“Going down?” I asked as I stepped onto an elevator already occupied by a few of my future colleagues. I had just signed a contract to implement and direct the HIV/AIDS strategy for a major mainline Christian denomination with a focus on the United States. In my first of many elevator speeches over the next couple of years, I introduced myself and my new role as director of the HIV/AIDS strategy, and I was received with welcome and enthusiasm, and a peculiar yet sincere question:

“So how’s HIV going in Africa?”

In a single elevator ride it was already clear to me that my task to educate, elevate awareness, and eradicate stigma among American Christians regarding the U.S. HIV crisis was beyond great. That was almost a decade ago. 41 years into the epidemic and many people still believe HIV is a disease relegated to the continent of Africa, including people of faith.

Indeed, in 2021 nearly 26 million of the more than 37 million people living with HIV worldwide were in Africa. Likewise, the World Health Organization (WHO) estimates that 40% of health care delivery in Sub-Saharan Africa is delivered by Christian clinics, hospitals, and community health centers. Christian Missionaries were among the first to invest in modern medicine in Africa and have historically had conflicting effects on the HIV epidemic there. American Christians have long been eager and willing to financially support efforts to combat the HIV epidemic in Africa through local churches with global ministries.

Yet U.S. faith leaders and congregations are often not well informed or connected to public health efforts for HIV and AIDS here at home. On one hand, the United States finds itself in the similar company of countries in Africa, in that the epidemic in the U.S. predominates in poor and African Descent communities. On the other hand, over half of the people living with HIV in Africa are women and girls, whereas the majority of new HIV infections and people currently living with HIV in the U.S. are among men who have sex with men, and women of trans experience. It’s perhaps this contrast that has attracted U.S. churches to HIV advocacy abroad as opposed to making intentional connections with local efforts.

Consider the long yet tenuous relationship between Christianity and HIV/AIDS. The intersection of sex and sexuality with HIV and AIDS has presented some sects of Western Christianity with a ‘moral’ dilemma. As the disease has disproportionately impacted the LGBTQIA+ community in the United States, supporting women and girls impacted by HIV halfway around the world becomes more palatable and less confrontational than supporting the same-gender-loving man secretly living with HIV in our own choir stands. The former reality affirms the Christian call to welcome the stranger, heal the sick, and bless the poor which makes us feel good; the latter challenges our belief that the face of this potentially deadly virus is sickly, poor, and foreign when in fact the faces of HIV are among us, hiding in plain sight.

It’s no coincidence that the region of the United States that accounts for the largest population of Black and LGBTQIA+ Americans with the highest prevalence of people living with HIV is also the region of the country with the highest confluence of Christian churches – the U.S. South, also known as the ‘Bible Belt.’ It’s not to say that Christianity is the cause of the disproportionate impact of HIV on people in the southern United States - that would be an unfair and unfounded claim of causation.  However, there is a correlation that we cannot ignore: the past silence of Christian churches in the fight to end HIV in the U.S., and the Church’s refusal to name sex and sexuality as a God-given part of the human experience, has helped create a closet of secrecy and shame that stigmatizes those most vulnerable to HIV.

HIV-related stigma now kills more people than HIV. We are at a point in the epidemic’s history where we have science and medicine to prevent HIV transmission and effectively treat people living with HIV, but stigma and discrimination still prevent vulnerable populations from accessing the scientific and medical breakthroughs that would benefit them most. What we need now in order to end HIV as a public health crisis in the U.S. is to treat people, and not just disease. We cannot get there without the advocacy of the largest faith community in the country, because the body of Christ has HIV.

First Corinthians, chapter 12, verses 12-31, says:

(12) For just as the body is one and has many members, and all the members of the body, though many, are one body, so it is with Christ… (14) Indeed, the body does not consist of one member but of many… (19) If all were a single member, where would the body be? (20) As it is, there are many members yet one body. (21) The eye cannot say to the hand, “I have no need of you,” nor again the head to the feet, “I have no need of you.” (22) On the contrary, the members of the body that seem to be weaker are indispensable, (23) and those members of the body that we think less honorable we clothe with greater honor, and our less respectable members are treated with greater respect, (24) whereas our more respectable members do not need this. But God has so arranged the body, giving the greater honor to the inferior member, (25) that there may be no dissension within the body, but the members may have the same care for one another. (26) If one member suffers, all suffer together with it; if one member is honored, all rejoice together with it.

People living with and affected by HIV and AIDS include members of the U.S. church body and people of faith and goodwill around the world. When one member of the body of Christ suffers, the rest of the body suffers with them. The good news is that an awakening is certainly happening, with Christians and other people of faith at the forefront. The mere existence of the HVTN Faith Initiative is a testament to how far we’ve come by faith. If we are to end HIV as a public health crisis by 2030, our understanding of the U.S. HIV epidemic and our role in responding to it must go beyond elevator speeches to become sermons and ministries that service the local church and community.

As a follower of Jesus Christ, I’m proud to lead the U.S. HVTN Faith Initiative alongside my multifaith brothers and sisters to honor even just one member of the body, so that we might ‘all rejoice together with it.’