The Black Church Is a Place of Healing. Why Is HIV Still So Hard to Talk About?
Growing up in rural Georgia, Ciarra “Cee-Cee” Brown was a faithful Christian like most people in her small town, and her church was the foundation of her social and spiritual life. Sunday worship was a given, the Bible guided daily life, and sex before marriage was a sin — full stop.
As she became a teenager, Brown grappled with urgent feelings about the opposite sex, but hesitated to confide in anyone in her church, much less ask for advice. So she reached her own conclusions and became sexually active, even though she didn’t know everything she needed to protect herself.
Then, barely out of her teen years, Brown sought out birth control (“I was gonna have a hot girl summer,” she quipped) and was offered a routine HIV test along with it. The result — HIV positive — was an emotional turning point that tested Brown’s faith. But it was the judgment and hostility she encountered from her church that would reshape her journey.
“I knew that I was going to have to come up with my own understanding of spirituality and my own relationship with God,” says Brown, now director of programs for The Well Project, a nonprofit HIV organization that helps guide and empower HIV-positive women. Her church, Brown said, “saw me as unclean and unsafe, and all of my behaviors were something to be demonized.”
For generations, churches and faith communities have been among Black America’s most trusted sources of comfort, information, and support. Yet when it comes to sexuality in general, and HIV prevention in particular, Christian messages of love, acceptance, and compassion are generally hard to find. Yet even as the HIV crisis in the Black community continues, preaching rooted in abstinence, shame, and moral judgment, however, is more common, hindering frank conversations precisely when — and where — they may be needed most.
That was the message Brown and others delivered at “Separation of Church & Sex: Faith and the Fight Against HIV,” a ViiV Healthcare-sponsored plenary at the National Association of Black Journalists convention in Atlanta last month.
Moderated by Nikole Hannah-Jones, a Pulitzer Prize-winning journalist, the panel included Rev. Don Abram, a theologian and LGBTQ activist; Dr. Jackie Walters, an obstetrician and star of the reality TV series, “Married to Medicine”; actress and media personality Eva Marcille; and Randevyn Piérre, Head of External Affairs at ViiV Healthcare.
The conversation carried particular urgency: despite remarkable advances in prevention and treatment, Black Americans remain disproportionately affected by HIV. In 2024, they accounted for nearly 4 in 10 new diagnoses nationwide, even though they make up roughly 12% of the U.S. population.
Black women like Brown are especially vulnerable, accounting for more than half of HIV diagnoses among all women.
The takeaway was as blunt as it was frustrating: medicine has gotten better at fighting and suppressing HIV, allowing people to live long, healthy lives, but stigma and shame — particularly in the Black church, a cultural cornerstone — have proved much harder to kill. At the same time, access to PrEP — a blockbuster medication that can literally prevent HIV, in as few as two doses a year — remains deeply unequal, with Black Americans far less likely than white Americans to receive it.
The Cost of Silence in Sacred Spaces
Opening the conversation, Hannah-Jones said those numbers cannot be separated from the Black church’s attitude. It matters, she said, because faith and Black culture are intertwined.
“The Black Church serves as a beacon of health, hope, and healing in our communities,” Hannah-Jones said. “And yet conversations about HIV have too often been absent from the very places that people turn to when they are in need of healing and hope.”
That silence, she said, carries a cost: it can perpetuate stigma and misinformation about HIV, particularly within communities where conversations about sexuality and health are limited. As a result, people may delay testing, prevention, or treatment, increasing the risk of poorer health outcomes.
It also leaves “too many people feeling isolated and unsupported from the resources and communities that can help them thrive,” Hannah-Jones said. That includes PrEP.
Pierre concurred: “The innovations are not innovations unless they meet community and unless they turn into access and affordability, which are big conversations right now.”
But those conversations have to address stigma, which is too often a barrier to treatment.
Rather than condemn people, the church must help “make sure that people feel good about giving themselves permission to value themselves,” Pierre said. That means helping people with reasons to seek HIV treatment “understand that they are worthy of wellness, and that's a big part of the work that we have to do now.”
“The innovations are not innovations unless they meet community and unless they turn into access and affordability,” he said.
Respectability Politics and ‘Death-Dealing Theology’
Abram, a Harvard-trained theologian and queer person, believes part of the problem lies in how some Black churches have historically understood the human body itself, as well as in their embrace of “respectability politics” as a way to combat racism. In an effort to counter harmful stereotypes about Black people, like promiscuity, some churches promoted abstinence and marriage at the expense of acknowledging the realities of human sexuality and experience.
“We have really demonized desire and demonized the body,” Abram said. “And as a result, we live in these worldviews which suggest that an HIV diagnosis is somehow God's judgment on your moral failing, as opposed to it being a public health crisis, which it is.”
That theology wasn’t just contained in Sunday sermons, Abram said; it spread into the community and helped deepen stigma around sex, homosexuality and HIV-positive diagnoses. Stigma, he says, promotes fear and self-loathing, increases anxiety and inhibits self-care — everything from seeing caregivers to taking medications that could help them stay healthy..
Abram says it’s an uncomfortable challenge for an influential institution built around the promise of forgiveness and salvation.
“You can't preach death-dealing theology from the pulpit while attempting to engage in life-saving and life-affirming ministry in the public square,” he said.
Bridging the Pulpit and the Exam Room
The panelists agreed that breaking the cycle of shame and HIV stigma requires faith communities and leaders to see HIV as a public health emergency and replace judgment with honest conversations.
Walters, the obstetrician, said medicine has its own role in dismantling that shame. She routinely offers STI testing because “everybody needs to know their status, especially their HIV status.” The key, she said, is having those conversations “in a non-judgmental way” and building enough trust that patients feel comfortable discussing sex, testing and PrEP.
“I try to practice where I'm the ‘good girlfriend’ — you know, let's talk about it and like what you're doing, who you're doing, how you're doing it, what we can do for you to keep you safe,” she says. “My job is to keep you safe and to keep you healthy. I educate and advocate that you find a doctor that you align with and that you can trust. If you can't have a conversation with your doctor, then why go?”
Ultimately, she said, medicine and the church must work together to address the HIV crisis: “With the trust that [the church] has, and the information that we have, we can certainly save lives.”
For Ciarra Brown, that means changing the conversation before an HIV diagnosis ever happens. Growing up in church, she said, she should have had a safe place to talk about sexuality rather than having to “figure it out on my own.”
Treating abstinence as the only acceptable reality, she said, does young people “a disservice,” leaving them without information while reinforcing the idea that an HIV diagnosis resulted from bad behavior rather than “the fact that we’re in the middle of a public health crisis.”
Editors Note: The panel “Separation of Church & Sex: Faith and the Fight Against HIV” was convened by ViiV Healthcare. ViiV is a funder of the Counter Narrative Project (CNP).
