Christian Leadership on HIV/AIDS Advocacy in Southern Africa

Guided by the social capital theory, this study systematically reviews empirical evidence on Christian leaders’ advocacy roles in HIV prevention across Southern Africa. The objective was to assess how different forms of social capital shape the effectiveness of faith-based HIV advocacy across the region. The review was conducted in accordance with the PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted between January and June 2025, covering peer-reviewed studies published in English from 2001 to 2021. The eligible studies employed qualitative, quantitative, or mixed methods; and explicitly examined Christian leaders’ HIV/AIDS advocacy within Southern African contexts. Fifteen studies met the inclusion criteria. Methodological quality was appraised using the mixed methods appraisal tool (2018), with most studies rated moderate to high quality. The findings indicate that prevention and behaviour change initiatives rooted in bonding social capital within congregations represent the most consistent and impactful dimension of Christian HIV advocacy. Dense, trust-based pastoral networks were associated with improved HIV awareness, reduced stigma, strengthened caregiving practices, and enhanced treatment adherence. In contrast, community engagement, partnerships with public health actors, and policy advocacy broadened reach through bridging and linking social capital; but yielded more variable outcomes, often constrained by limited technical capacity, donor dependency, and structural inequalities. Overall, faith-based HIV advocacy is most effective when inclusive and trust-based relationships are strategically aligned with biomedical knowledge. The study concludes that strengthened theological engagement, targeted clergy training, and equitable collaboration with public health stakeholders are essential to enhance sustainability and structural impact.