Background:
HIV/AIDS-related stigma is an important barrier to HIV/AIDS prevention and control. Many institutions uphold belief systems which include social messages that may influence or perpetuate HIV-related stigma. Churches are essential institutions within which to work to address HIV-related stigma as they represent an important socializing force in the United States, especially in minority communities.

Objective:
To explore how Christian churches in Baltimore City, Maryland have responded to HIV/AIDS, how religious doctrine influences the prevention and care activities in which a church may be involved, and, when conflicts between doctrine and programming occur, how they are reconciled.

Method:
Between February 2005 and January 2006, in-depth interviews were conducted with 24 religious representatives from a variety of Christian faiths in Baltimore.

Result:
While many churches are engaged in HIV/AIDS service delivery and care, prevention activities were less common. Many participants relayed that moral codes based on religious doctrine make it difficult for some churches to embrace certain aspects of prevention such as the need for explicit sexual discussion. Others reported finding biblical justification to support such activities. Most often church leaders who engaged in comprehensive HIV/AIDS prevention education described that they did not condone risk behaviors such as pre-marital sex or homosexuality, yet felt compelled to address these issues due to the community which they serve and/or personal experience

Conclusion:
HIV-related prevention and care activities implemented by churches may be limited due to the specific religious doctrine of the institution. Efforts are needed to increase awareness among church leaders and members of how such biases may result in stigmatization of those infected with or at risk for HIV/AIDS.

Implications:
In-service trainings should be developed that enable church leaders to critically examine how biases in HIV/AIDS activities due to religious doctrine may potentially perpetuate HIV-related stigma.