The interrelationship between religiosity and HIV infections in Uganda: a community case of study
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Background In Uganda one of the strategic actions to accelerate prevention of sexual transmission of HIV infections is to utilize religious institutions for delivery of HIV prevention messages. There is limited empirical data on the association between religiosity and HIV infections, for evidence-based planning of faith-based HIV prevention interventions. Objectives To examine how Ugandan communities understand the concept of religiosity and its role in HIV prevention; to adapt and validate the brief multidimensional measure of religiosity/spirituality; to assess the association between religiosity and HIV-risk behaviours; and to assess the association between religiosity and HIV prevalence rates. Methods The main study was an unmatched case-control study. The cases were HIV positive youth 15-24 years and the controls were HIV negative youth from the same age-group. Results Religiosity was defined by communities as good behaviours in accordance with God’s guidelines. It was considered to be of great importance in HIV prevention. The adapted brief multidimensional measure of religiousness/spirituality had adequate validity and reliability. Cronbach’s alpha was 0.86 for both Christians and Muslims. Higher levels of many dimensions of religiosity were associated with behaviours likely to reduce new HIV infections. Lower levels of religiosity were associated with higher HIV infection rates when the following dimensions of religiosity were analysed among Christians: feeling guided by God in daily activities (odds ratio 1.70, p=0.035), feeling thankful for God’s blessings (odds ratio 1.76, p=0.042), praying privately (odds ratio 2.02, p=0.001), trying hard to be patient in life (odds ratio 1.74, p=0.024) and trying hard to love God (odds ratio 1.57, p=0.039). Among Muslim, those without Sujda the hyperpigmented spot on the forehead as a result of prostration during regular prayers, had more HIV infections (odds ratio 2.90, p=0.029) Conclusions Adherence to the religiosity dimensions that were significantly associated with lower HIV infections should be scaled up by all stakeholders involved in implementing faith-based HIV prevention interventions.