The influence of pastors’ ideologies of homosexuality on HIV prevention in the Black Church

Abstract

Young, Black men who have sex with men (YBMSM) are disproportionately affected by HIV and Black churches may be a source of stigma which can exacerbate HIV risk and contribute to negative health and psychosocial outcomes. Findings from this study are based on 21 semi-structured interviews with pastors and ethnographic observation in six Black Churches. Interview transcripts and field notes were analyzed in MAXQDA using thematic content analysis. Although pastors espoused messages of love and acceptance, they overwhelmingly believed homosexuality was a sin and had difficulty accepting YBMSM into their churches. The tension around homosexuality limited pastors’ involvement in HIV prevention efforts, although there still may be opportunities for some churches.

The Black Church has long been a focal point of the Black community and its reach often extends beyond a place of worship and spiritual guidance. Churches have served as centers for political activity, social activism, and health promotion (Coleman, Lindley, Annang, Saunders, & Gaddist, 2012) for centuries and have been a significant source of support and strength for Black communities. The prioritization of racial disparities within public health has contributed to the Black Church’s increasing involvement in numerous disease prevention efforts including breast and cervical cancer (Matthews, Berrios, Darnell, & Calhoun, 2006), diabetes (Samuel-Hodge et al., 2006), and obesity and physical activity (Wilcox et al., 2007). Significantly, church-based health programs and interventions have been shown to positively affect health behaviors within the Black community (Campbell et al., 2007).

Religiosity has a number of significant health benefits including being protective against morbidity, mortality (C. G. Ellison, Hummer, Cormier, & Rogers, 2000), mental health problems (C. G. Ellison & Gay, 1990), and maladaptive coping to racial discrimination (Bierman, 2006). Moreover, religious involvement may promote healthy living and improve health-seeking behaviors (Felix Aaron, Levine, & Burstin, 2003; Holt-Lunstad, Steffen, Sandberg, & Jensen, 2011; McCullough, Hoyt, Larson, Koenig, & Thoresen, 2000). Despite the Church’s involvement in health care and disease prevention activities, many churches have been hesitant to get involved in HIV prevention programs. Yet, as the racial disparities in HIV persist, Black churches have the potential to provide trusted, community-based culturally relevant HIV prevention programs.

The racial disparities in HIV are longstanding. As early as 1986, just five years after the recognition of the epidemic, the Centers for Disease Control and Prevention released a series of articles highlighting the rate of HIV infection and AIDS diagnoses among racial and ethnic minorities (Centers for Disease Control and Prevention (CDC), 1986). More recently, efforts have been focused on the high rates of HIV among young Black men who have sex with men (YBMSM).(Prejean et al., 2011) Estimates indicate that nearly a quarter of Black MSM who are seronegative at age 18 will be HIV-infected by the time they are 25 (Stall et al., 2009), and data from the Centers of Disease Control and Prevention indicate that YBMSM are almost four times more likely than their White or Hispanic peers to be HIV-positive (Centers for Disease Control and Prevention (CDC), 2010). These racial disparities in HIV are influenced by a number of behavioral, social, and structural factors, one of which is stigma. Introduced by sociologist Erving Goffman, stigma is the socially constructed persecution of a group of individuals perceived as being different from group norms, making them vulnerable to alienation and discrimination (Goffman, 1963). Sexual stigma, or homonegativity, refers to the inferior status of sexual minorities and justifies social and political power differentials and discrimination (G. M. Herek, 2007).

Although religiosity is associated with numerous positive mental and physical health outcomes,(Chatters et al., 2008; C. G. Ellison & Gay, 1990; C. G. Ellison, 1995; C. G. Ellison, Boardman, Williams, & Jackson, 2001; C. G. Ellison & Flannelly, 2009; Krause, 2004) the presence of stigma and homonegativity in religious contexts may diminish the associated health benefits for lesbian, gay, bisexual, and transgender (LGBT) persons. Homonegativity is often magnified within churches, where religious doctrine and beliefs condemn homosexuality, which can contribute to, or exacerbate, community-wide homonegativity (Shulden et al., 2008; Smith, Simmons, & Mayer, 2005; Tyrell et al., 2008; Williams, Palar, & Derose, 2011). Historically, stigmas surrounding HIV, homosexuality, and the behaviors associated with HIV transmission (i.e. unprotected intercourse and injection drug use) have impeded a response to HIV from the Black Church (Fullilove & Fullilove, 1999), and the association between HIV and homosexuality has hindered Black churches’ response to HIV among Black MSM in particular (Miller, 2007; Wilson, Wittlin, Munoz-Laboy, & Parker, 2011). Although harsh criticisms and denunciation of homosexuality from the pulpit are evident in a few churches (Foster, Arnold, Rebchook, & Kegeles, 2011), the quiet disapproval of homosexuality and slight microaggressions against LGBT persons may be more common, but just as damaging. Typically applied to racism, microaggressions are brief, commonplace, daily slights or assaults on one’s identity, which may be social or environmental, verbal or nonverbal, and intentional or unintentional (Sue et al., 2007). Applied to this context, pastors may not necessarily be espousing direct insults or discrimination within their churches, but rather, are more likely to assert minor, unintentional verbal and nonverbal assaults. These microaggressions can be internalized by LGBT individuals and become a significant source of stress (G. M. Herek, Gillis, & Cogan, 2009).

Despite this stigma, public health officials have called upon the Black Church to mobilize in response to the HIV epidemic (Centers for Disease Control and Prevention, 2007; White House Office of National AIDS Policy, 2015). Yet, there has been limited work exploring pastors’ perspectives on homosexuality and HIV to understand how they might best be able to respond to such a call. Using data from qualitative interviews and ethnographic fieldwork, the current study explores Black church pastors’ ideologies surrounding homosexuality and whether these influence their involvement in HIV prevention interventions for YBMSM.

Methods

We conducted 21 one-on-one interviews conducted between November 2013 and February 2014 with pastors of Black Churches in Milwaukee, WI and conducted ethnographic observation in six of those churches. Inclusion criteria for the pastor interviews were being 18 years of age or older, self-identifying as a Black or African American, and being a pastor or clergy member in a self-identified Black Church in Milwaukee. Pastors were recruited using direct recruitment through partnerships with community organizations and participant referral strategies. Pastors were sampled for diversity based on congregation size, denomination, and whether or not the Church was currently involved in HIV prevention—to obtain a broad view of beliefs and experiences. Interviews took place at the pastor’s church. Written informed consent was obtained prior to each interview. Twenty of the 21 interviews were digitally recorded with the consent of the pastor. One pastor declined recording but wished to participate in the study. Detailed notes were taken during this interview.

Interviews were based on a semi-structured interview guide that allowed for flexibility to ask follow up questions and explore certain areas in more depth (Bernard, 2011). Pastors were asked about their views on homosexuality and HIV, including how often they discussed these topics within their sermons or other church activities and what kinds of messages they hoped to convey to their congregation and YBMSM specifically. They were also asked about their views on adolescent sexual behavior, homosexuality among youth, and what role they believe the Church should play in addressing HIV.

Ethnographic observation was conducted by the Principal Investigator to contextualize the data from semi-structured interviews and provide triangulation to ensure validation of interview data. The church pastors had to have participated in an in-depth interview and agreed to allow participant observation in their church. All pastors interviewed welcomed the observation and the six churches selected were sampled to obtain diversity on congregation size, pastor views on homosexuality, involvement in HIV prevention, and denomination. Over the course of nine months, there were 22 participant observation sessions, ranging from three to six observations per church. Observation included attending Sunday services, Bible studies, and prayer groups, volunteering in church offices, observing a health clinic connected to a church. When appropriate, detailed field notes were taken during and after all observation sessions. Informed consent and research protocols were reviewed and approved by the Institutional Review Board at [Anonymous Institution].

Digital recordings were transcribed verbatim by trained transcription staff and transcripts and field notes were coded and analyzed using MAXQDA using thematic content analysis, guided by the principles of grounded theory analysis (Corbin & Strauss, 2008; Glaser & Strauss, 1967) and constant comparative method by the Principal Investigator. A codebook was created to capture broad content areas and key analytical concepts. Initial codes were established using open coding to identify broad content areas and key themes and categories. The codebook presented with 43 codes and 24 sub-codes, which included messages around homosexuality, views on HIV within their community, perceived barriers to HIV prevention engagement for churches, and the role of scripture and sermons to communicate messages. Analysis consisted of continual development and refining of coding schemes, allowing for exploration of emerging relationships between themes and patterns and the identification of new and unanticipated relationships. Transcripts were analyzed for differences and similarities based on pastor denomination, age, and congregation size. Emergent themes, patterns, and meanings were uncovered using content analysis to understand the experiences and beliefs of pastors and identify broad themes.

Results

Pastor characteristics are indicated in Table I. All pastors were Black males and ranged in age from 32 to 73 years old, with a median age of 53, and had been pastors anywhere from one to 34 years. The congregations were nearly all 100% Black. Denominations included African Methodist Episcopal, Pentecostal (Church of God in Christ), Missionary Baptist, American Baptist, United Methodist, and non-denominational. Pastors in eight of the 21 churches initially reported having HIV-related programs within their church, although upon further discussions only one church had an active HIV ministry. Pastors without active HIV ministries noted previously participating in the Black Church National Week of Prayer for the Healing of AIDS or an interest in participating in future HIV efforts. Despite a range of church denominations sampled for interviews and observation, pastors’ beliefs did not appear to differ significantly by denomination.

Table I.

Sample Characteristics

Pastors (n=21)
Pastor age (median, range)	53 (32–73)
Years as a pastor (median, range)	18 (1–34)
Education level
High school degree	1 (5%)
Some college	9 (43%)
Master’s degree	3 (14%)
Doctorate	4 (19%)
Congregation size (median, range)	300 (20–1500)
Current or previous involvement in HIV prevention programs	8(38%)

Church Doctrine, Pastor Influence, and Homosexuality

Pastors overwhelmingly held views of homosexuality that could be viewed as negative, hurtful, or stigmatizing to LGBT individuals, and the majority of pastors considered homosexuality to be a lifestyle or choice. As a 72-year-old Church of God and Christ pastor said, “I don’t believe God designed anybody with that kind of flaw, a moral flaw, a personality flaw like that. I don’t believe we’re born like that. I believe that it’s a learned behavior.” One of the primary concerns pastors had with the concept of homosexuality is the idea of homosexuality as an identity, rather than a personal choice.

47 year- old Christian Methodist Episcopal Pastor: It is difficult and it is challenging because [homosexuality] is a sin, but it’s so basic to who that individual believes they are. That’s what makes it difficult. Just as an example, if someone steals, they know that’s wrong and there is no question about that; they can separate that and they can understand that. But for homosexuality, I would say again clearly I believe it is a sin but the person who is homosexual or gay, they believe that is who they are. I don’t want to say stigma as much as a very difficult thing within the Church because the person really believes this is who I am and the Church says that’s wrong.

This pastor referred to one of the central conflicts between homosexuality and religion. Many gay individuals, and increasingly, society, believe sexuality is inherently part of who they are, yet the Church unapologetically condemns that aspect of one’s identity. In order for pastors to consider homosexuality sinful, it must be understood to be a personal choice, rather than the way God created someone. If pastors subscribed to the idea that God intentionally created some individuals gay, it would be nearly impossible to consider that characteristic sinful, as individuals have no control over their sexuality. As such, pastors offered a variety of explanations for why youth might be gay including the influence of the media, the lack of father figures, childhood sexual abuse, and the manipulation by adult gay predators.

Although the notion that homosexuality was a sin was universally accepted by participants, it was not viewed simply as pastors’ opinions.

53 year-old Assemblies of God Pastor: We believe as Christians that the Bible and the Word of God is the absolute authority and standard for all of life. We all might have our opinions, but what does God say? So when it comes to the issue of sex and sexuality, there are a lot of question marks. I don’t have the right to have an opinion as a minister of the Gospel or as a Christian; the final word comes from God.

Pastors referred to several Biblical passages they interpreted as clearly prohibiting same-sex sexual behavior (namely, Genesis 19: 1–29, Leviticus 18:22, Romans 1:26–27, and I Timothy 1:9–10). In their understanding, the determination that homosexuality is a sin comes directly from God. As such, the pastors’ opinions were seen as irrelevant or secondary to the ‘truth’ of the scriptures.

The majority of pastors interviewed took a fundamentalist approach to Biblical interpretation, believing that the Bible was the infallible, literal, word of God. Not only is the word of God seen as the absolute authority, but pastors believed they had a unique ability and responsibility to communicate that word of God to the community. As one pastor explained during a sermon (56 years old; United Methodist), “God has ordained us with the power to be his spokesperson and I believe God has ordained me, has told me that if I’m going to minister to people, I have to keep it real” (Observation, July 15, 2014). This highlights the considerable power afforded to pastors, particularly in Black Churches. The reliance on scripture to support opinions on homosexuality can be viewed as an excuse or justification for opinions or ideas that might otherwise be considered homophobic. Yet, by positioning themselves merely as messengers, pastors can use scripture as a scapegoat, and relieve themselves of responsibility for such views, and thus, cannot be accused of being homophobic or intolerant.

63 year-old Pentecostal Pastor with previous or current HIV programming: [We] emphatically hold that the Bible is the infallible word of God, so we do not compromise for what the word says. We have people that come into our churches who are living an immoral lifestyle and this word is what they have to deal with … I don’t judge people. I’m not homophobic- I’m sin-phobic. So the Church is not condemning, the Church is about saving and we love Christ like the word says, we will love people regardless of their race, their sexual orientation, their lifestyle.

As this pastor explained, the Church loves all people, regardless of their sexuality, but the infallible scriptures indicate that homosexuality is a sin and the job of the Church and the pastor is to save them.

As documented in previous research, pastors are often highly respected and as messengers of God’s Word, their messages can be extraordinarily influential in the community.(Quinn & Dickson-Gomez, 2016) This authority granted to pastors may unintentionally perpetuate homonegativity if pastors teach their congregations about the sinfulness of homosexuality, especially for young people who may be more easily influenced. As one pastor explained (45 years old; Pentecostal), “Pastors are very influential and so I think that it’s important to be accessible to the people, especially the young people about sexuality and stuff like that.” Although pastors may not have complete authority in interpreting the scriptures, they are responsible for relaying messages to the broader congregation. Pastors’ perceived position as authority figures and leaders makes their messages important to consider, as members of the congregation and community recognize and honor this authority, whether or not the pastor himself actually subscribes to that belief.

55 year-old Missionary Baptist Pastor with previous or current HIV programming: You got people that look at their pastor and look at them as God . . . . they look to their pastor and believe what he says, instead of studying themselves and going on their own judgment and following their own hearts. You know, you have people who have gay children and they are unable to accept them because they are listening to these old pastors, feed them all this old stuff. We have to change their thoughts, their way of thinking, and then we can change the way the Church is ran and then maybe we can get a new message out there for them to accept people for who they are. We have younger preachers that are coming up now who have a different message.

This pastor was among the minority in his more liberal perspective on the need to challenge the Church to become more accepting. Yet the perceived influence of the pastor was nearly universal. The messages pastors deliver about homosexuality may become widely adopted and normalized by the congregation, including LGBT congregants and their friends and family, which may subsequently lead to stigma and homonegativity among the wider congregation (Quinn & Dickson-Gomez, 2016).

Messages around Homosexuality

The extent to which pastors addressed homosexuality and broader issues of sex and sexuality within the congregation varied considerably. Several pastors never raised the issue with the congregation, as some found it difficult to discuss, in part due to the recognition that the Church’s views on homosexuality may be alienating and stigmatizing to LGBT persons. For other pastors, homosexuality was not as pertinent as other, more pressing, issues such as community violence and education, especially for youth. This avoidance of the issue was also, in part, due to the belief that there were not any LGBT persons in their congregation. For those pastors who did discuss homosexuality, the majority of pastors said it only occasionally came up, while others routinely discussed sexuality issues with their youth groups or in Bible study. Pastors rarely condemned gay congregants, but were clear that, in the eyes of the Church, homosexuality was wrong. As the pastor of a Baptist church noted one Sunday morning,

On this issue of homosexuality, please note that the Bible offers zero scriptures, no scriptures that support same-sex or homosexual lifestyles. The reality is also that we don’t struggle with what the Bible has to say on homosexuality, it’s very clear. The issue that we wrestle with is … the issue is, who is the Church for? Why does the Church exist? Who gets to participate in our church? What are the requirements for membership in Jesus’ church? How good do you have to be to get in and join? . . . . It boils down to the question of belonging. Belonging asks the question, ‘Do you really welcome me, and do you really love me, even if I don’t believe, and if I don’t behave, or if I haven’t become, like you?’[Observation, June 8, 2014]

This narrative highlights the dilemma pastors face in understanding homosexuality to be a sin while simultaneously advocating for the acceptance of sinners. Although he was clear in his conviction that homosexuality was a sin, he focused his sermon on accepting all people into the Church, even if they didn’t necessarily act in accordance with the scriptures. He acknowledged that although the Church intends to be welcoming, those who don’t fit in are not always actually welcome.

However, although pastors believed that homosexuality was undoubtedly a sin, it was no more severe than any other sin. As a 37 year-old Missionary Baptist pastor explained:

I think that our congregation is very traditional, so you know homosexuality is a sin. How do we look at sin is the question. I think there is too much emphasis on homosexuality, quite frankly. So whether people believe that it’s a sin or whether you believe it’s not a sin, we can debate all of that if we want to. Here is where I stand: Do we have the same strength and rigor around people who are engaged in other sins? Do we have the same engagement or the same messaging around that? Is this because of our own phobia to homosexuality?

He later went on to say:

We try and separate homosexuals over here and all other sinners over here. Well, if you believe in sin, why are they singled out? Why are you putting homosexuality on an island? Why don’t we deal with all of sin because that’s what our charge is to do, speak prophetically to sin and wrong in a community. Why don’t we deal with it all?

One of the consequences of the stigma around homosexuality is the tendency to separate homosexuality as a distinct, more severe sin. Homosexuality is often singled out as one of the most egregious sins, but as many of the pastors suggested, it should not be, as homosexuality is no greater a sin than any other sin. Pastors seemed to suggest homosexuality is equal to other sins in an effort to downplay the attention and focus it has received within the Church. Yet, in their efforts to do so, they may be unintentionally contributing to the stigma around homosexuality. In their views, homosexuality was not understood to be a totalizing state or inherent aspect of individual, but a temptation and vice people may face. As such, pastors were able to approach homosexuality as a modifiable aspect of one’s identity or an individual vice, allowing them to continue to love the individual and focus instead on changing their behaviors.

Love the sinner, hate the sin

It was clear that pastors overwhelmingly condemned homosexuality, which is not surprising given Christian doctrine and biblical hermeneutics. Yet, despite these negative views, there was a very clear ‘love the sinner, hate the sin’ mentality that predominated. That is, pastors believed it was their duty to love all people, regardless of their sins, yet loving someone did not mean the pastor condoned their behavior. As a 45 year-old Pentecostal pastor said in discussing LGBT youth, “The first thing that I would have to do is love them. And a lot of people say that is a good exit word, but I would have to love them. But I know the way we stand; it’s not right.” Yet, as he and other pastors acknowledged, saying you would love the person can be viewed as an easy out for pastors, as Christianity suggests they are to love all people, regardless of sins. What it meant for a pastor to love LGBT youth in their congregation varied, but for most, it did not include welcoming them in the Church as they are, advocating for them, or supporting their identity. The struggle for pastors was to determine how to love someone without condoning their behavior. Pastors made a distinction between homosexual identity and behaviors, arguing that as Christians, they were required to love the individual although they did not necessarily agree with their ‘lifestyle’ or same-sex sexual behaviors.

50 year-old Church of God in Christ Pastor: I say this with no disrespect to anyone, but I do not condone homosexuality, nor do I condone lesbianism – that’s the predominant where HIV is coming through. Not saying that I say that, really, because the Bible tells me that it’s wrong. Do we hate people? No, we are not haters, we are lovers. We just do not want to condone an unrighteous practice that my Bible tells me, so that’s it. So I don’t condone it, but we don’t hate people because of their sexual orientation. Now, I love you my sister, I love you, my brother, but hey, I’m not going to be condoning of the sins that you are involving yourself in.

As this pastor explained, although he did not condone the “unrighteous practice” of homosexuality, LGBT individuals are still loved by the Church, as directed by the bible, and nearly all pastors talked about the need to love and save those who were participating in any practices perceived to be sinful. This pastor explained where the love the sinner, hate the sin mentality may stem from:

52 year-old African Methodist Episcopal Pastor: I think African American people are primarily theologically conservative and politically liberal. Theologically conservative in the sense that we do hold to the adage that marriage is between a man and a woman. Politically liberal in the sense that although we hold that view, we still don’t think a person should be socially discriminated against, subject to prejudice or hatred based solely on their sexual orientation. That’s what we see a great deal of in our society – that unfair treatment – and, of course, we as African Americans are not unfamiliar to that.

The fundamental beliefs about the sin of homosexuality are rooted in theological conservatism promoted by so many of the pastors. Yet, as this pastor explained, their more liberal political leanings and historical civil rights struggles make them uncomfortable with discrimination or maltreatment toward the individual. As a result, pastors generally advocated for and encouraged LGBT individuals to change and move away from that sinful lifestyle. Thus, although homosexuality was nearly universally considered sinful, the response to that sin was never one of explicit hatred or exclusion. On the contrary, pastors generally believed their role as pastors was to ‘save’ gay members of their church or help them through what was viewed as a difficult period of their lives, often equating changing from a “gay lifestyle” to recovery from drug and alcohol abuse.

47 year-old Baptist Pastor: I want [young people] to know that there is always hope and their future can be brighter than what they have envisioned it to be, but there are some steps they have to take. We are not here to crucify you and we are not here to nail you to the cross. We are here to let you know that you have support. We are here to let you know that there is a better way and you can get past this. You don’t have to stay in that particular situation; there is help for you . . . . I’ve actually seen one or two lifestyle changes where they have actually admitted and just actually have changed their lifestyle, I’ve seen it. They have changed their sexual partners, their attitudes have changed. And we’ve seen them go through the trauma, or if I can use the word, the withdrawal of the thing, where they are going through the process of really disciplining themselves not to fall back into these desires.

Pastors generally believed they were supportive of LGBT youth, reminding them that God still loved them and suggesting there was still ‘hope for them.’ They maintained that LGBT youth were confused about their sexuality, influenced by gay adults, or lacking love and guidance from their parents.

Acceptance in the Black Church: Don’t Ask, Don’t Tell

There were few, if any, openly gay congregants in these pastors’ churches, as far as pastors were aware. Several pastors said there were one or two individuals whom they suspected were gay, but were not open, particularly in the music ministry.

Interviewer: How are gay men treated in the church community?

32 year-old Community Baptist Pastor: Well, almost a don’t ask, don’t tell, you know? For the Black Church culture, you know, we have always been able to sense, I don’t know. Is that gaydar? Interestingly enough, they’ve always been in the music industry. Not all, but you know, music directors, musicians, that kind of thing. And we’ve created a space for them in the Church, but not to be who they are in the fullest, you know. Don’t talk about it, we won’t ask, you know? There’s still a lot of stigma, there’s a lot of shaming, a lot of rejection, really.

Interviewer: Why do you think that is?

Pastor: People nurtured with a deep-seated prejudice around those issues and perverse homophobia, you know? A fundamentalist theology. When you put it all together, you can get a recipe for real kinds of visceral responses to people’s sexual identities.

Several pastors acknowledged this double standard that existed within the Church. Pastors believed that, in general, the Church was accepting of gay men if they possessed gifts that added to the value of the Church and were quiet about their sexuality. However, they simultaneously acknowledged the stigma around homosexuality and the hostility and isolation that can result when people are open about their sexuality. Despite this, pastors viewed themselves as overwhelmingly welcoming of LGBT youth.

52 year-old African Methodist Episcopal Pastor: I think of the Church as an environment where somebody should be able to come to be who they are and talk about the struggles that they might be having, how they’re struggling to come to grips with their identity, and to do that without feeling censored and condemned. That’s who we’re supposed to be. And so, if you can’t come to the Church and feel that and receive that, then there’s not much hope for you going anywhere else and getting that. We have to be that community that will receive and accept you irrespective of your lifestyle choices.

Acceptance, including acceptance of gays, was seen as a non-controversial, loving, Christian thing to do. Yet, the degree to which individuals were actually accepted varied considerably. The pastor above held more liberal views on acceptance of gays within the Church. Although he believed homosexuality was a choice, he also condemned the hostility gays and lesbians receive from Christians and suggested the Church needing to be more welcoming. Furthermore, this pastor differed from others who preferred gays be a quiet presence in the Church and conceal their homosexuality.

Despite perceiving their churches as accepting and welcoming, no matter what your sexual identity or sin, it was clear that such acceptance was often conditional.

73 year-old Baptist Pastor with previous or current HIV programming: As long as [gay congregation members’] behavior coincide with the decorum that we have in our worship services, they are welcome.

Interviewer: What do you mean by that?

Pastor: Well, sometimes people like to come out and say who they are and what they are. I don’t practice that here, you know? If you have a friend, fine, you come and worship and go about your business. But parading them around and introducing them? No, no, no, not here… I wouldn’t put anyone out of the congregation who wants to be part of the congregation, but I will not allow anyone to disrupt the congregation. I don’t condone same sex relationships and again, we probably would have them in our congregation so long as they don’t parade themselves. They are welcome here, I guess, for lack of a better word, as long as they stay in their place.

Although this pastor says he would welcome gay congregation members, they were only welcome so long as they ‘stay in their place’ and do not ‘disrupt’ the congregation by introducing their partners to other congregation members. Several pastors believed their congregation would be uncomfortable if there were an openly gay member in the Church, although many pastors seemed uncomfortable with the idea as well, sharing the view that such acceptance would be disruptive to the Church. In particular, several pastors suggested the dress or mannerisms of LGBT individuals would be especially disruptive.

43 year-old American Baptist Pastor: If an openly gay person came in, male, dressed with lipstick on, hair, nails, you’ll get frowned upon. That’s the nature of the Black Church. If you came in as a gay male that, even though others knew it, but you came dressed as a male you wouldn’t have a problem… If they came to the Church with their partner, that would make them ostracized. Because as long as their presentation is good, you know, that’s fine.

This conditional acceptance raises questions about the extent to which these churches are actually welcoming and accepting. Pastors viewed themselves and their congregations as welcoming and loving of all people, just as directed by scriptures, yet it was clear that unless gay men were willing to stop being gay, conformed to certain standards, or concealed aspects of their identity, there was not a place for them in the congregation.

The role of the Church in HIV prevention

In general, the response to HIV from these pastors and their churches has been minimal. Eight of the 21 pastors interviewed indicated that they were currently or previously involved in HIV prevention activities, ranging from offering HIV testing once a year to regularly offering testing or referral services along with other health services. Several pastors participated in the annual Black Church Week of Prayer for the Healing of AIDS, an awareness campaign to mobilize faith communities. While three pastors mentioned offering HIV tests during church services during the week-long event, others mentioned allowing professionals to come in and talk about HIV testing and services with their congregation. No churches had extensive HIV prevention programs, nor was it a priority among any of the pastors. Pastors tended to be more actively involved in issues that were seen as affecting the majority of their congregation including community violence, education, employment, and poverty. That being said, pastors overwhelmingly believed the Church should be involved in HIV prevention efforts, especially those that address racial disparities affecting YBMSM.

43 year-old Christian Methodist Episcopal Pastor: I believe that it is the Church’s job. I think any social concern is a responsibility of the Church. Whether it’s HIV, mass incarceration, poverty. Any social concern, because that’s how I understand Jesus of the scripture. If Jesus was concerned about the livelihood of the people, then I think as a Church it’s our responsibility. When we fail to do that, we fail to fully embrace the teachings of Jesus.

Although all pastors believed they had a responsibility to get involved in HIV prevention efforts to some extent and engage their congregation in that work, they differed in what that involvement should look like. Generally, abstinence and sex between a married man and woman were seen as ideal, although some pastors also acknowledged individuals were not always following the ideal.

37 year-old Missionary Baptist Pastor: It’s always controversial when you come to the churches about condoms and things like that, but you know, I think prevention is really educating people around sex and sexuality and its relationship to the body and relationship to the Bible . . . . One of the challenges as a pastor is to balance the spiritual and the practical. We believe in abstinence before marriage and stuff like that, but you know, practical data suggests to you that that’s not happening.

Acknowledging that not all youth are abstinent, the majority of pastors believed sexually active teens should be using condoms if they are having sex. Despite this belief, pastors generally did not feel comfortable teaching about condom use in the Church, explicitly encouraging teens to use condoms, or distributing condoms within the Church or church programs. A few pastors, however, acknowledged that although things like condom distribution and open conversations on HIV risk behaviors are not supported or encouraged by the Church, they are necessary for the larger purpose of saving lives and suggested the Church needed to be more open about encouraging condom use.

32 year-old Community Baptist Pastor: Maybe I’m more, I’m still a little bit young, so I’m still a little zealous. I will say it, you know, I’ve always pushed the envelope … I think the Church has to [have a conversation about condom use]. We have to have the conversation that will help them. Of course, the push back would be “Oh, we give them condoms. You’re just going to encourage them to do it.” You don’t have to encourage anybody to do anything natural. Impulses are what they are. Now, we have to be responsible in terms of how we respond, but they are what they are. And I would rather, if we’re going to save a kid’s life say ‘Man, you need to protect yourself. Be responsible so there’s no disease, unwanted pregnancies, and those other kinds of things.’ We have to do something, yeah, we have to do something.

As this pastor recognized, his more liberal stance on condom use may be attributable to his age. As the youngest pastor interviewed, he was generally more comfortable and willing to discuss issues of sex and sexuality with young people in his congregation, and further, was more comfortable with the idea of discussing and encouraging all young people to use condoms to prevent unwanted pregnancies, STIs, and HIV. Older pastors, especially those with decades of pastoral work, tended to be more conservative in their thinking and approach to HIV, focusing on conversion of homosexuals and abstinence before marriage, and may struggled with how they felt the Church should respond.

Interviewer: What role do you think the faith community should play in HIV prevention?

53 year-old Assemblies of God Pastor: I don’t know. Sometimes I think that the faith community should play a good role, a lead role. But at the same time, you have to be careful because you know it’s a lifestyle that we don’t condone. But at the same time, there is a disease out there that is affecting Black men. So you know, who has the courage to stand up and say something?

Therein lies the struggle for many pastors. Although they recognize HIV is a significant issue, particularly within the Black community, and acknowledge that they could take a significant leadership role in addressing sex and HIV, the issue of homosexuality is an obstacle. The sexual transmission of HIV appears to be something pastors can overcome, but a specific focus on gay men presents challenges for pastors. Although pastors recognize the need to get involved, their convictions around homosexuality and the fear that their involvement in HIV prevention may appear as condoning homosexuality, make it difficult to do so. While pastors generally maintained they loved and accepted gay congregants, there was still an underlying discomfort and fear of being perceived as encouraging and supporting homosexuality.

Discussion

The results of this study reveal the complexity underlying pastors’ ideologies of homosexuality and the Black Church’s response to calls for involvement in HIV prevention activities. Although there is considerable diversity among Black pastors, the themes presented here were consistent across the majority of interviews. The ideologies espoused by pastors on homosexuality and acceptance were decidedly anti-homosexual, although they were not necessarily perceived as such by pastors.

According to these pastors, their churches are welcoming to all people and their approach to YBMSM or other gay congregants is one rooted in love, at least theoretically. In practice, however, the messages espoused by pastors and their underlying ideologies are not so accepting, and pastors rarely recognized the potential negative effects of their words and actions on recipients. A few pastors were explicitly anti-homosexual in their messages and teachings. They denounced homosexuality in Sunday sermons, Bible studies, and in youth groups, and generally believed that homosexuality and religiosity were incompatible. Yet, more commonly, pastors and other church members espoused casual microaggressions, which, while subtle, have the potential to be just as influential and damaging. For example, although pastors held a wide spectrum of views on how the Church should respond to gay congregants, there was an underlying conviction that homosexuality was a sin and did not coincide with Christianity. The sinfulness of homosexuality, or the belief that non-heterosexual orientation is morally wrong and sinful, is one of the seven identified typologies of sexual orientation microaggressions (Sue, 2010). The conviction that homosexuality is a sin can be particularly damaging for individuals struggling to reconcile their sexual identity and their faith and for youth, who may be actively struggling with understanding and accepting their own identity.

Despite the potentially negative views espoused within the Church regarding homosexuality, pastors viewed themselves and their churches as welcoming and accepting. By distinguishing between the individual and his or her identity or behavior, pastors were able to ‘love the sinner, hate the sin.’ This ideology has been promoted throughout Christianity and has been observed in other studies examining the Church and homosexuality (Barnes, 2009; Miller, 2007; Wilson et al., 2011; Wilson et al., 2011). However, the acceptance of gays within the Church was not so straightforward. The call to love gay congregants, as Christians are to love all people, seemed to be merely standard language used by pastors, and fails to accurately capture how pastors would respond to having a gay member of their church. Although gay congregants were theoretically welcome in the churches, they were only welcome insofar as they abided by cultural norms and their acceptance was conditional upon YBMSM hiding or modifying certain aspects of their identity so as not to ‘disrupt’ the rest of the congregation. This conditional acceptance, and the Christian ideologies that maintain homosexuality is inherently wrong, may inadvertently contribute to or exacerbate stigma around homosexuality.

Given the subtle nature of microaggressions, the perpetrator is often well-meaning and unaware of their actions, which was nearly always the case with pastors who perceived themselves as loving and welcoming (Sue, 2010). As a form of minority stress, microaggressions may have a cumulative negative impact on the health and well-being of those they are perpetrated against (Lewis, 2009; Meyer, 2003; Platt & Lenzen, 2013). Research on sexual orientation microaggressions in religious contexts is limited, but early work suggests this type of microaggression may play a significant role in the negative experiences faced by LGBT individuals, especially those who have strong ties to their religious faith or strong cultural and familial roots in religion, as is true for many African Americans (Platt & Lenzen, 2013). Although more research is needed, emergent research suggests that sexual orientation microaggressions contribute to lowered self-esteem, negative feelings about one’s sexual identity, stress, anxiety, depression, and posttraumatic stress disorder for some individuals (Burn, Kadlec, & Rexer, 2005; Nadal et al., 2011; Platt & Lenzen, 2013; Wright & Wegner, 2012). Microaggressions, and subsequently internalized heterosexism, are more likely to have significant social and mental health effects when coming from close friends, family, and other highly esteemed individuals (Balsam, Molina, Beadnell, Simoni, & Walters, 2011). This is particularly important with regards to the Black Church, which is often seen as so significant that even as individuals leave the Church they are profoundly influenced by early experiences in the Church and the messages they received from the Church’s leaders (Ward, 2005).

Although there are certainly barriers to implementing church-based HIV prevention initiatives (not least of which are pastors’ ideologies around homosexuality), there may still opportunities for the Black Church to respond to HIV. Pastors were enthusiastic about participating in HIV prevention efforts, especially those designed to address the racial disparities in the disease, although few were currently involved in such activities, which was largely attributable to a discomfort in discussing the sexual behaviors that put individuals at risk for HIV. Consistent with previous research (Coyne-Beasley & Schoenbach, 2000; Cunningham, Kerrigan, McNeely, & Ellen, 2011; Harris, 2010; Koch & Beckley, 2006; McNeal & Perkins, 2007), pastors acknowledged that HIV was an important issue that necessitated a response from the Church and all participants were open to the idea of implementing some type of HIV prevention program within their church. Most notably, the HIV prevention field is increasingly shifting from behavioral to biomedical or biobehavioral interventions, which simultaneously shifts a focus away from sexual behaviors deemed to be sinful. Pre-exposure prophylaxis (PrEP), for example, involves the use of HIV treatment medications to prevent infections among individuals who may be at risk of infection (Anderson et al., 2012; Donnell et al., 2014). Such interventions may be better well-received by pastors and more easily promoted within a religious environment. Furthermore, their community mobilization skills, community outreach experience, and general influence in the broader community situate them well to respond to the HIV epidemic among YBMSM.

The stigma around homosexuality in Black churches is prominent and the effects of this on YBMSM or other LGBT individuals are not yet fully understood. Although pastors perceived their churches to be accepting, it was clear that such acceptance was conditional upon individuals’ compliance with heteronormative behaviors, which may unintentionally distance YBMSM and other LGBT congregants from the Church. Furthermore, the ideologies surrounding homosexuality are deeply rooted in history, faith, and scripture, and are unlikely to be significantly modified in the near future. While this certainly presents challenges for the reconciliation of homosexuality and Christianity, it does not necessarily present an impasse for churches to get involved in HIV prevention. In fact, previous research has found it may not be necessary for congregations to be affirming of homosexuality in order to engage them in HIV-prevention strategies (Bluthenthal et al., 2012).

Interventions and collaborations with churches should focus on reducing the stigma around homosexuality within religious congregations, recognizing that stigma need not always come by way of direct verbal assaults or discrimination. The liberal political leanings and Civil Rights histories of the Black Church suggest stigma reduction may be an effective avenue to pursue with churches. Pastors recognized that the stigma around homosexuality could easily result in discrimination, which Black churches are sensitive to and strong advocates against. Effective stigma reduction interventions may want to focus on educating pastors about the negative effects of homonegativity on a gay individual, exploring how they parallel the effects of racism. Although involvement in HIV prevention activities does not necessitate stigma reduction, congregational HIV activities may actually contribute to future stigma reduction (Bluthenthal et al., 2012). Furthermore, given the significant health and social consequences associated with stigma and homonegativity, reducing stigma around homosexuality is critical for HIV prevention, as stigma can directly influence HIV risk behaviors and interfere with the effectiveness of HIV prevention activities.

This study’s findings should be considered in light of its limitations. Although pastor sampling efforts allowed for the achievement of greater diversity in terms of congregation size and denomination, pastors’ time constraints proved to be a barrier to recruitment for some pastors. Many pastors of smaller churches are bi-vocational, working full-time in addition to their role as a pastor, which made it difficult for some pastors to participate in the interview. Those who did participate may have been more likely to have an interest in public health, HIV prevention, or community partnerships. Furthermore, this is a small sample of pastors in a single Midwestern city. The opinions and experiences of these pastors may not be representative of Black pastors in other cities or regions of the country. The observations that occurred within churches were done with the permission of the Church pastors, who knew the focus of this research. However, as a White female in predominantly Black churches, my presence was noticeable and perhaps distracting to other members of the congregation. This was especially true in smaller churches, where it was obvious that I was not a regular member. Furthermore, my noticeable presence also meant that the pastor or other religious leaders knew when I was in attendance, which may have made them more cognizant of talking about, or avoiding, the issues they knew I was studying. Finally, additional research on the experiences of YBMSM within the Black Church is necessary to fully understand the effects of pastors’ messages and ideologies. Despite these limitations and important considerations, this research yielded important findings that will be useful in future efforts to engage the Church in HIV prevention and tackle stigma and homonegativity among YBMSM and other LGBT individuals.