HIV-positive people who say religion is an important part of their lives are likely to have fewer sexual partners and engage in high-risk sexual behavior less frequently than other people with the virus that causes AIDS, according to a study issued today by the RAND Corporation.
As a result, people with HIV who have stronger religious ties are less likely to spread the virus, according to the study by the nonprofit research organization.
The study measured religiosity by asking people to report how important religion was in their lives; whether they identified with a particular religious group; whether they preferrred being with people of the same religion; and how often they attended religious or spiritual services.
David Kanouse, a RAND senior behavioral scientist and principal investigator on the project, said the study did not identify what specific component of religiosity made a difference in sexual activity. However, he said said two factors – moral beliefs and membership in a faith community – may be important.
"Moral beliefs may indicate an underlying altruism and a desire to make sure no one else is infected with HIV," Kanouse said. "Promoting these feelings could then be used as a component of HIV prevention programs."
"These are some significant findings about the role of religiosity in the lives of people who are HIV-positive," said Frank H. Galvan, lead author of the study and assistant professor in the Department of Psychiatry and Human Behavior with the Charles R. Drew University of Medicine and Science in Los Angeles. "The next step is to find out how can we use this information in a way that can help lower the rate of spreading HIV to others."
Religion remains a dominant force in America today, but the main focus of many faith communities is sexual abstinence, rather than examining how else religious beliefs may help to prevent the spread of HIV, Galvan said.
"This study suggests that there's a role for religious institutions to play in the fight against the spread of HIV," Galvan said. "They have these core belief systems that do have a positive impact on the lives of people who are HIV-positive and who are sexually active. Religiosity is an untapped resource in the whole struggle against HIV and AIDs, and should be looked at more thoroughly."
Researchers studied a nationally representative sample of 1,421 people getting medical care for HIV -- 932 of whom reported recent sexual activity.
Catholics were less likely than other mainline Christians, non-Christians and non-religious people to report unprotected sex. Catholics also were less likely to report high-risk sex than other mainline Christians and reported fewer partners than non-Christians.
There was no statistical difference between Evangelicals and Catholics in reported sexual activity. Evangelicals were as likely as Catholics to have fewer sexual partners, and equally likely to engage less frequently in unprotected and high-risk sex.
The RAND Health study is titled "Religiosity, Denominational Affiliation and Sexual Behaviors among People with HIV in the U.S." It appears in the February issue of the Journal of Sex Research, which was published in March. The study was conducted with a grant from the National Institute of Child Health and Human Development and the National Institute on Alcohol Abuse and Alcoholism.
The new report used data from the HIV Cost and Services Utilization Study (HSCUS), which was conducted by RAND from January 1996 to April 1997, with follow-up interviews from December 1996 through June 1997. What makes this data set unique is that it was collected from a national probability sample -- not race- or gender-specific -- and remains the only national probability sample of HIV-positive patients in care.
Galvan said the RAND study's findings are not likely to have changed over time. He said the findings are consistent with other studies that have found a link between religiosity and fewer lifetime sexual partners and an inverse relationship between religiosity and other high-risk behaviors, such as substance abuse.
Other studies have found that gay men report a similar rate of attendance at religious services as male heterosexuals, and about the same rate in the frequency of prayer as do female heterosexuals. African-Americans, who have been disproportionately affected by HIV/AIDS, also report high levels of both attendance at religious services and prayer.
HCSUS survey respondents were given a choice among 46 denominational affiliations, as well as the categories of agnostic/atheist, no religious preference, or having a religious preference not mentioned on the list provided. Those affiliations were then grouped into the following categories: Catholic, Evangelical, Other Christian, Non-Christian Religion, and No Religion/Agnostic/Athiest.
The RAND study found several religious differences between the survey group and the general U.S. population. The survey group appeared to be more likely to be Evangelical and more likely to be nonreligious, but less likely to come from Christian religions other than Evangelical or Catholic.
Some of these differences may be explained by the racial makeup of the survey population. African-Americans made up nearly a third of the survey population -- compared with 13 percent of the U.S. population -- and are more likely to belong to Evangelical denominations. Another factor influencing the high number of non-religious respondents is the fact that many religious groups consider homosexuality to be a morally unacceptable lifestyle. Gay and bisexual men made up more than half of the study population.
The researchers said they don't understand why there were differences between the different denominations, including why Catholics were more likely to use condoms despite the Catholic Church's prohibition on birth control, but said it was a point worthy of additional research and further exploration by faith-based communities.
Other studies also have found differences between denominations in people's sexual attitudes and behavior, often depending on which sources each denomination looks to for moral decision-making. Some Christian denominations rely solely on the Bible, while others allow for additional guidance from other sources, such as other church traditions or one's personal conscience.
"Although the Pope may issue a proclamation on some aspect of sexual behavior, Catholics increasingly are inclined to consider their individual consciences as sources of moral authority," the study notes. "What role this may play in the sexual behaviors of Catholics and how this may differ from other religious groups warrants further investigation."
Other authors of the study include: Rebecca L. Collins, Philip Pantoja, and Daniela Golinelli, all of RAND.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care quality, costs and delivery, among other topics.
The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. To sign up for RAND e-mail alerts: http://www.rand.org/publications/email.html.
The Journal of Sex Research