Table of Contents

Preface iii

Figures vii

Tables ix

Summary xi

Acknowledgments xvii

Abbreviations xix

Chapter 1 Introduction 1

Background 4

The Three Countries: Guatemala, Honduras, and Belize 4

Scope of This Study 5

Framework 6

Approach 7

Limitations of the Study 9

Chapter 2 Background and Overview of the Region 11

Who Is Affected by HIV and AIDS? 11

Overall Population Indicators 12

Prevalence and Mortality from HIV/AIDS in the Three Countries 12

Vulnerable Populations 16

What Health Care Services Are Available to Prevent and Treat HIV/AIDS? 20

HIV/AIDS Prevention Efforts 20

HIV/AIDS Treatment 22

HIV/AIDS-Related Policies 24

Conclusion 26

Chapter 3 Faith-Based Organizations' HIV/AIDS Activities 29

Prevention and Testing 29

Medical Care and Mental Health Treatment of PLWH 36

Hospice Care and Home-Based Care 37

Pastoral Care and Social Support of PLWH and Families 39

Stigma Reduction and Advocacy 41

Conclusion 48

Chapter 4 Facilitators of and Barriers to FBO HIV/AIDS Activities 51

Advantages/Facilitators of FBO HIV Activities 51

Challenges/Barriers to FBO Involvement in HIV/AIDS 56

FBO Attitudes and Beliefs 57

Organizational Barriers 67

Resource Barriers 68

Disagreements and Tensions Between Faith-Based Organizations and Secular Health Organizations 70

Conclusion 72

Chapter 5 Discussion 73

Roles for Faith-Based Organizations 74

HIV Prevention 75

HIV Testing 77

Care and Support Services 77

Stigma Reduction and Advocacy 78

Need for Collaboration Between Faith-Based Organizations and Other Organizations 81

Implications 85

Appendix: Study Approach and Methods 89

References 95