A conversation about the challenges and benefits of HIV testing in church, with Jannette Berkley-Patton, Ph.D., and Kathryn Derose, Ph.D.

There were approximately 1.2 million people with HIV living in the United States in 2021.

That year, African Americans made up 37% of new diagnoses, despite making up only 14% of the country’s population — the result of compounding factors including systemic racism and limited access to HIV testing.

Two of the researchers working to bridge this gap are Jannette Berkley-Patton, Ph.D., professor and researcher at the University of Missouri, Kansas City, in the School of Medicine’s Department of Biomedical and Health Informatics, and Kathryn Derose, Ph.D., professor of Community Health Education at the University of Massachusetts Amherst.

Their community-based participatory research project, Taking it to the Pews, was designed to study the effects of a religiously tailored intervention on HIV testing rates on African American church members and community members using church outreach services such as food pantries. Interventions included printed information/posters, resource tables and sermons. Results showed that the odds of HIV testing increased 47% for each additional intervention exposure reported.

Results were published in the original outcomes paper ‘HIV Testing in African American Churches: Results from the Taking It to the Pews Cluster-Randomized Trial,’ published in August 2025.

Most recently, along with lead author Chavon Hamilton-Burgess from the Department of Health Promotion & Policy, University of Massachusetts Amherst, they published ‘Exploring Participant Perspectives on Implementation and Sustainment of Taking It to the Pews: A Faith-Based HIV Intervention With African American Churches’ last month in AIDS education and prevention. It explored the church participants’ perspectives about the intervention.

Berkley-Patton, the principal investigator of the former study, and Derose, her co-author, recently sat down with Managed Healthcare Executive to discuss their findings and what they could mean for increasing healthcare equity within African American communities.

MHE: Your study suggests that African American churches have a reach beyond their congregation. How was this reflected in the findings, and why is faith such a central part of many African American communities?

Berkley-Patton: The Taking it to the Pews project was generated from work that was already done in churches a few years before I even came along at the University of Missouri, Kansas City. Kansas City has one of the longest-running Black Church Weeks of Prayer for the Healing of AIDS Initiatives in the country, which started in New York.

When I joined in to hang out in the meetings, it was like, ‘Wow, Black folks really don't even know about this disease.’ I would talk to other people, and they'd be like, ‘What are you talking about? That's not an issue in Kansas City; that's in San Francisco or New York.’ Once I started getting involved, it was clear that there was an opportunity to learn how churches could be even more effective in sharing information about HIV, and particularly in doing HIV testing. One thing our pastors let us know was that they didn't want any part of any detailed sex education talks. At that time, we were battling all the church taboos, like HIV and stigma, but then when you add on issues related to homosexuality, premarital sex and contraceptives, all of those issues came into play. The pastors decided that testing was the one thing that they could feel comfortable doing in their churches and that their members would embrace it because they felt like it was a public health issue. At that time, gosh, almost 20 years ago, lots of folks didn't know they were infected, and so the need to know one status to help reduce the spread was something they saw as a public health and even a social justice issue.

Derose: Jeanette and I have collaborated for a number of years. We found each other through some mutual colleagues who knew that we both work with faith-based organizations, and we were both working on the issue of HIV with faith-based organizations. I think that not all, but a lot of congregations, particularly African American congregations in urban areas, serve their broader communities, as do Latino congregations in urban areas.

MHE: Because HIV disproportionately affects gay and bisexual men, did you encounter any tension around discussing sexuality in church settings? How did you handle it?

Berkley-Patton: The very first full discussion that we had around the approach that would be used, about 20-something pastors showed up, and it actually became a heated debate.

There was shouting going on; some pastors who truly believe that condoms had no place in the church were shouting to other pastors who are more progressive and believe this is the business of the church to make sure we can keep people healthy so that, in the end, hopefully we can get them saved, too.

But here's what's interesting. By the time we finished the first pilot study with 500 and something participants, most of those same pastors who argued against condoms were the ones who then would put a bowl of condoms on the table when a testing event was going on. What we agreed to do was to meet pastors where they were.

One of our key partners was the Kansas City, Missouri Health Department, who would come to the churches to do the testing because they had a communicable disease unit that you know already did community testing. We worked directly with them and some of our pastor representatives to develop the intake form that would happen at the testing and the scheduling of the event. What they all agreed on was to have a checklist so they could determine how far the health department could go. They could just do testing. They could do testing and bring condoms. They could do those two things and add on sex education, and so churches were able to cherry-pick which services they felt comfortable with. They also could provide. They also provided, in many cases. The churches also had the option to provide tests for gonorrhea and syphilis during the HIV testing.

The very first time that we did this in the sanctuary, the pastor got up in front of the pulpit and said, ‘You're going to take this survey. Don't be afraid of the questions, particularly the last page, because the last page is what we call the “loaded page," with questions about how many times you’ve had sex, oral sex, anal sex — all of those different kinds of things. When we passed out those surveys, people were raising their hands, and old ladies were saying, “Oh, baby. I don't even remember the last time I had sex, but I can tell you what: when I did, I think I had about this many partners. Can I kind of estimate?”

Once one hand went up, other hands went up, and it was clear that the members aren't afraid of these topics. They're dealing with them every day, with their kids and in conversations with their friends.

MHE: Most participants were female and heterosexual. Were you surprised by that, given the higher HIV risk among gay and bisexual men?

Berkley-Patton: Not at all, because when you go to most Black churches, the faces that you see are of women. Even with our other faith-based studies that are not focused on HIV, we always see at least 65% women.

It's really interesting, because you still have some churches where women can't go into the pulpit, yet women are truly the backbone of the church.

Derose: We also know that women tend to participate in research projects more, too, just like they tend to seek out healthcare more than men do.

Berkley-Patton: African American women, among women, are also disproportionately affected by HIV. African American women also tend to set the temperature for any kind of health care, even preventative health care.

One of our taglines was ‘take someone's hand and get tested together.’ What you would see at testing events, especially if the pastor encouraged this, would be the women grabbing the hands of their teenagers, their sisters and friends, and going to get the test together. We would see whole choirs go get tested, row by row, and your choirs are mostly made up of women as well. That safe space among women spreads out to the rest of the congregation. We even saw wives pulling their husbands to go get tested.

MHE: What is something that you hope somebody takes away from the study?

Berkley-Patton: I think for most African Americans who have been associated with the church in any way, we agree that its presence as a Black institution is probably one of the most enduring institutions in our community.

Churches were places that people learned how to read, that led the Civil Rights movements and that have led other social justice movements. When COVID-19 hit, churches did what our health departments didn't do; they started providing information about COVID-19 and then became some of the first COVID-19 vaccination sites in Black communities in Kansas City.

With that rich history and presence, there's so much we can do to improve the health of not only African Americans but also other churchgoers throughout this country.

Derose: Churches shouldn't have to do it alone, either. Yes, they fill the gaps, but what I would like people to take away from this work is the real importance of partnership between faith communities, public health entities and other service providers, because together they can serve the community better.