The question is posed on billboards by some of the region's most prominent black Baptist, A.M.E., and Muslim clergy: We Have Been Tested for HIV. Have You?
It is provocative, unusual, and, the pastors say, the beginning of what they hope will be a public conversation about an infection that is devastating the African American community, particularly in Philadelphia.
More than 100 houses of worship have committed to raising the issue in some form over the next few weeks, organizers say. At least 30 will host HIV testing on site. Dozens of pastors will speak from the pulpit - in some cases mentioning resources and statistics, in others crafting sermons around the story of Jesus healing the leper.
Many black clergy have been reticent about publicly discussing a disease that is often spread through homosexuality or multiple sex partners. The billboards are partly intended to get them thinking about new approaches.
"I'm steadfast on [preaching] abstinence," said the Rev. Kevin R. Johnson, senior pastor of Bright Hope Baptist Church in North Philadelphia. But he insists that couples who are getting married be tested - and did so himself before the congregation at a morning service in May.
"This is the first time that I have seen pastors come together in a collective way to address this epidemic," Johnson said. "My hope and prayer is that people will be as informed about HIV/AIDS and that their lifestyles will change so that the epidemic does not spread any further."
Even the leaders admit surprise at some statistics, most of which are not new:
- About 2 percent of Philadelphia's black population is infected. African Americans account for more than two-thirds of those living with HIV or AIDS. (Hispanics make up 12 percent and whites 20 percent.)
- Nearly 30 percent of the city's HIV-positive population is female. More than 70 percent is over age 40.
- Heterosexual sex is the most common risk factor for HIV here. While the shape of the epidemic varies around the country, a study published in September found that Philadelphia is by far the most heterosexual among the 12 cities with the most cases. (Men who have sex with men, however, account for the biggest percentage increase here in recent years.)
"You don't know who has got it anymore. You don't know whom to be careful with," said Imam Abdul Malik Ali of Masjid At-Taqwa mosque in Trenton. At an HIV workshop, he recalled, "a woman stood up and said, 'I'm HIV-positive.' And people said, 'What? She is gorgeous!' If she hadn't stood up, you would have never known."
"If we speak to our congregations," said the Rev. Alyn E. Waller, "our congregations speak to their relatives and friends, and the word gets out." He is senior pastor of Enon Tabernacle Baptist, the megachurch on Cheltenham Avenue.
"It gets to the stigma issue because we are joining with the [Centers for Disease Control and Prevention] in suggesting that everyone, from 13 to 65, get tested. So getting tested now is not about shame," said Waller, whose church tested 1,000 congregants in one day in 2007.
The campaign has unusual roots. Amy Nunn, a social-science researcher at Brown University School of Medicine who focuses on racial disparities in HIV, wanted to study prevention strategies involving the church.
"African Americans have seven times the rate of HIV infection as whites nationally, and scientifically, we cannot explain why that is," Nunn said. ". . . One thing that is important is thinking what churches can do that we [experts] can't do."
She invited about 50 faith leaders to participate in focus groups in June. The research session opened with two prayers - one Christian, one Muslim - and then Nunn asked the assembled to "name the elephant in the room."
"You're white!" exclaimed Waller.
For several hours, the participants - secular and religious, people with liberal views on homosexuality, and others on the conservative side - learned about the epidemic and discussed prevention strategies in small groups. Then Waller again took the floor.
"He is very provocative," Nunn recalled, "and he said: I know a lot of you wouldn't come out for me on a Thursday morning, and I know I wouldn't come out for a lot of you on a Thursday morning, but how bad is it that it took somebody from out of town . . . to come talk about this crisis in our community?"
And then, Waller recalled, he challenged the room to work together to reduce HIV in Philadelphia.
The Rev. Marguerite E. Handy, executive director of the Mayor's Office of Faith-Based Initiatives, persuaded Clear Channel Outdoors to donate the five billboards, which are strategically placed in high-HIV neighborhoods and will get an estimated 1.7 million views over four weeks. Handy, who is on the billboard, also contacted thousands of pastors.
The Kaiser Family Foundation printed up thousands of information packets, buttons, even church fans listing "5 ways you can be greater than AIDS." Handy and Nunn will distribute some of them when they address a quarterly convention of the African Methodist Episcopal Church on Friday in Philadelphia, hoping to bring more clergy on board.
Much of the campaign is straight talk about facts.
"People tend to have sex with people of their own racial or ethnic group," said city health commissioner Donald Schwarz, whose department is supporting the campaign.
So, just being African American raises your risk, he said, and getting a negative HIV test for you or your partner doesn't change that: HIV is most contagious during the first three months of infection, but a test usually will not catch it for six months. "Safer sex practices are critical here."
Nunn, who is leading the effort, along with Handy and Waller, found through her own research that many people at highest risk of contracting HIV perceive themselves to be at lowest risk. Heterosexual black women, for example, make up one demographic where infections are on the rise.
They also tend to go to church. And they need to know that HIV is not just a gay disease, said the Rev. Jay Broadnax, pastor of Mount Pisgah A.M.E. Church in West Philadelphia. "It is an everybody disease right now."
Will preaching, testing, and teaching make a difference?
"I think it will have an effect, but it is going to be very slow," said a 60-year-old woman who has told just four people - her mother, daughter, husband, and one friend - that she has been HIV-positive for 10 years.
"There is a lot of denial. It is taboo. Some people don't even think it exists, that it is a hoax," said the woman, a retired schoolteacher with a master's, who did not want to be identified because of the stigma.
"I didn't think I was at risk. I thought it was something that happened to gay men. I thought it happened to people who used drugs. I thought it happened to people who were promiscuous.
"I was none of that. All I did was meet somebody, fall in love - one partner - and, you know, I was at risk."
Contact staff writer Don Sapatkin at 215-854-2617 or email@example.com.