NASHVILLE, Tenn. — Taking an HIV test in the pulpit on Sunday morning was itself simple.
At Spruce Street Baptist Church, one of Nashville’s oldest and most established predominantly African American congregations, a public health worker opened the test kit and handed the swab it contained to the Rev. Raymond Bowman.
Bowman opened his mouth and, well, swabbed.
In the two minutes that it took, there was awkward silence. There were murmurs. Musicians broke into a low-volume instrumental, usually reserved for moments of prayer.
That scene, or something like it, was repeated June 29 in 26 other predominantly African American churches around Nashville.
The tests and the messages from pastors that followed about the value and ease of HIV testing, the opportunity for a free test and the need for every adult to know their status were part of a Metro Health Department effort to harness the power and influence of black churches to slow the spread of HIV.
“Sexuality has always been discussed in the black church,” said Bowman after the service. “It’s just that with what is going on in the world today, it has got to move from the back burner to the front. We are going to continue to talk about abstinence. But if we want our daughters and our sons to be healthy enough to marry the people that they love, we are going to have to talk about testing, too.”
The federal Centers for Disease Control and Prevention estimate at least 250,000 people in the United States are infected with HIV and are not aware of it. And in the 27 years since the HIV/AIDS epidemic began, African Americans have come to contract HIV and die of AIDS at disproportionate rates.
While only 13 percent of the U.S. population is black, black men and women account for more than 49 percent of AIDS cases. AIDS is the leading cause of death for black women ages 25 to 34 and the second-leading cause of death for black men ages 35 to 44.
In Nashville, where about 27 percent of the population is black, 55 percent of AIDS cases involve black patients.
Although a group of churches and ministers have been vocal about HIV prevention and testing, that has not been the norm, said the Rev. Jerry Maynard, who is also a Metro councilman-at-large.
Instead, churches — the institutions that for many black families and neighborhoods are the oldest and most influential in their lives — have remained virtually silent about HIV/AIDS prevention.
Maynard works as a staff attorney for a Nashville health care center and also leads the 7-month-old Southside Community Church.
He approached the Health Department with the church testing idea.
On National HIV Testing Day, Maynard led 13 African American ministers in signing a covenant promising to provide their parishioners with scientifically sound information about HIV/AIDS and aggressively encourage those within their “sphere of influence” to be tested.
Stemming the spread of HIV and AIDS is a part of the African American churches’ “social justice ministry,” the covenant says.
After completing his own in-pulpit test last Sunday, Maynard talked about his own fears of HIV tests while in the Army. Maynard was young, loved women and, in his words, was “unsaved.”
“You haven’t never prayed like you pray if you are a sinner about to take that test,” Maynard said to the congregation. “But that was before I was saved. That was ‘before.’ Now, we are dealing with the ‘after.’”
Maynard rejects the idea that traditional church teaching about abstinence before marriage and fidelity after makes discussions about HIV and AIDS inappropriate for church. Health care — including HIV testing — is a part of what churches need to talk about. So, too, is risky behavior, he said.
Directly after the service at Southside, about 25 people who watched Maynard’s testing took their own test. Marilyn Lawrence was one of them.
A few years ago, her brother died of AIDS.
“This is a church where you get in where you fit in, come on in as you are and get what you need,” said Lawrence, a retired home health care worker. “For a lot of us, for me, that includes a test.”
Over at Spruce Street, about 10 people went downstairs for testing right after the service.
The results of the rapid HIV tests were available the same day but were given to test takers over the phone later for added privacy, Metro Health Department officials said.
But at Spruce Street, the assessment of one of its oldest members was available.
“You know, I was glad to see it, I think a bit surprised, but glad,” said Mary McEwen, who has been a member of the church today known as Spruce Street for 80 years. “Our ministers have always been guides for our people [African Americans] and our churches involved in the critical issues in our lives.”
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