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Objectives: A pilot project was launched in 2000 in Jimma Zone of the Oromiya Regional State to determine the effectiveness of religious leaders in promoting HIV/AIDS awareness and prevention.
Methods: In this ethnographic study, 180 religious leaders (100 Moslems and 80 Orthodox Christians) were selected from the 13 weredas of Jimma Zone to enroll in a three-day training course of five workshops held in March 2000. During the workshops participants were given posters and booklets concerning HIV/AIDS awareness and prevention developed for them to use during their community teaching activities.
Eight months after the training, in November 2000, the activities of the leaders were evaluated to determine their effectiveness and to rectify any impediments to the leaders' continuing anti-AIDS efforts. A total of 71 participants (29 Christians and 42 Moslems) and 36 key informants from all 13 weredas who were enrolled in the study were visited. The evaluation was carried out using in-depth interviews and direct observations of religious ceremonies at the respective institutions. Using semi-structured and unstructured interviews, from religious leaders and key informants who were identified by health workers and local kebele offices. Participants were asked mainly about their activities following their training, and also about their successes, failures, and any problems they had encountered in their communities. Key informants were consulted to verify information obtained from the religious leaders and the community members' perception and knowledge of the religious leaders' involvement during the pilot intervention. Participating churches and mosques were also visited at routine prayer times, including the Friday prayer for Moslems (Jum'aa) and Sunday Orthodox church services, to further evaluate their HIV/AIDS programs.
Results: Religious leaders were found to participate most actively at the beginning of the program and less during later stages. Most leaders were active in communities beyond their immediate jurisdiction and were most effective in rural communities. The majority of them spoke openly to their congregations about HIV/AIDS, with only a few reluctant to discuss this topic in churches and mosques. According to the communities, investigators' observations, and the religious leaders themselves, leaders were very effective in breaking the silence, overcoming various misconceptions about HIV/AIDS, and addressing the stigmatization problem. Nevertheless, sensitive subjects such as sexual transmission of HIV and use of condoms proved difficult to discuss.
Conclusion: Given proper training, religious leaders can become strong allies in HIV/AIDS prevention and control programs focused on awareness creation, behavioral change, and the elimination of stigma and discrimination against people living with the virus.
Recommendations: It has been shown that religious leaders can play an important role in HIV/AIDS prevention in view of their influence and acceptance among their respective congregations; it is thus critical to meaningfully involve them in prevention and care and support endeavors. Development of culture- and religion-specific training materials to empower them and provision of technical support are crucial strategies.