How a Nashville church became prevention leader

Faith ministry reaches out to MSM, prostitutes

The Metropolitan Interdenominational Church of Nashville, TN, was about 3 years old in 1984 when the congregation learned that one of the founding members had died of a little-known disease called AIDS.

"We were unaware of what the disease was, and so we began to educate ourselves," says the Rev. Edwin C. Sanders II, a senior servant and a founding member of the church. "And that education translated into our getting involved in doing education, initially in our church community, but then in our larger community."

Now 20 years later, the church has paved new ground in showing what a faith-based institution can do to educate the public about HIV/AIDS and provide compassionate care to people who are infected with the disease.

In 2002, about 5,000 people received help from the church’s First Response Center, and 296 people received case management assistance, says Sharon L. Crawford, PhD, executive director of Metropolitan Interdenominational Church First Response Center, which houses all of the church’s ministries.

The church also spreads its HIV education and prevention to other churches through the Metropolitan Interdenominational Church — Technical Assistance Network (MICTAN), which receives funding from the Centers for Disease Control and Prevention (CDC) of Atlanta, says Jacqueline Fleming Hampton, PhD, capacity building and evaluation coordinator of MICTAN.

With programs that target the African-American community, men who have sex with men (MSM), and disenfranchised people, the church has been filling in a gap that AIDS activists and public health officials long have lamented: The church is able to reach at-risk minorities and others who may not acknowledge their own HIV risk behaviors, and at the same time, the church is able to offer acceptance and understanding for people who are HIV-positive.

"The church is the place where people turn to when they’re in a crisis," Sanders says. "The church ends up being the hub of benevolence in our community."

For Crawford, who was a member of the church before she was hired to head the First Response Center, the combination of faith and health is a natural fit. "From a biblical perspective, Christ went to those who others didn’t go to, and he brought comfort to them and healed them," she says. "What you hear from our church is that it’s our role to provide assistance and services to respond to the needs of those who are oppressed, disenfranchised, and disconnected from mainstream society."

Here are some of the programs offered through the church’s First Response Center:

Men of Faith, Men of Color Prevention, Education, Enhancement, & Referral

This project targets African-American men and women who are at risk for HIV infection through a variety of services, including the Prevention Education Enhancement & Referral (PEER) service. "We have a women’s prevention curriculum that targets African-American women, but have begun using it for everybody," Crawford says. "We offer it in two arenas, including institutional settings, such as the county jail and residential treatment facility; and we offer it in a retreat format."

Retreats are one-day, eight-hour workshops for women in faith-based settings, she says.

The curriculum, which also can be set up in six shorter sessions, provides a holistic overview of HIV risk behaviors. "It’s for women who don’t necessarily see themselves as being at risk, but may be at risk because they’re ill informed and don’t have good information about HIV and the risk of HIV," Crawford says. "It focuses on helping women understand themselves better by increasing self-awareness, self-efficacy, and providing them with information that will help them make better decisions about their health and behavior."

Another component of PEER focuses on men who have sex with men (MSM), again targeting a group that doesn’t receive HIV prevention messages within the community, she says.

"A lot of men in faith settings are on the down low, meaning they aren’t going to places where they could access information," Crawford explains. "And they’re more at risk because they engage in clandestine meetings when they’re out of town and where they think they’re safe, and no one will find out."

These men might be having sex with male prostitutes in exchange for drugs or money, she says.

"Although there are a lot of prevention activities for [MSM], I don’t think we have a lot for that particular population," Crawford adds.

Through the Men of Faith project, staff outreach workers also target men on the streets, including male prostitutes.

"They offer meals to male prostitutes and offer them a place to come and talk," she says. "They may come to us because they are living with HIV or because they used drugs but weren’t revealing they were engaging in MSM behavior."

These men also may be referred to substance use programs and treatment.

Often, the MSM reached by the program heard about it through their own churches and went to the Metropolitan church’s First Response Center because they were assured of their anonymity and told they could receive confidential HIV testing, Crawford says.

She contends the program, which is in its infancy, is beginning to show signs of success because of the trust that is building between the minister who helps run the program and the MSM of color who seek help.

"The minister is very careful not to do anything that would break that relationship of trust," Crawford says.

First Response Wellness Center

Supported by Ryan White funds, the wellness center has various support groups, including one for women, a coeducational support group, and a group that provides services to MSM, says Beverly Glaze-Johnson, BSW, case manager of the First Response Wellness Center.

The center also offers nutritional counseling and referral, transportation services, a comprehensive wellness plan, and pastoral counseling and care, she says.

It’s support services include individual and family counseling, emergency rental and utility assistance, and financial help for homeless individuals and others who need money to obtain a state identification card and birth certificate.

"We take them down to the driver’s license bureau and help them get state identification," Glaze-Johnson says. "We will provide clients with a gift card to take to a local grocery store so they can feed their family."

The program receives referrals from AIDS service agencies, clinics, hospitals, and medical providers, she says. "We work with a largely inner-city population, and when people are in crisis, many times the first place they turn to for help is the church."

Metropolitan Community AIDS Network (Metro CAN)

Metro CAN works to improve health within the African-American community through providing a variety of services, including:

— HIV-prevention community outreach;

— HIV risk-reduction interventions;

— HIV testing and case management services;

— referrals for substance abuse treatment;

— referrals for health and mental health services;

— spiritual nurturing and support, including a psychoeducational support group for women and men in recovery;

— weekly recreational outlet for people in recovery.

Outreach to injection drug users and substance abusers

Methadone Outreach Recruitment Retention & Enhancement provides assistance to African-American injection drug users through a collaboration with Middle Tennessee Treatment Center. The treatment center provides methadone maintenance treatment to opiate users, as well as other services, including medical evaluations and care, counseling, detoxification, acupuncture, and testing for tuberculosis and STDs.

The First Response Center also has an Alcohol and Drug Coordination program in which HIV-positive individuals are assisted with gaining access to alcohol and drug treatment services. The program also assesses substance abuse problems, refers people to treatment facilities, and provides intensive case management.

International HIV/AIDS outreach

Through Partners For Life (PFL), the church provides an international ministry that seeks to establish partnerships between faith-based and community-based organizations with South African orphanages, where many children have lost their parents to AIDS. PFL recruits United States organizations and identifies and recruits orphanages in hopes of providing some relief and assistance to some of the estimated 420,000 children orphaned by AIDS.