Exploring pastoral attitudes and lived experiences of people living with HIV and/or AIDS: A case study of churches in Thulamela Municipality, South Africa

Background: The role of the church in addressing healthcare disparities, particularly human immunodeficiency virus (HIV) and/or acquired immunodeficiency syndrome (AIDS), and how pastors’ attitudes influence the development and effectiveness of HIV and/or AIDS interventions remains underexplored. Aim: This study aimed to examine pastors’ attitudes towards people living with HIV (PLWH) and to explore the lived experiences of PLWH in relation to these attitudes. Setting: Participants included pastors and congregational members living with HIV who resided in Thulamela Municipality and were affiliated with various Christian denominations. Methods: A qualitative phenomenological design was employed using semi-structured interviews. Purposive sampling was used to recruit nine pastors, while six PLWH were recruited through snowball sampling. All participants resided in Thulamela Municipality. Results: Findings indicated that pastors generally expressed sympathetic, non-judgemental and normalising attitudes towards PLWH. However, discussions around sexuality and HIV and/or AIDS were often considered taboo within the church context. People living with HIV reported experiencing stigma, and a prevailing belief among congregants attributed HIV transmission to individuals outside the church. Some participants also associated HIV infection with demonic possession. Conclusion: While pastors demonstrated compassion towards PLWH, inadequate knowledge contributed to persistent negative attitudes and stigma. Enhanced collaboration among pastors, interdenominational forums, healthcare professionals and communities is essential to promote accurate information sharing, reduce stigma and improve HIV and/or AIDS responses within faith-based settings. Contribution: This study highlights how pastor-led biblical discourse, influenced by limited theological training, shapes attitudes towards HIV and/or AIDS and underscores the need for stronger collaboration between churches and public health.