码。
传统治疗师（TH）和信仰领袖经常被描述为对立者，但二元性占主导地位，许多信仰领袖同时相信传统治疗。教派间的流动性很高，并且受到实用主义的指导。为病人祈祷是一种常见的做法，超过三分之一的受访者表示祈祷可以治愈 HIV。HIV 阳性通常被视为“上帝的惩罚”和罪恶的后果。由于罪恶可能源于“撒旦的工作”，因此可以原谅，并且“与上帝和解”被认为是疾病有利缓解的必要条件。一些信仰领袖认为巫术可以通过邪灵造成疾病，并声称他们可以驱除“恶魔”。虽然祈祷可能有潜力“完全”治愈 HIV，但一般不鼓励使用抗逆转录病毒治疗，因为上帝只能“发挥一部分作用”。然而，精神选择的潜在优势可能会导致一些使用者中断治疗。
ART 的推出是在新药物与现有多种选择竞争的背景下进行的。只要信仰领袖没有明确而明确地说明祈祷和 ART 的互补性，精神选择可能被解释为更优的替代方案，并可能阻碍对 ART 的依从性。在对新药物持矛盾态度的情况下，增强信仰领袖对 ART 的优势和缺陷的理解，是使他们成为积极参与 ART 推广计划的合作伙伴的重要步骤。
