Socio-demographic characteristics of the participants.
In Table 2, the socio-demographic characteristics of the respondents are presented quantitatively. However, a qualitative description of these characteristics provides a deeper understanding of the composition of the sample and highlights key patterns and trends. The majority of the respondents were male, with 18 out of the 20 key informants being men. A notable proportion of the participants (7 out of 20) had between 21 and 30 years of experience in their respective religious roles. The sample comprised a diverse range of religious denominations, including Catholic, Anglican, and Pentecostal traditions. Additionally, a substantial portion of the participants (7 out of 20) identified themselves as pastors.
Religious denominations: A sub group within a religion that operates under a common name, tradition, and identity. Religion: a set of organized beliefs, practices, and systems that most often relate to the belief and worship of a supernatural being.
Table 3 shows the 2 major themes that emerged from the data: (a) Religious leaders’ knowledge regarding HIV prevention, and (b) Perceptions of religious leaders about HIV among young people.
Table 3
Summary of themes and subthemes
Theme | Sub-theme | category |
Religious leaders’ knowledge regarding HIV prevention | a) Understanding of HIV prevention b) Understanding of modes of transmission of HIV | |
Perceptions of religious leaders about HIV among young people. | Religious leaders’ HIV risk perception among young people | |
| Perceived roles of religious leaders in HIV prevention | mentoring the youth, setting an example, speaking out against HIV, raising awareness, and working with medical professionals. |
| Concerns about HIV prevention among young people | |
| Perceived enhancers for participation in HIV prevention | Ease of access to young people, the respect accorded to faith leaders, being trusted by the congregation |
| Perceived barriers to participation in HIV prevention | Lack of transport, lack of finance, and inadequate equipment |
| Solutions to the challenges faced | Continuous counseling, proximity to youth, and serving as a role model |
| Suggestions about how to strengthen HIV prevention | Training the religious leaders, facilitating them in terms of transport, and giving them the necessary equipment |
Legend: A summary of the themes, sub-themes, and categories of knowledge and perceptions of religious leaders towards HIV prevention among young people in Lira district.
Theme 1: Religious leaders’ knowledge regarding HIV prevention
We investigated the religious leader’s understanding of HIV prevention and preventative methods, as well as their understanding of the modes of transmission of HIV.
Understanding of HIV prevention
The participants expressed varying understandings of different aspects of how HIV is prevented. Below are voice excerpts from some of the study participants:
“I think this is taking care of young ones so that they won’t be exposed to HIV. “Male, R1.
“HIV prevention I would say in my local understanding as measures taken to see to it that the young people are protected from contracting the disease.” Female, R4.
“Of course, the prevention is abstinence and that is the only way how you can prevent it.” Male, R1.
Other participants, however, identified HIV prevention strategies as awareness creation, abstinence, faithfulness in marriage, and HIV testing before sex. This was mainly expressed by the participants, as seen in the below quote;
“You should first test your blood. Then you use a condom and you also have to be faithful to each other.” Female, R8.
Although some participants knew condom use as a way of HIV prevention, they did not recommend it for use among the youth. A participant said:
“I always see from other places, they encourage youth to use condoms but for us as the church, we don’t allow the use of condoms because we would be promoting sexual practices which is against our faith and it is not proper at all.” Male, R7.
Understanding of modes of transmission of HIV
Knowledge regarding HIV was mostly expressed in terms of modes of HIV transmission. That is, participants were able to give a comprehensive account of how HIV is spread from one person to another. They noted that the greatest number of people get HIV through unprotected sexual intercourse as a route for HIV transmission. Some of the participants said that...
“…HIV spreads through the sexual relationships between girls and boys. For if a girl falls in love with a boy and has unprotected sexual intercourse, the infected person can transmit HIV to the other.” Male, R7.
Some religious leaders felt they lacked knowledge of HIV prevention methods, which limited their involvement in efforts towards HIV response among young people. A participant said that:
“Most of us lack knowledge on HIV prevention. We should be taught various HIV prevention measures to update our knowledge of HIV. It will make us understand and help in HIV prevention. Male, R18.
The same view was also shared by another key informant who reported that;
“We need to have more knowledge about this. A leader has to have general knowledge, to respond to youth questions. We have to study enough ….” Male, R10.
Theme 2: Perceptions of religious leaders about HIV among young people.
The perceptions of religious leaders about HIV risk acquisition among youngsters and prevention measures were investigated. The participants were questioned regarding their perceptions and concerns regarding HIV prevention among young people.
Religious leaders’ HIV risk perception among young people
Some study participants believed that young adults as well as adolescents were at a greater risk of acquiring HIV. The high risk was associated with early sexual debut, fornication, and inadequate knowledge of HIV prevention. One of the study participants narrated that:
“The danger of HIV among girls and boys starts from the age of 12 years. Secondly, they are entering into fornication when they are young, and they copy bad dress codes.” Male, R6.
In addition, another participant also said;
“The youth are at a very high risk of contracting HIV. And they are not only contracting HIV but are also spreading it.” Male, R9.
Perceived roles of religious leaders in HIV prevention
In the interviews, when asked about how the religious leaders perceived their roles in preventing HIV among young people, a predominant view of their responsibilities included mentoring the youth, setting an example, speaking out against HIV, raising awareness, and working with medical professionals. One of the participants said:
“Our role is to teach people in God’s way, teaching them using the bible while using the word of God against sin… so we teach widely about sin, how we can prevent sin such as fornication which leads to HIV infection. So, we teach, sensitize, and, normally encourage them.” Male, R10.
Another participant also said:
“Religious leaders are the first key people to create awareness of HIV positive to the young and they are the most important people and they play an important part to the communities because they have access to teach the youth. Male, R3.
Some participants perceived that HIV prevention starts with religious leaders being exemplary. A number reported that by being exemplary, young people could be inspired and empowered to prevent the spread of HIV. A participant said:
“In my view, ……. to live an exemplary life to the young people and it’s my role to mentor them and empower them to be more careful with HIV.” Male, R13.
Some people perceived that breaking the silence surrounding HIV and openly discussing it in public was essential to preventing it among young people. One participant narrated:
“As a religious leader, I believe that the only way to prevent HIV is to inform young people about HIV honestly and openly to expand on their knowledge of the disease. Male, R20.
A few of the participants reported that one of the most important aspects of HIV prevention is having medical experts speak to the youth. Some even went so far as to say that they occasionally invite medical professionals to speak with the young people and inform them about the risks and modes of HIV infection. One participant said:
“What we always do in the church program, there are weeks that sometimes we dedicate to the medics to come and handle health-related issues for the whole church…. we let them come and talk about the health issues, so if the issue is about HIV, they will talk about it.” Male, R19.
Concerns about HIV prevention among young people
Participants expressed various concerns and held beliefs about HIV prevention among young people. Thus, they expressed views such as the fear of God. A good number of respondents reported that if the young people feared God, there would be fewer cases of HIV infection among them. Additionally, they stated that adhering to religious principles and practices could help lower the frequency of new HIV infections among the youth. One participant narrated that:
“If they are aware of the fear of God, they will turn away from all the issues ………. If these young people adopt all of these preventive measures, they will, in my opinion, live longer, be healthier, and fulfill all the plans and purposes that God has for them.” Male, R3.
The need to involve parents, school administrators, and other stakeholders in educating young people about HIV prevention was also mentioned by some of the participants. They expressed concern that young people are susceptible, vulnerable, and unreceptive to advice. Some of them said this:
“… In the prevention of HIV, there is a need to join hands among parents, among school leaders, among political leaders, teachers or government leaders and should talk about the prevention of HIV in public” Male, R5.
Although religious leaders make efforts to prevent HIV infections among the youth, the youth most often don’t cooperate with them. Some of the religious leaders perceived the young people as very rebellious. They further reported that young people do not listen to advice from family members. One of the key informants thus said:
“……they should stay away completely from sex because I have seen how the youth are behaving today, the way they talk, and not listen to the family yet they are very young. They cannot understand…. awareness should be given every day … so people should not keep quiet, we should not keep quiet.” Male, R1.
Another participant also reiterated that:
“We face difficulties. The first one is when we gather the youth and speak to them as we always do, but they choose not to listen.” Male, R11.
Perceived enhancers for participation in HIV prevention
When asked how easy it was to reach young people, one group of study participants perceived accessibility as easy. They further said the ease of access to young people is beneficial when discussing HIV prevention strategies. One participant said:
“…. we have access to young people, and also when we conduct outreach ministry where we get to interact with very many people including the young persons ...” Male, R20.
Another also said;
“What I think about that is religious leaders may be of advantage because every time they are speaking to people, praying for them regularly, and counseling them.” Male, R17.
A dominant view from the interview shows that religious leaders perceived that they commanded much respect from their societies, which has a positive impact on preventing HIV in young people. The respect accorded to faith leaders motivates them to lay tireless efforts and strategies aimed at reducing HIV spread among young people. One participant said:
“… they believe in us when we talk, and they take it to be serious because they know we are representatives of Christ. So, when we talk, it means it’s the voice of Christ thus they hear and obey…” Male, R19.
The participants also stated that the congregation has a high regard for religious leaders and is more likely to follow their counsel. A participant said:
“The advantage is that being spiritual leaders, people trust us and that many religious leaders live by example, and thus their audience believes in them. “Male, R13.
Perceived barriers to participation in HIV prevention
Nevertheless, religious leaders reported that they face numerous challenges that have become bottlenecks to the success of the implementation of HIV preventive initiatives among youth. They stated some of the challenges that these religious leaders face during their participation in HIV prevention, such as lack of transport, lack of finance, and inadequate equipment. They stated as follows:
The study participants highlighted a challenge of transport, which limits the access of religious leaders to young people. One participant said:
“ …….. for me to go down there, I need to have transport means, because these peoples’ homes are too far, too distant, and very many. That is the problem that I get, and sometimes I even think of just giving up.” Male, R5.
In addition, some of the religious leaders perceived the lack of financial support as a major hindrance in providing HIV prevention strategies to young people through activities like outreaches. A participant narrated:
“Another challenge is financial problems; we don’t have enough financial support.” Male, R2.
Another participant said:
“So, the problem is finance because these people are many which makes it hard to visit all the groups of the youth.” Male, R5.
On the other hand, a section of participants perceived the lack of equipment such as charts, and posters to limit their efforts on HIV prevention messages among young people. A participant narrated that:
“…. sometimes we are always limited with the facilities, the equipment, and the things that are required providing HIV prevention messages to the young people…” Male, R19.
Similarly, another participant said:
“I get the problem of not having the tools for work for example, we don't have blackboards or even posters that we can use to help these people.” Male, R5.
Sometimes religious leaders are conflicted by religious beliefs and doctrines which are against some of the prevention measures against HIV, like condoms. A participant said:
“As I talked about the use of condoms, we cannot be advertising agents and leave it open for them like that to use it. We would be walking away from our principles though we don’t discourage.” R19
Solutions to the challenges faced
During the discussion with the participants, ideas about how to help religious leaders overcome obstacles emerged, including different ways to empower them in their efforts to urge the youth to use HIV prevention strategies. It's interesting that some of the solutions called for ongoing counseling, proximity to youth, and serving as a role model. Some leaders said that they always keep talking to and counseling young people. This would help increase young people’s awareness of HIV. One participant said:
“We are overcoming these challenges by frequently talking with these youths for example every Sunday like one or two words on counseling and guidance, and constantly preaching that HIV is there.” Male, R5.
Additionally, some religious leaders emphasized that getting close to the young people would help them understand them.
“Another thing is being close to those young ones, which puts me in a position to know their weaknesses.” Female, R4.
Apart from being close to the young, if religious leaders serve as a good example to the youth would enable them to learn and follow their spiritual leaders.
“I must set an example for others. When you want to act as an example, you should be serious and mean what you say because people will eventually follow you if they see you doing it.” Male, R1.
Suggestions about how to strengthen HIV prevention
Fascinatingly, study participants highlighted how they perceived that HIV prevention can be strengthened among young people. Various views emerged about how to increase religious leaders’ participation in combating HIV spread, some of which included training the religious leaders, facilitating them in terms of transport, and giving them the necessary equipment.
Furthermore, one participant emphasized the fact that religious leaders need to be updated about HIV all the time. In their own words, they said:
“You might not be able to fill in the blanks, but you will need to have some knowledge. So, one thing I am doing diligently is learning more about HIV and AIDS.” Male, R9.
Another participant also said:
“ …….. for me to go down there, it needs me to have transport means, because these peoples’ homes are too far, too distant, and very many.” Male, R5.
Some of the participants reported that greater milestones would be reached in HIV prevention among the youth if religious leaders worked together with healthcare workers. Some of the study participants suggested that they would prefer inviting healthcare providers to their various places of worship to train the religious leaders and also talk to the young people directly. One participant said:
“As religious leaders, we request that the medical personnel should spare some time and come and train us or help us talk to the young people.” Male, R11.
Last but not least, the majority of the respondents reported that supplying teaching materials to different places of worship and religious authorities would present a chance to provide young people with accurate information. Some study participants preferred receiving equipment to use when instructing and educating children. A participant said:
“They should give us work equipment, like posters having teaching pictures, pens, and books ….” Female, R8.