Objective: To examine the impact of 2 mitigating social institutions, religious organizations, and the state, on Malawi women's vulnerability to HIV.
Design: In-depth interviews with a purposive sample of 40 central leaders from 5 faith-based organizations in Malawi were recorded and transcribed as part of an on-going larger study. Qualitative description was used to identify themes and categories.
Setting: Primarily urban and periurban areas of south-central Malawi.
Participants: A minimum of 6 leaders from each faith-based organization were interviewed; the mean age of the primarily male (68%) participants was 44 years (range 26-74).
Results: Analysis of religious leaders' messages about HIV produced an overarching theme, the condom divide, which conceptualized the divergence between faith-based organizations and the state's prevention messages related to HIV prevention strategies.
Conclusion: Faith-based organizations have "demonized" state messages about condoms as promoting sin. The faith-based organizations' insistence on abstinence and faithfulness leaves women with few options to protect themselves. As socially conscious citizens of the world, nurses can increase the responsiveness to the disparate levels of suffering and death in countries like Malawi.