“Loving the sinner, hating the sin”: an investigation of religious leaders’ perceived role in the lives of persons living with HIV in Soweto, South Africa

# Background In South Africa, the Church has historically played an important role in the lives of the Black population. In light of the high number of Black persons living with HIV/AIDS (PLWHA) in the country, it is important to explore religious leaders' perceptions of HIV/AIDS and PLWHA to inform the development and implementation of faith-based interventions. # Aims This article explores Christian religious leaders' perceptions of people living with HIV/AIDS (PLWHA) in Soweto and the role of religious institutions in the lives of PLWHA. # Methods We conducted a mixed-methods cross-sectional study of religious leaders serving in Soweto. A questionnaire was administered to 45 religious leaders who self-identified as Black, Christian, and serving congregations in Soweto. The questionnaire included general demographic information about the religious leaders and their Churches, perceptions of the role of the Church in the lives of PLWHA, and HIV-related stigma. Of the questionnaire respondents, 26 participated in qualitative interviews. Survey and interview results were analysed separately, then compiled for additional analysis. # Results Leaders reported HIV/AIDS is a concern (40%) or great concern (49%) to the Church and 84% believed the Church should support PLWHA, yet 80% reported persisting HIV-related stigma. Expectations of PLWHA depended primarily on the mode of infection: if as a result of 'sinful' behaviour (pre/extra-marital sex), spiritual reconciliation is needed; when as a result of another's behaviour (spouse, rape, mother-to-child), making peace and forgiving is important. Leaders saw themselves as 'restorers' of the faith of PLWHA. Despite the overwhelming compassion and willingness to be of assistance, religious leaders (71%) admit to having inadequate skills to address HIV/AIDS-related stigma and resources needed to support people living with HIV/AIDS. # Conclusions Religious leaders are willing to tackle HIV/AIDS-related issues in their congregations but need the appropriate support and training to address HIV stigma and to provide support to PLWHA.