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Recognizing and Responding to the Many Faces of AIDS

The United Methodist Church has resolved to minister compassionately with all persons living with HIV/AIDS and their loved ones, following in the way of healing, ministry, hospitality, and service shown by Jesus.[1] Churches and other concerned United Methodist communities have been in ministry since the beginning of the pandemic.

The Context of Caring Ministry

HIV/AIDS affects and infects a broad cross-section of people in the United States and Puerto Rico: all ages, all races, both sexes, all sexual orientations. In 1995, the Centers for Disease Control (CDC) noted that the proportion of AIDS cases among women, racial/ethnic people, and children continues to increase, while the rate of AIDS among gay/bisexual men has leveled. From a geographic perspective, more persons in the South and Northeast contracted AIDS in 1994 than in 1993.[2]

The United Methodist Church can help to stop the spread of HIV/AIDS through providing sound comprehensive age-appropriate prevention education, including information that abstinence from sex and injection drug use[3] is the safest way to prevent infection. In addition, the church can provide a grounding in Christian values for children, teens, and young adults, somethingthat cannot be done in public schools or in official government prevention material.

Teens and Young Adults

AIDS will increasingly affect and infect our next generation of leaders. Since 1991, AIDS has been the sixth leading cause of death among 15- to 24-year-olds in the United States. In 1994, 50 percent of new infectionsof HIV were among persons under 25. Older teens, males, and racial/ethnic people were disproportionately affected. The CDC reported:

Many American teenagers are engaging in behaviors that may put them at risk of acquiring HIV infection, other sexually transmitted infections, or infections associated with drug injection. Recent CDC studies conductedevery 2 years in high schools (grades 9-12) consistently indicate that by the twelfth grade, approximately three-fourths of high school students have had sexual intercourse; less than half report consistent use of latex condoms,and about one-fifth have had more than four lifetime sex partners. Many students report using alcohol or drugs when they have sex and, in the most recent survey, 1 in 62 high school students reported having injected an illegal drug.[4]
By 1993, HIV became the leading cause of death in the United States among all persons aged 25-44.[5] Racial/ethnic groups have been especially hard hit. By 1991, HIV infection had become the leading cause of death for African Americans and Hispanics among males aged 25-44 years.

By 1993, it was the top cause of death for African American women in the same age group. Among Asians/Pacific Islanders and American Indians/AlaskaNatives young adults, AIDS ranks in the top ten leading causes of death.[6]


Racial and Ethnic Groups

African Americans, Hispanics, and Native Americans have been disproportionately infected with HIV/AIDS. In 1993, racial/ethnic people accounted for 51 percent of the cases of AIDS among adolescent and adult males, 75 percent among adolescent and adult females, and 84 percent of the cases among children.

Race and ethnicity are not in themselves risk factors for HIV. The CDC observes that "unemployment, poverty, and illiteracy are correlated with decreased access to health education, preventive services, and medical care, resulting in an increased risk for disease. In 1992, 33% of blacks and 29% of Hispanics lived below the federal poverty level, compared with 13% of Asians/Pacific Islanders and 10% of whites."[7] HIV/AIDS prevention education must therefore take into account the racial, cultural, economic realities of each group. Additionally, as the church, we are called to work for the conversion of those principalities and powers that promote racism, poverty, drug addiction, and other oppression.


Women

AIDS among women has been mostly "an invisible epidemic," even though women have been affected and infected since the beginning.[8] Since 1992, HIV/AIDS has been the fourth leading cause of death among U.S. women aged 25 to 44. African American and Hispanic women make up 21 percent of all U.S. women, these two groups accounted for 77 percent of the AIDS cases reported among women in 1994.[9] That same year, the AIDS case rate per 100,000 population was 3.8 for white women; 62.7 for African American women; 26.0 for Hispanic women; 1.3 for Asian/Pacific Islander women; and 5.8 for American Indian/Alaska Native women.

Dr. Michael Merson of the World Health Organization has identified the following reasons for the growing number of HIV infections in women. His observations, though made in the context of global AIDS, are also applicable to women in the U.S.A. and Puerto Rico. He says that

  1. women are biologically more vulnerable to heterosexual transmission of HIV and other sexually transmitted diseases (STDs);
  2. women tend to marry or have sex with older men, who have often had more sexual partners and therefore are liable to be infected; and
  3. women often live in cultures or situations of subordination to men, which often means they cannot insist that their partner use a condom.
Merson has said, "Women face extra challenges in protecting themselves and their children from HIV infection. But this vulnerability is hard for women to challenge as individuals, or even through female solidarity alone. It will take an alliance of women and men working in a spirit of mutual respect."[10]

Older Adults

By the end of 1993, persons age 50 and older accounted for 10 percent of all cases of AIDS nationwide.[11] That same year, the increase in persons with AIDS age 60 and older increased 17 percent over the previous year.[12] The most prevalent behavioral risks for older adults are multiple sexual partners and having a partner with a behavioral risk.[13] "The myth that people become sexually inactive as they age has produced dreadful consequences in the age of AIDS."[14]

Most older people believe they are not at risk if they are heterosexual and do not inject drugs. Since they are not worried about pregnancy, older people are less likely to use condoms.[15] One HIV/AIDS social worker says, "Reaching significant numbers of older adults with the HIV prevention message will entail exploring creative venues--the widows' support group at the senior center, the seniors' bowling league, the Gold Age clubs at community centers and churches. Wherever seniors gather, the HIV message must be visible, accessible, relevant, and respectful."[16]

The Challenge for Church Action into the Next Century

Churches and other United Methodist organizations need to continue compassionate ministry with persons living with HIV/AIDS and their loved ones. In terms of prevention education, United Methodists have an opportunity to teach not only the facts about HIV transmission and how to prevent infection but also to relate these facts to Christian values. We can do HIV/AIDS prevention education in broader contexts, such as human sexuality and holistic health and addressing societal problems, such as racism, sexism, and poverty. We call on United Methodists to respond.

  1. We request that General Board of Discipleship
      (a) prepare curriculum resources for all age levels that is sensitive to cultural diversity, in consultation with the General Board of Global Ministries and the General Board of Church and Society. The curriculum will include biblical, theological, and ethical grounding, information on what individuals and communities of faith can do in the areas of compassionate ministry and HIV/AIDS advocacy, and age-appropriate comprehensive prevention education, including teaching that abstinence from sex and injection drug use is the safest approach to HIV/AIDS prevention. This material is to be made available in the first half of the quadrennium.
      (b) revise the United Methodist sexuality curriculum across age-levels to include HIV/AIDS prevention education.
      (c) prepare worship resources to assist in HIV/AIDS ministry which can be used by both laity and clergy.

  2. We call upon the Interagency Task Force on AIDS to coordinate a second national United Methodist HIV/AIDS consultation for the 1997-2000 quadrennium (the first one was held in San Francisco in 1987) in response to frequent requests from individuals, local churches, and conferences for HIV/AIDS training to equip them for ministry in the 21st century. We ask that the event be planned in consultation with appropriate United Methodist racial/ethnic national organizations. The event will equip United Methodist adult and youth to address HIV/AIDS issues and concerns into the 21st century, including the trends noted in this resolution, such as HIV/AIDS and women, youth, children, and cultural and racial diversity. The emphasis will be on HIV/AIDS in the United States but will have a global component.

  3. We urge all national leadership training sponsored by general church agencies include an HIV/AIDS education awareness component, basic facts about HIV/AIDS, workplace issues when appropriate, and ministry concerns.

  4. We ask local churches and all United Methodist organizations and communities to respond to the concerns of this resolution through use of the planned resources and materials, such as the United Methodist HIV/AIDS Ministries Network Focus Papers, and working with religious and/or community-based HIV/AIDS organizations to do prevention education with church and community. The United Methodist Church has a congregational HIV/AIDS ministry called the Covenant to Care Program, whose basic principle is "If you have HIV/AIDS or are the loved one of a person who has HIV/AIDS, you are welcome here...." We commend those who have been in ministry through this program and recommend A Covenant to Care to all United Methodist organizations.[17]

END NOTES
  1. "AIDS and the Healing Ministry of the Church," General Conference 1988.
  2. CDC, "Current Trends: Update, Acquired Immunodeficiency Syndrome--United States, 1994," 02/03/95.
  3. By injection drug use, we are referring to sharing of needles and works done by injection drug users. Usually this refers to use of heroin on the streets or steroids in sports contexts. We are not referring to persons who are diabetic, for instance, who use only sterile needles and inject insulin to maintain health.
  4. CDC Hotline Training Bulletin #114, 01/06/95.
  5. Morbidity and Mortality Weekly Report [MMWR], 02/03/95.
  6. MMWR, 09/09/94.
  7. MMWR, 09/09/94.
  8. See Gena Corea, The Invisible Epidemic: The Story of Women and AIDS (New York: HarperCollins, 1992).
  9. CDC Fact Sheet, "Facts about. . . Women and HIV/AIDS," 02/09/95.
  10. Press release published in Edinburgh, England on September 7, 1993 during the 2nd International Conference on HIV in Children and Mothers.
  11. National Institute of Health, "Older Americans at Risk of HIV Infection Take Few Precautions," 01/04/94.
  12. New York Times, 08/09/94.
  13. NIH, "Older People," 01/04/94.
  14. Gregory Anderson, "HIV Prevention and Older People," Siecus Report, December 1994/January 1995), p. 19.
  15. Rebecca A. Clay, "AIDS Among the Elderly," Washington Post, 01/16/93.
  16. Anderson, p. 20.
  17. For more information about the Covenant to Care program and HIV/AIDS ministries resources contact:
    HIV/AIDS Ministries Network
    Health and Welfare Ministries, General Board of Global Ministries, The United Methodist Church
    Room 330
    475 Riverside Drive
    New York, New York 10115
    Phone: 212-870-3909
    Fax: 212-870-3624
From The Book of Resolutions, 1996. Copyright © by the United Methodist Publishing House. Used by permission.