Many faith-based organizations (FBOs) are providing valuable care and support to people living with and affected by HIV/AIDS. The overall response of FBOs, however, has been controversial, particularly in regards to HIV/AIDS prevention and FBO’s rejection of condom use and promotion. This response has negatively influenced national HIV/AIDS prevention response efforts. The aim of this thesis is to explore the factors influencing the HIV/AIDS prevention policy process within faith-based non-governmental organizations (NGOs) of different faiths, and in particular how faith is reflected in and interacts with this process. These processes were examined within three faith-based NGOs in Dar es Salaam, Tanzania – a Catholic, Anglican and Muslim organization. The research used an exploratory, qualitative case-study approach. It employed a health policy analysis framework, examining the context, actor, and process factors and how they interact to form content in terms of policy and practice within each organization. Three key factors were found to influence faith-based NGOs’ HIV/AIDS prevention policy process in terms of both policy development and implementation: 1) the faith structure in which the organizations are a part, 2) the presence or absence of organizational policy, and 3) the professional nature of the organizations and its actors. The interaction between these factors, and how actors negotiate between them, was found to shape an organization’s HIV/AIDS prevention policy process. By understanding the factors and processes that influence faith-based NGOs’ HIV/AIDS prevention policy process, and how this conflicts with the national policy response, more appropriate policies can be developed and implemented within faith-based NGOs. Furthermore, the government may be better able to identify how best to intervene and/or work with faith-based NGOs in order to meet their HIV/AIDS prevention targets, and achieve a more uniform and evidence-based approach to HIV/AIDS prevention.

Alternative beliefs about HIV – such as the man‐made origins of the virus or the secret existence of a cure ‐ can undermine trust in, and engagement with HIV prevention and treatment initiatives. These effects make understanding such beliefs an important component of responding to HIV/AIDS in South Africa. Echoing Robins’ observation that the current era allows for “the possibility of critical reflection on the ways in which contestations over scientific truth unfold under particular historical conditions” (2009a), this thesis seeks to reconsider dominant explanations for alternative beliefs about HIV/AIDS in South Africa. Previous studies maintain that the experiences of apartheid, the transition to democracy, and the early years of the new government have had permanent implications for the public’s trust in biomedical claims. In this thesis I argue that in addition to these explanations, individuals express distrust about HIV science because certain aspects of these scientific explanations do not ‘add‐up’, particularly when considered in light of their everyday observations and experiences. These disjunctures in information do not simply reflect a lack of HIV knowledge or rejection of scientific principles. Rather, in drawing on past and present experiences, individuals demonstrate their commitment to “street‐level epistemologies of trust” (Hardin 1992), an informal manner of empirically engaging with science’s rationale. Employing the Public Understandings of Science (PUS) framework to analyze these beliefs, this study conceptualizes trust and mistrust of scientific and official claims about HIV along a spectrum. Study participants endorse a range of alternative beliefs and knowledge about HIV/AIDS. They cite experiential and observational reasons to justify why they trust some authority figures and not others. In their role as trusted sources of information about HIV, peer educators with the Treatment Action Campaign draw on various “rhetorics of persuasion” (Robins 2009b) in order to lend practical plausibility to their claims. Ultimately, this study argues that respondents’ distrust of HIV science should be seen less as a rejection of scientific principles and more as a form of skeptical engagement with certain aspects of these scientific claims.