By Fia Curley

As the 19th annual World AIDS day approaches, organizations across the nation are pushing forward to spread messages of prevention and healthy living to those affected by HIV and AIDS.

Metropolitan Interdenominational Church in Nashville, Tenn., is continuing its tradition of informing the public as it gears up for World AIDS Sunday with speaker, Dr. James Hildreth, a leading HIV researcher from Meharry Medical College.

The church has never shied away from questioning glances about its avant garde practices, offering clinical services, intensive case management, housing and financial assistance as well as nutrition and mental health counseling.

And although Metropolitan, under the direction of Reverend Edwin C. Sanders, II, has become a cornerstone of the community, when it comes to its work in HIV prevention, it started off with one basic goal in 1981: Create a church for all denominations to come and feel included.

"The 12 people who started the church really liked the idea of different people from all segments of society coming together and worshipping together and ministering together," said Executive Director Dr. Sharon Edwards. "If a church is built on the principle of love, everybody should be able to walk through the doors and feel accepted, everybody should be able to walk through the doors and feel loved. It's a 'whosever church.'"

But when one of the founders died of AIDS-related complications two years later, church members began a journey in search of answers.

At the time, Edwards said, people thought the virus was being passed solely among homosexuals.

But "it was attacking everybody and it had the potential of devastating poor and undereducated communities," she said.

By 1994, Metropolitan was providing educational services for other church groups, counseling people living with HIV, providing case managers to individuals and offering transportation to and from medical appointments.

"As African-Americans, we're more likely to get diagnosed later and we're more likely to die earlier, so it's imperative we get health care," Edwards said. "It has always been Rev. Sanders' vision and that of the church, to offer the services not offered elsewhere."

Metropolitan soon provided a flexible clinical care model, becoming the primary health care facility for the "medically fragile," and offering services for drug users and homosexuals, that caused some members to raise their eyebrows.

"It can be a hard church to be a member of because you get questions (about) what your church is doing," Edwards said. "It's known as the AIDS church, it's known as the gay church or the church where drug addicts attend."

But social stigma hasn't deterred Metropolitan. As a recipient of an Office of Minority Health (OMH) grant, the church has stayed busy maintaining its outreach, prevention and education, testing, counseling and referral services.

Since Jan. 1, Metropolitan has offered 16 community events, contacted about 3,500 individuals through their street outreach program and provided case management services to 337 people. Of the 337 clients, 67 percent are African-American and living below the poverty line, making an average of $435.68 a month.

With a staff of more than 30 full-time workers, volunteers and contractual workers, Metropolitan continues to offer services not only in Tennessee, but also across the United States through the Metropolitan Interdenominational Technical Church Assistance Network (MITCAN). This network, which has offered 35 sessions this year, provides information regarding HIV prevention from a faith-based perspective to religious groups and civic organizations.

Although people continue to be educated about the transmission of HIV/AIDS, an estimated 1,039,000 to 1,185,000 persons in the U.S. are currently living with HIV/AIDS, with 24-27% undiagnosed and unaware of their HIV infection, according to the Center for Disease Control and Prevention (CDC). About half of the HIV population is comprised of African Americans despite the fact that 13 percent of the U.S. population is classified as African American.

Last September, the Centers for Disease Control and Prevention (CDC) released new testing guidelines for Americans. These new guidelines recommend that all Americans aged 13-64 be tested for HIV as part of their routine health care. According to CDC, 50 percent of the people living with AIDS in Tennessee in 2004 were African-American, 10 percentage points higher than the national average. Things haven't fared much better on the local level as African Americans make up 26 percent of the population in Davidson County but about half of the population living with HIV/AIDS.

"Because we have treatments and people are living longer and better, the sense of urgency is kind of gone," said Bob Baxter, director of addiction and educational services for the New Jersey Community Research Initiative (NJCRI). "People don't think of [antiretroviral] as being something that keeps you from getting sick, but something that cures you."

Baxter said he realized first hand the lack of knowledge about HIV after visiting a nearby college campus, finding out condoms were not available through health services and hearing students incorrectly identify ways of contracting the virus.

And while the Newark, N.J. organization, also known as the North Jersey AIDS Alliance, does serve students, it has worked to solidify its credibility within the community, by opening their doors to all, reflecting the diverse community through their staff and following a simple rule.

"We treat people with dignity and respect," Baxter said. "Nobody likes to be talked down to, and nobody likes to be yelled at. It may seem corny, but we say, 'treat others the way you want to be treated.'"

Many of the clients visiting the largest AIDS service in New Jersey are African-American or Hispanic (83 percent) and 70 percent are males, Baxter said. More than half of the clients have a history of substance abuse through injection, which led to above-average rates of HIV infection in the past, Baxter said. According to the CDC, in 2004 about 56 percent of people living in the U.S. with AIDS were African American compared with 16 percent of Hispanics and 26 percent of whites.

That's one of the reasons NJCRI strives to be a "comprehensive, integrated program that offers one-stop shopping," said Executive Director and Founding Member Bill Orr. People may come in to get tested for HIV, but they are able to stay and receive information regarding protection and clinical testing, which takes place onsite.

The NJCRI was started in 1988 by physicians, activists and individuals with HIV in order to make clinical trials available to people with HIV in New Jersey.

"When we first got started, we figured we would do a few clinical trials and we would find a cure and then we would go back and do something else," Orr said. "The reality is we need to continue these efforts."

To reach the masses, NJCRI is collaborating with organizations such as the Salvation Army and the American Cancer Society through an OMH grant-funded program Partners Improving Community Health (PICH), to help spread the word about proactive healthy living to a wider audience base. NJCRI also received an OMH grant to help fund its Newark Technical Assistance Program (NTAP), which assists other community-based organizations to help improve their practices such as financial development, grant writing and staffing.

For the 19th annual World AIDS day, Baxter said the organization has scheduled a concert featuring several hip-hop artists at Newark Symphony Hall, where it will offer preventive information.

It will also continue its efforts with the program United We Stand, utilizing about 40 volunteers to visit neighborhoods known for populations of heavy drug use and offering free HIV testing during the evening hours, following Bill Orr's philosophy that "geography shouldn't determine the ease of getting treatment."

"We try to work in the community," Baxter said. "We're in areas where it's not comfortable to be, but they need the services."

Links

Office of Minority Health Observances Pages
www.omhrc.gov/hivaidsobservances/world/index.html

HIV/AIDS
www.omhrc.gov/templates/browse.aspx?lvl=2&lvlID=22

Center for Disease Control and Prevention
www.cdc.gov/hiv/topics/surveillance/basic.htm
www.cdc.gov/omh/AMH/factsheets/hiv.htm

Kaiser Family Foundation
www.statehealthfacts.org/cgi-bin/healthfacts.cgi

Metropolitan Interdenominational Church
www.metropolitanfrc.com/

New Jersey Community Research Initiative
www.njcri.org/

National Minority AIDS Council
www.nmac.org/home/

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Fia Curley is a writer for the OMHRC. Comments? Email: fcurley@omhrc.gov