The 2013-2014 Zambia Demographic and Health Survey (ZDHS) reported HIV prevalence
rate among adults aged 15-49 at 13.3%, ranking Zambia 7th
among countries experiencing
devastating effects of a mature and generalised epidemic. This report is particularly noted as
the first to measure HIV incidence1
. Chanda Kapata
2 et al. posting results from Zambia’s
largest population-based mobile testing survey (2013–2014) placed the HIV prevalence rate
generally lower. In 2002, the National AIDS Council (NAC) was established to lead a multisectoral
national response to stem the tide. Government Agencies and the United Nations led
the responses. In 1992, The World Health Organisation (WHO) observed that abstinence and
marital fidelity might constitute strategies capable of completely eliminating the risk of
infection from HIV and other sexually transmitted diseases (STDs). Yet funding for
applicable initiatives has seldom been prioritised in this respect. On one hand, from the onset
of global interventions, condoms were seen primarily as most potent towards reducing the
risk of infection. On the other hand, in due course, the implementation of Abstinence and
Being Faithful (AB) initiatives by Churches among others, has since been seen as holding
massive comparative advantage in facilitating sustainable interventions for prevention and
mitigation of AIDS impact. However, church-congregation engagement in AIDS work, for a
while, remained under-researched, and applicable interventions were often undocumented
and unmeasured in relation to impact. This study investigated (1) how interventions affect
impacts in congregation-based HIV/AIDS programmes, and (2) how abstinence and marital
fidelity function within the larger picture of overall strategies to combat AIDS. It examined
the community work of the Circle of Hope Family Care Centre, a congregation-based
HIV/AIDS support group initiative undertaken by the Northmead Assembly of God Churchin Lusaka, Zambia. The main research question was: 1) Is a person’s sexual behaviour
influenced by their attitude and behaviour towards God? Two subsidiary questions were: i)
what are the factors that affect a person’s sexual lifestyle? ii) Does attendance at the
church’s HIV/AIDS programmes cause a change of behaviour in a person’s sexual
relationships? A triangulated methodology required the collection of both quantitative and
qualitative data. The experimental design included a purposively selected intervention group
and a control group. Both groups were studied by employing baseline first, and follow-up
measures after three months. Quantitative data analysis was carried out in two stages
comprising first, cross tabulations to examine the relationship between safer sexual
behaviour and socio-economic variables. For the statistical analysis, chi-square tests of
independence were conducted at the bivariate level, and the differences were determined at P
< 0.01 and P < 0.05 significant level. Next, major predictors were carried out with the help of
logistic regression analysis. The results of the logistic regression models were converted into
odds ratios, which represented the effect of a one-unit change in the explanatory variable on
the indicator of experiencing safer sexual practices and abstaining from sex. Qualitative data
were analysed using Atals.ti software to produce the attendant themes and sub-themes. The
results of the logistic regression analysis show that those who participated in the
interventions were 4.1 times more likely to report having adopted new behaviour or modified
old behaviour, specifically to live positively, than those who did not attend the interventions.
Similarly, participants in the faith-based interventions were 2.3 times more likely than those
who did not take part to report having adopted safer sexual practices. Further analysis
revealed that those participants were more likely to report abstinence from sex than those
who did not attend. The conclusion is that church congregations have immense comparative
advantage to influence sexual behaviour through increasing captive audiences constituting
the churches’ presence in the community. Additionally, their morally based interventions
such as abstinence and marital fidelity show significant impact on sexual behaviour change
and have potential to turn the tide of HIV/AIDS, as the tested models are replicable, scalable
and sustainable.