HIV and AIDS remains a starkly gendered epidemic in the African region. Sub-Saharan Africans represent 68 percent of HIV+ people globally, with an average of 13 women infected for every 10 men. While men as a group have lower prevalence rates than women, local studies have also shown that amongst men, men who have sex with men (MSM) face greater vulnerability to HIV infection than heterosexual men. These gendered realities make it imperative to analyse and contest the influence of sexist and homophobic fundamentalist actors on policy and popular discourse across Africa. Drawing on interviews with African and international HIV and AIDS activists, women’s rights activists, and academic and policy research, this case study explores the agendas, strategies, and influence of Christian fundamentalist actors in HIV and AIDS responses in the African region.

It examines how Christian fundamentalist engagement in the HIV and AIDS sector has supported the moralistic patriarchal discourses around sexuality, gender, and sexual practices, and continues to affect practice and policy on HIV and AIDS treatment and prevention. The case study shows in conclusion that women’s rights and other progressive African activists involved in HIV and AIDS responses recognise that some faith-based initiatives are already and can continue to play a constructive role in the multi-sectoral response to HIV. It is nevertheless vital that progressive activists engage with and better understand the faith sector in terms of fully analysing discourses and challenging approaches that impact negatively on health outcomes and on human rights, particularly on women’s rights and those of LGBTI people.