Responding to AIDS from the Altar: Religion, Politics and AIDS in Brazil

1. Responding to AIDS from the Altar: Religion, Politics and AIDS in Brazil Richard Parker, Ph.D. Miguel Munoz Laboy, Dr.PH. Jonathan Garcia, M.Phil. Laura Murray, M.H.S May 7, 2009 HIV Center Rounds

2. 1995-2002 1988-1994 1980-1987 Space distribution of districts with at least one case of AIDS. Brazil, 1980 - 2002.

3. Stabilization of the epidemicTendency of AIDS epidemic: 1996-2007 Source: National AIDS Program, Brazilian Ministry of Health, Boletim Epidemiológico AIDS. ANO V No. 01. 2008

4. Stabilization of the epidemicTendency of AIDS incidence rate 1983-2007 30 Source: National AIDS Program, Brazilian Ministry of Health, Boletim Epidemiológico AIDS. ANO V No. 01. 2008

5. Research Problem • Little recognition of the fact that organized religion, religious beliefs and religious institutions and organizations have played a key role in shaping the Brazilian response to AIDS. • The impact of religion has arguably been as important as the impact of government programs and policies in shaping the ways in which Brazilians have confronted the epidemic and the challenges it has posed.

6. Historical Conceptual Framework • Political economy of the religious movements in Brazil • Social movements theory • Community mobilization theory • Political economy of AIDS in Brazil

7. Research Context: Religious Plurality in Brazil

8. Roman Catholic Church (1500 – Present) • Historical dominance of the Catholic church in the country for centuries • Liberation theology movement (1960s) • “Christian Base” Communities (CEBs)

9. Evangelical Church (doubled in the 1990s) • Multiple denominations: • Assemblies of God • Universal Church of the Kingdom of God • The Pentecostal Church of Jesus Christ

10. Brazilian Candomblé (1549 – Present) Candomblé in Bahia Xangô in Pernambuco Batuque in Rio Grade Sul Candomblé Jejé-Nagôin Rio de Janeiro

11. Umbanda in Brazil (1900s – Present)

12. Patterns of movement through religious tradition in Brazil • Terreiro  Pentecostal Temple

13. Patterns of Religious Migration in Brazil Roman Catholics Source: De Almeida & Montero (2001).

14. Spiritists Roman Catholics Not Religious Source: De Almeida & Montero (2001).

15. Spiritists Roman Catholics Historical Protestants Pentecostals Not Religious Source: De Almeida & Montero (2001).

16. Spiritists Roman Catholics Afro-Brazilian Religions Historical Protestants Pentecostals Not Religious Source: De Almeida & Montero (2001).

17. Spiritists Roman Catholics Afro-Brazilian Religions Historical Protestants Pentecostals Not Religious Source: De Almeida & Montero (2001).

18. Religious responses to AIDS emerged from long traditions of institutional involvement in the health and illness of religious followers.

20. Religious Responses to AIDS in BrazilU.S. National Institute for Child Health and Human Development (Grant number: 1 R01 HD050118)

21. Project Specific Aims • To develop a comparative analysis of the multiple ways in which Catholic, Evangelical, Protestant, and Afro-Brazilian religions have responded to HIV and AIDS. • To empirically document the importance that each of these three major traditions have given to HIV and AIDS, and the reasons that have led them to do so.

22. Project Specific Aims • To assess the ways in which the responses of each of these religious traditions have interacted with local communities, the wider social universe of civil society, and the nation-state, in impacting upon the broader social response to the epidemic. • Through comparative analysis, to more fully understand the organizational and institutional structures that each religious tradition exhibits, and the ways in which each interacts with and articulates itself with communities, civil society, and the state, in order to shape the social and political response to AIDS.

23. Religious Responses to HIV and AIDS in Brazil: Study Field Sites (Locations, Populations, AIDS Burden) Research Site 1: Recife Population: 3,750,000 Accumulated AIDS cases until 12/2003: 3,297 (1.1%*) Research Site 2: Brasília Population: 3,500,000 Accumulated AIDS cases until 12/2003: 3,672 (1.2%*) Research Site 4: São Paolo Population: 20,200,000 Accumulated AIDS cases until 12/2003: 59,773 (19.3%*) Research Site 3: Rio de Janeiro Population: 12,150,000 Accumulated AIDS cases until 12/2003: 29,352 (9.5%*) Research Site 5: Porto Alegre Population: 3,950,000 Accumulated AIDS cases until 12/2003: 11,190 (3.6%) * % of national accumulated AIDS cases until December 2003 Source: National AIDS Program, Brazilian Ministry of Health, Boletim Epidemiológico AIDS. ANO XVII No. 01. 2004

24. Research Team Structure Richard G. Parker, PhD (Principal Investigator) Veriano Terto, Jr., PhD (PI– Brazil) Miguel Muñoz-Laboy,DrPH (Co-PI) Columbia University Vagner de Almeida (Project Director) Jonathan Garcia Carmen Yon Laura Murray Porto Alegre Fernando Seffner, PhD (Local PI) Luana Rosado Emil Marcello Múscari Carolina Peres Terra S Sao Paulo Vera Paiva, PhD (Local PI) Dani Carli Licciardi  Andrea Paula Ferrara Alessandro O. Santos Cristiane Silva Rio de Janeiro Cristina Pimenta, PhD (Local PI) Ivia Maksud Juan Carlos Raxach Aline Lopes Recife Felipe Rios, PhD (Local PI) Cinthia Oliveira Francisca Luciana de Aquino Claudia Cruz David Handerson Coelho

25. METHODOLOGY: INSTITUTIONAL ETHNOGRAPHY

26. Institutional Ethnography • Archival research • Ethnographic case studies including: • Oral Histories • Life histories • In-depth interviews • Participant Observation

27. Ethnographic Case Studies • Themes explored with each institution: • Religious belief systems as they relate to HIV and AIDS • Organizational structure and the internal organization of ecclesiastical power • Relations with the external world • The construction of risk, illness, care and treatment

28. FINDINGS:FOCUSING ON ONE CASE STUDY

29. “Strange Bedfellows”: The Brazilian National AIDS Program and the Catholic Church • Strained relationship between Catholic Church and government HIV programs in other • Brazil unique in terms of the nature of relationship between the National AIDS Program and the Catholic Church

30. Formula for a Positive Pelationship • Shared Values • Similar Backgrounds • Right Place, Right Time

31. Shared Values We don’t discriminate at the time of funding a project. We have a historical principle to respect human rights, diversity, and this is how we establish partnerships, be they with the church, forming institutions, civil society, or the university. (National AIDS Program official) So the Church finds itself faced with AIDS. [With] the reality of the person that needs treatment, of the person that needs affection, of the person that needs to be included and not excluded...The Church places itself before an infected person that needs to be seen with mercy, with the same care that God wants us to have for any person. (Catholic Priest)

32. Similar Backgrounds: Political Context In Brazil, we can never separate the organization and the community work of the Church. I am convinced of this…when people ask me how is it that in Brazil…the government and civil society are able to work [together], I always respond the same way: it is because Brazil has a history where the Church, was progressiveand worked a lot at the community level.” (former National AIDS Program official)

33. Organizational Structure of National AIDS Program and CNBB

34. Right Place, Right Time: Social Networks For us, it’s strategic, the churches arrive at places that it would take us too long to arrive. They are able to bring together an very large group of volunteers to be able to work, this is another characteristic of the dedication related to the cause; I would say that it is a war of positions, bringing together the possible movements with the ones allied with the church, to be able to expand the strategy. There is no doubt, it is a political strategy. (National AIDS Program official)

35. Political Alliances • Relationship between Catholic Church and National AIDS Program concretized through formation of the Pastoral da AIDS • Partnership seen as mutually beneficial: “It was hunger coupled with the desire to eat together.” (National AIDS Program official)

36. Lovers’ Quarrels • Condoms and Compromises • They [the Church] have to understand that the families do what they call sins, and they have to include the question of condoms, and other methods…there is a negotiation. The National [AIDS] Program does not want to say that “they have to use condoms,” but it is has to be put out there that there are relations outside of marriage, and that for these relations to be safe, they have to be protected. So the negotiation is in this sense, of being attentive a little to the language without taking away the content of the information. (National AIDS Program official)

37. Making Up • AIDS and Religion Seminar 2006 • AIDS Ribbon at Christ Statue in Rio 1988 and 2007

38. Examples of Broader Findings • Politics and policy • Gender and sexuality • Care and treatment

39. Examples of Broader Findings, Cont. • Stigmatization and sex • Interaction and intersection between HIV, youth, sexuality, and religion • Gender, power, violence, and conflict in intimate relationships

40. Future directions: ‘Til death do US part?

41. Final Year of Study: Next Steps Finalize case study write-ups Finalize data analysis Organize national seminar to disseminate results

42. Next Steps Cont. Dr. Patrick Wilson’s supplement on the role of religious institutions in responding to HIV and AIDS among Black MSM in NYC (Grant number: 5 R01 HD050118) Jonathan Garcia’s dissertation: Responses of Afro Brazilian religions to HIV and AIDS in Brazil (Grant number F31HD055153) New research and interventions?

43. Publications and Presentations • Conference presentations in Brazilian and international settings • Publications for Brazilian and international readership • Academic and lay publications

44. Publications

45. Publications

46. Finally:Irreconcilable differences?

47. Times of London, March 2009 New York Times, March 17, 2009

48. The Pope’s form of prevention?

49. Thank you! • Richard G. Parker: rgp11@columbia.edu • Miguel Munoz Laboy: mam172@columbia.edu • Jonathan Garcia: jg2320@columbia.edu • Laura Murray: lrm2137@columbia.edu