SATURDAY, Aug. 4 (HealthScoutNews) -- Cultural and religious influences are two of the major contributing factors to southern Africa's AIDS and HIV crisis, a Michigan State University expert concludes.
Over the past year, Jon Lacey traveled to Zimbabwe, Botswana, Lesotho and the island nation of Mauritius, where he trained health care providers, clergy and others to care for AIDS patients.
Lacey says he found that many, but not all, branches of the Christian, Muslim and traditional African religions in the countries have trouble grappling with the epidemic.
''There are religious groups that oppose the use of condoms and believe in abstinence only. There are folks who believe that talking about prevention methods like safe sex or the use of latex condoms and other barriers - the mere talk . . . encourages sexual activity,'' says Lacey, who is director of the university's AIDS Education and Training Center.
Some African religious communities refuse to discuss AIDS because they view it as a homosexual disease. In other religious groups, talking about AIDS prevention can be uncomfortable because it deals with sexuality, substance abuse and death.
''There are many people in Africa in religious communities across the board who simply don't want to talk about these issues and believe if their members are faithful to their faith, that they'll have no need for AIDS prevention because they won't be engaging in behaviors that put them at risk,'' Lacey says.
''So I think religious feeling, religious doctrine, religious practices really have not adapted well to full discussion of the real threats that are there with HIV/AIDS," he adds.
Lacey stresses that such religious attitudes aren't unique to Africa. Religious biases are also an obstacle in the struggle against HIV/AIDS in the United States.
But in Africa there are other barriers, particularly involving cultural sensitivities, Lacey says. The continent is a patchwork of cultural and social differences and that means anti-AIDS messages have to be culturally specific and sensitive.
"A particular group of people simply does not talk about sex," he says by way of example. And that makes sexual behavior or risk the No. 1 route of transmission of HIV/AIDS in Africa, "a very difficult kind of thing to deal with," he adds.
Language is another stumbling block. As an example, Lacey relates his efforts to discuss HIV/AIDS with the San people of the Kalahari Desert.
''Just trying to have someone translate the basic information about AIDS transmission was a very difficult thing to do because the words which we were trying to use, when translated into their language, were words of embarrassment and shame and stigma,'' he says.
Also a factor: What may work in one country can become a joke in another country.
Lacey cites a successful poster campaign in Uganda that played on the country's agricultural heritage. It featured cattle images and urged people to stay in their own pasture. But the poster and its message failed in Botswana, a country in which cattle are free to roam and where cattle ownership is often communal.
The head of the HIV/AIDS Division of the U.S. Agency for International Development agrees with Lacey's observations, but thinks the message is finally getting through.
Dr. Paul De Lay says many of the religious groups that have been caring for and supporting AIDS patients and their families are finally recognizing they have to take a lead in preaching prevention practices.
"The response of religion to this epidemic has evolved dramatically in the last five years," De Lay says.
Some of the groups, such as fundamental Christians, that were strongly opposed to condoms have had to reconsider their stand in the face of the incredible devastation the epidemic has had on their congregations, he adds.
"We've seen a far more pragmatic view about how people need to protect themselves," De Lay says.
The UNAIDS organization estimates that worldwide, 36.1 million people are living with HIV/AIDS, and 22 million have died since the epidemic began in the early 1980s.