AIDS Ministries and The United Methodist Church

Introduction

Much has been learned about AIDS since it was first diagnosed in 1981 as a truly new disease: one we have been forced to deal with while researchers have worked to understand its cause and progression. Even in the short time since the United Methodist National Consultation on AIDS Ministries in 1987, many changes have occurred. For example, terminology is changing. No longer are health practitioners and researchers concerned primarily, or only, with persons who have been diagnosed with clinical AIDS. In the future we will be reading and hearing less about AIDS itself and more about HIV/AIDS.

With the knowledge that AIDS is caused by Human Immunodeficiency Virus (HIV), health professionals are becoming increasingly concerned about the entire spectrum of HIV/AIDS which starts when a person becomes infected with the virus. Some of these persons show no signs of illness. Other might experience chronic swollen glands, tiredness, night sweats, and weight loss. Still others will develop lingering infections which the body has difficulty overcoming. Many of those who go on to develop clinical AIDS will suffer from AIDS-related pneumonia (Pneumocystis carinii pneumonia), rare cancers (such as Karposi's sarcoma), tuberculosis, and among women there might be higher incidences of pelvic inflammatory diseases.

As we have learned more about AIDS and the virus which causes it, we've also gained knowledge about how the virus is transmitted. So, too, have we learned that education about how to prevent the spread of the virus is everyone's business. Presently, there is no way to kill the virus once it has infected a person. People must know how HIV is transmitted and how to prevent becoming infected in the first place.

What can we as United Methodists do in the face of this epidemic? We need to carefully plan our involvement in a compassionate and caring way. This disease provides us with the opportunity to respond from our deeply rooted belief system of caring for all people. How we can do that is the purpose of this focus paper.

1. Education of Church Staff and Church Workers.

Before beginning a program in the church, staff need to have in-depth education about HIV/AIDS covering the following topics: health and social issues, community resources and policy needs. In many communities, the public health department or HIV/AIDS community-based organizations have educators who are available to provide such training. In other areas, ecumenical or interfaith organizations are conducting workshops for churches. Staff and church workers must know the issues around this disease before beginning a program within the church.

2. Education of the Congregation/Church Family.

There are three distinct groups to educate: adults, teens, and children.

a. Adults

Education programs should be timed so adults are educated first and can respond to questions from teens and children. the areas to cover in adult education are much the sane as would be covered with the staff: HIV/AIDS; a clear definition of the disease; the ways the disease-causing virus is and is not transmitted, with an emphasis on the fact that the virus is not transmitted by casual contact; and the needs of HIV positive persons.

In The United Methodist Church we have many personal stories about HIV/AIDS has affected families. These stories can bring home the reality of HIV/AIDS.

There are many sensitive issues that will need to be addressed when discussing this disease. These include: intimacy in sexual relations; abstinence and monogamy as well as specific safer sex practices including using a condom; intravenous drug use and sharing of needles; abuse of drugs; and caring for all types of people. These are very difficult issues to discuss at any time, but now with HIV/AIDS it is essential that we address them.

The virus which causes AIDS does not discriminate. It is not who you are, but what risk behaviors you engage in that put you at risk for becoming HIV positive. Congregations will find this the most challenging part of the education program, to put it mildly.

Experience in HIV/AIDS education over the past years has taught us that generally a persons needs 5 to 6 educational sessions to really begin to deal with the subject. Do not plan just a one day session.

The First United Methodist Church in Portland, Oregon planned a four session program for adults. Subjects covered included: HIV/AIDS basic information presented by a public health epidemiologist, "Living with AIDS" presented by two people who are HIV positive, world issues around AIDS, treatment schedules, and the church response to AIDS. It was discovered by the third session that four were really not enough. The next series will be longer.

Special all day workshops can be scheduled for the entire church, but they must be followed with more information at a later date. Ecumenical and interfaith workshops are also effective, bringing together outside experts who work full-time in HIV/AIDS.

b. Teens.

The planning committee should consult with the local school system and their local public health department to learn what education teens and elementary children already are receiving. In some states there are state laws or rules requiring HIV/AIDS education. The local church program should be planned with this knowledge.

It is very meaningful for teens and children to learn about HIV/AIDS in the church setting. Not only can they learn about the medical facts, they can discuss church teachings regarding caring for persons who are ill and for families in need. they can discuss how decisions are made regarding sexual behavior and IV drug use which put people at risk of HIV.

To be able to discuss these issues together at a special session after parents and students have completed HIV/AIDS educational sessions, or to be able to discuss these issues at home offers a unique opportunity for family communication. Youth and parents who are able to face these issues together will be more likely to make educated decisions when faced with risk taking behaviors. They will be more likely to respond with compassion to those within and outside the church who are affected by HIV Disease.

A foundation of on-going parent-child discussions about sexuality, intimacy, love belief systems and HIV/AIDS will have been established. Teens will know that our church is a caring church in a hurting world.

c. Children.

In kindergarten and elementary grades, the education message is very simple and age appropriate. These younger children need to know basic information about infection control in general, such as washing their hands with soap after going to the toilet. They can also be taught some specifics about what to do when a friend gets cut and bleeds. Children can learn that instead of touching a friend's blood, they can get a tissue for the friend to apply to the wound while another child seeks the help of a responsible adult.

Children also need to know that a virus causes AIDS, but that you do not get this virus by casual contact in the classroom or at church.

Many schools are beginning HIV/AIDS education in K--6, so the local school district should be contacted before doing this unit. They may have very good ideas which will supplement what the children are already learning in school.

As you begin to plan education programs for adults, youth and children in your congregation reach out for guidance and assistance. Turn to your local state or health department, the county medical society and community health professionals. Look for professionals who are AIDS-educated and AIDS-aware. You can also receive valuable assistance from the local Red Cross Unit, the Visiting Nurses Association, and from child and youth serving professionals who are involved prevention education. If there is a community-based AIDS organization in your town, be sure to be in touch with them, as well as with ecumenical and interfaith AIDS projects to get the names of people they have used to do education workshops and seminars.

These individuals and organizations should be able to recommend good educational resources, both printed and audio visual, which have been designed for different age groups, the various communities of color, for heterosexual couples, gays and lesbians, men and women, and for individuals and families who are affected by I.V. drug use and needle sharing.

3. Worship Services. A Message of Compassion.

Church services and the sermon can be planned in response to the HIV/AIDS education program in the church. Compassion for those already infected is a message appropriate to worship.

Emphasis can focus in the Biblical basis for the churches' response to this disease and the epidemic we are facing. How we as a church face this challenge will show our belief in the church as a healing, caring community. The way we care for those in our midst who suffer has been the topic of countless sermons. If Jesus were here today, He would be going to persons with AIDS and their loved ones just as He reached out to those who had sicknesses of body, mind or spirit in His day.

By addressing HIV/AIDS in the church service, we say we are a church committed to caring for all people: that we are committed to serving those with HIV/AIDS, their parents, and loved ones, and that we will not turn our back on them in their time of greatest need. By setting the example in the church, we open up our church members to take this compassionate message into their homes, workplace, and the greater community.

4. Written Policies on HIV/AIDS.

The United Methodist resolution, "AIDS and the Healing Ministry of the Church," adopted in April 1988, addresses the matter of workplace policies and the need for church programs to open their doors to adults, youth and children who are infected with HIV or who have been diagnosed with AIDS.

Here are two pertinent excerpts from the resolution. The first addresses the important role of education in policy development, and the second addresses the open stance which should exist regarding HIV positive employees and volunteers.

. . . educational efforts can prepare congregations to respond appropriately when they learn a member is HIV positive or diagnosed with AIDS, and can lead to the development of compassionate rational policies, educational materials and procedures related to the church school, nurseries, and other issues of institutional participation.

As a Church we call upon our general agencies, annual conferences, local churches and members to support the development of workplace policies that permit all persons with HIV/AIDS to work as long as they are able and wish to do so, with medical assurance that their presence in the workplace does not constitute a threat to co-workers or others.

The position of the church is clear. Persons with HIV or AIDS are not to be discriminated against in employment or volunteer activities, or denied participation in the services and programs of the church at any level.

In keeping with the denomination's resolution on AIDS, each local church should prepare written policies on HIV/AIDS infection. It is critical that these policies be written and that all staff know about the policies. Take action now to develop them. There is too much trauma around this disease to try to write appropriate policies when faced with an HIV positive employee.

The issues that need to be addressed include: specific policies for employees and volunteers who are HIV positive or who have been diagnosed with AIDS; specific policies for children and youth who are HIV positive or who have AIDS and who wish to participate in church programs; infection control policies which cover how to handle blood spills, and other bodily fluids such as semen and vaginal secretions including menstrual blood. (Infection control nurses in local hospitals are an excellent source of information.)

Infection control procedures must cover the proper disposal of any sanitary or waste products; how to give first aid; and ways to protect the health of the infected individual. If all children participate in cleaning cabins and bathrooms at camp, they all need to have proper instruction in use of gloves and disinfectants.

Special policies should be written for HIV positive children and youth who are participating in the church school, the nursery, day school, youth activities and camping programs. Such students should not be hindered from full participation in the life if the church. Adults in charge of these programs need training in infection control and knowledge about HIV/AIDS with special emphasis that it is not communicated by casual contact.

Each state has different laws regarding confidential information relating to HIV and AIDS. You should check with your county or state health department.

In Oregon and many other states, an AIDS diagnosis for an adult is totally confidential. Only the person with AIDS has the right to notify his or her employer about his/her condition; and there is no requirement that the employer or anyone else be notified. It is possible that an employee who is feeling well, even though AIDS diagnosed, will not tell their employer until the illness requires excessive time off from work. It is also possible that HIV positive persons (who are symptom free and who are unaware that they are infected) are already on our staffs or working with us as volunteers. for these reasons, it is important to treat everyone alike. This means applying infection control procedures at all times with regard to all persons.

Remember, infection control procedures apply in regard to First Aid situations, and other situations which require handling or disposing of blood, semen, and vaginal fluids including menstrual blood. Ordinary work place contact in church settings would rarely put one in contact with potentially infected bodily fluids, except in the case of cuts and wounds.

Decisions, also, need to be made as to how to show care and compassion in the following types of situations: seeing that a person is served communion even though he or she might lack energy to walk to the front of the church; being open to the needs and realities of same-sex partners, giving them the respect and attention (and same opportunity to make decisions) that would be given to any spouse whose loved one is ill or dying.

5. Services the Church Can Offer.

a. Counseling/Pastoral Care.

To PLWAs (persons living with AIDS), their loved ones and families these are critical services which every local church should be prepared to offer.

Learning to Live with HIV/AIDS. As drug therapies are perfected and available earlier to larger numbers of persons with HIV, it is to be hoped that more of these persons will be able to live longer, more productive, enjoyable lives.

A key role to pastoral care, in the midst of the AIDS crisis, is to help people live the fullest lives possible (physically, mentally and spiritually) while dealing with the uncertainties and, at times, terrible realities of a progressive disease.

Ministries that keep hope alive, and which embrace individuals and families when hope seems but gone, are a part of what our faith and our church are all about.

Care groups and support groups made up of persons with HIV/AIDS and their loved ones are critically important. They help individuals know they are not alone and that there are other people going through the same thing who are available to bear each other's sorrows and joy.

Learning to confront the Realities of dying and death. For many PLWAs, AIDS means they must think about dying and make preparations for death at an early age. As Lyle Loder stated in AIDS: A Healing Ministry, the video of the United Methodist Church's AIDS Consultation, he had to adjust to the reality that his elderly parents would have to bury him; whereas, as the youngest son, it had been Lyle's expectation and hope that he might live long enough to see his mother and father through their dying and death.

Lyle's death was a perfect example of why families need help with the life and death realities which are affecting them regarding their children, spouses and loved ones.

Caring for Families and Loved Ones. Many parents in the United States have learned that their sons were gay and living with AIDS at the same time. Some parents are able to accept their sons and to grow in their love for them. Others are not. For some it is almost more then they can bear. To all these families, the church can be present to offer compassionate counseling.

The church can also be there to assist in family reconciliation and to help mother and fathers understand that their son might have a same-sex partner who is hurting; who wants to continue to care for their son; and whom their son might have chosen to be the one to make decisions for him.

b. Use of Church Space and Facilities.

During much of the week most local churches have unutilized space which can be used by a local AIDS service organization for an office, meetings, education programs or group counseling sessions. PLWAs live all over the U.S., in towns small and large, and in urban and rural areas. In some of these places it is very difficult for AIDS service organizations to find space. Space donated by a local church can make the difference to these organizations which provide valuable services while functioning on a very meager budget.

c. Day Care.

Day care centers for persons with HIV Disease, including AIDS, are greatly needed in some communities. Churches are known for their adult Day Care Centers. Similar services, designed to meet the particular needs of persons with HIV/AIDS, can be developed by local churches.

Currently, in smaller communities, some of the houses for PLWAs are also offering day care to other PLWAs in the community. Day care programs provide a place where PLWAs can be together during the day while their parents or significant others go to work or enjoy a respite (break) from the responsibilities of caregiving.

d. PAL (Personal Active Listener).

As PLWAs become more homebound there area many simple tasks they just cannot perform. Some of these include, grocery shopping, preparing nutritious, well-balanced meals, cleaning the house, writing letters, making phone calls, and simply talking about their life and what AIDS has meant to them. Because we often have a difficult time talking about the most important issues in our lives, family members and loved ones might not be able to ask about, or want to discuss, the issues PLWAs wan and need to talk about.

Church members can, with training from the local AIDS community organizations, learn how to be a PAL or Buddy.

6. Additional Areas of Support and Education.

After having read this far, you probably have some ideas of your own about how your church can become involved. You know your own community needs and the resources in your church. Perhaps the following list will provide additional useful ideas.

a. Ecumenical/Interfaith Cooperation.

Ecumenical and Interfaith projects around HIV/AIDS are occurring in many areas. Become part of the one in your local area. (In Oregon, we have an HIV task force at Ecumenical Ministries of Oregon and have offered HIV/AIDS workshops for churches and counselors. We also have a Long Term Care Project for persons with AIDS which is seeking funding to open a facility. This project is much larger than any one denomination could do alone, but as an ecumenical project it is feasible.)

b. Direct Services.

As United Methodists we need to work with the child care programs, hospitals, and retirement and long term care facilities which are related to a connectional unit of our church to see that they are prepared to provide high quality, non-judgmental services to HIV positive children, youth, adults, families and loved ones.

c. Intersectoral Support.

Church members, congregations and annual conferences can support public schools and public health agencies in their HIV/AIDS education programs. Most schools in the country have begun HIV/AIDS education programs or will be starting them in the future. These public programs need support in dealing with controversial subjects.

d. Advocacy for Governmental Services/Programs.

As the church in action in our communities, we can encourage local and state governments to provide HIV/AIDS education and service to all citizens.

At the UMC National Consultation on AIDS Ministries in 1987, I was distressed by questions asked in a workshop I led about community resources. Some participants stated they had received no assistance from their health departments. As citizens you can request and expect such services.

e. Support for Community-based Organizations.

In a number of local communities there are community-based AIDS organizations. Some have been around since 1981 when AIDS was first defined by the Centers for Disease Control (CDC). Others are just beginning. These local organizations need support. They often need volunteers, facilities in which to meet, assistance in providing services for PLWAs, and access to community groups where they can speak about HIV/AIDS in the local area.

These community-based AIDS organizations were often the first and only resource to offer services to persons with HIV/AIDS. They deserve a very large thank you from the community, as well as cooperation and support for all the work they continue to do.

In summary, we are going to be faced to deal with HIV Disease, including AIDS, for the foreseeable future. The true test for the church is how we deal with it. Are we preparing now to offer preventive education in the church context? Or will we argue and appoint committees to study what our response will be and not become involved soon enough? The church has long been a pioneer in education, health and social change.

AIDS challenges us to act NOW, in the 1990's, and beyond. How we respond as a church community will send a loud message to our youth and the community at large. We must respond in the same positive and compassionate way the we have responded to other epidemics and national emergencies.

As a global church our response must show concern for those in our own communities, as well as in other countries and nations. We must be at work around AIDS in the world in which we live.