by Grayson Hester

To tell this story about a ministry in the Knoxville, Tenn., area in 2021, we have to travel back in time to rural Indiana in 2015.

Scott County, Indiana, a majority-white, rural, working-class area, only notable, as many such counties are, for not being very notable, suddenly found itself the epicenter of both an HIV outbreak and a media firestorm.

While under former Vice President Mike Pence’s governorship, this county experienced one of the worst and most concentrated HIV outbreaks in recent United States history. An area that usually saw three to four new HIV cases per year began to buckle under the weight of 230 new cases in just a few months.

By now, the logic of spreading disease is second nature to most Americans, wearied as we are by over a year of COVID-19 news coverage. But, five years prior, this phenomenon baffled scientists and the nation alike.

Eventually, epidemiologists traced the cases back to one person living with HIV, who had moved to Scott County and shared a syringe with a small group of people. This prompted the Centers for Disease Control to launch a full-scale investigation into the spread of HIV in areas previously seen as low-risk to an infection typically associated with urban areas.

Its findings forever changed the way advocates view the disease.

The CDC assigned to 220 counties a ranking of “most vulnerable” to HIV and Hepatitis C spread. Of those 220, 42 were in Tennessee, another 42 were in Kentucky, and a significant number were scattered throughout Ohio, West Virginia, Western North Carolina and North Georgia.

In short, Appalachia, where much coverage has centered solely around the opioid crisis, to the exclusion of its “syndemic” issue, bloodborne HIV and Hepatitis C. 

And that’s where Central Baptist Church Bearden’s Samaritan Ministry enters the picture.

“What can we do to advocate for direction and information to help save lives?” asked Wayne Smith, director of Samaritan Ministry. “What can we do as a small HIV organization to push into those other two areas?”

Founded in 1996, Samaritan Ministry is an official ministry of Central Baptist Church Bearden in Knoxville, Tenn., and a long-time partner of Tennessee CBF, that ministers to and serves people living with HIV/AIDS. And while this ministry remains its primary focus, the shifting nature of injection drug use—centered primarily around opioids—has guided its arms into more expansive outreach.

“Our goal is to teach people about it and let them know about the connection,” Smith said. “HIV can be spread by sharing needles. We’ve been talking so much, and so long, about sex, that sometimes I wonder if we need to be sure we’re telling the whole story.”

While Smith noted that sexual contact is still the primary means by which HIV is spread­—85 percent of cases are transmitted this way—he emphasized that injection drug use is still a major issue.

So major, in fact, that he convinced the pastor of Central Baptist, the Rev. Dr. Wade Bibb, to greenlight a five-week-long, churchwide series on the syndemic of opioid use, Hepatitis C and HIV. “Syndemic” is a term used to describe epidemics that are so interconnected as to not only occur simultaneously, but to influence and worsen the other.

The church titled the series “Remove the Risk” and spent a large amount of time educating its members about the connections among the spread of HIV, Hepatitis C and the opioid crisis.

“It gave me an opportunity to talk about Samaritan Ministry at our church and educate people that there’s a connection,” Smith said. “I hoped to push into people’s hearts a little bit that the opioid crisis is real and that it affects our families. We’ve been touched by it at Central Bearden.”

In addition to education, Smith led the church in a removal effort. It’s difficult to dispose of opioids without risking damage to the environment and/or other people, which is why it’s common for people to leave, for months on end, powerful painkillers in their homes, potentially fueling addiction.

A recent technology aims to fix this.

“We distributed Deterra, a drug de-activation pouch,” Smith said. “It’s an aluminum pouch you can put medications in. You put a little water in there, zip it up, and the charcoal preparation deactivates the medication.”

The church’s “Remove the Risk” series demonstrated, in microcosm, what Samaritan Ministry seeks to achieve in the Knoxville area broadly—education and meaningful action.

And that is likely why Together for Hope, CBF’s rural development coalition, emerged as a natural partner for its efforts.

In the past year or so, Together for Hope Appalachia, spearheaded by Keith Stillwell and headquartered in nearby Danville, Ky., has become fast friends with Samaritan Ministry. In recent weeks, by signing a memorandum of understanding (MOU), the partnership became official.

“It says we affirm each other, that we’ll list them as a partner, names us as a partner, and that we’ll work together where we can,” Stillwell said. “It’s mostly just to say, ‘We’re on the same team.’”

Since nothing about the MOU is legally binding, its thrust lies primarily in its symbolism and the trust shared by the two parties who signed it.

What it symbolizes is a more holistic view of the two issues each institution seeks to address—HIV/AIDS and, in Together for Hope’s case, intergenerational poverty.

“We serve 57 counties who were named by the USDA as experiencing ‘persistent poverty,’” Stillwell said. “We’re about poverty alleviation through asset-based community development. We work on building a coalition by consistently finding partners who share that approach to poverty alleviation.”

When people think of rural poverty, it’s doubtful that HIV, Hepatitis C or even opioid use are the first images that pop into their minds. It certainly wasn’t the case for Central Baptist Bearden’s congregation, or for the Fellowship.

But, if this partnership signals anything, it’s that one issue cannot be tackled without also tackling the other.

“To the degree that HIV/AIDS contributes to poverty, all of that is related to access to healthcare, jobs, education, adequate housing,” Stillwell said. “It’s all a piece of what is abundant life, a safe, secure life.”
Smith put a finer point on the interconnectedness of rural poverty and the HIV-Hep C-opioid syndemic.

“If you take the counties in Appalachia that are classified as experiencing ‘persistent poverty’ that Together for Hope focuses on and overlay that with the counties that the CDC has identified as most vulnerable to HIV/Hep C—it’s incredibly similar,” he said.

As to why this kind of partnership is so notable, and why Samaritan Ministry’s work is (and always has been) unique among churches, Smith had one word: stigma.
Those living with HIV/AIDS not only have to navigate chronic illness and an unfeeling healthcare system; they also have to endure crushing stigma that often leaves them marginalized, ostracized and alone.

In this way, the AIDS crisis of the 1980s never ended and, indeed, is just as strong now. This is to say nothing of its impact on Black and Brown communities, which is disproportionate and often ignored. 

“The fact that the South has higher rates of HIV than the rest of the country can be laid at the foot of religious conservatism,” Smith said. “Religion has gotten its nose in the way of public health practices.”

It is no accident that these areas, experiencing an outbreak of this syndemic, are both majority white and overwhelmingly conservative. And churches not only contribute to this spread, but are rarely, if ever, at the tables established to help address it.

This newfound partnership seeks to buck this trend.

“The message of God’s love is for all people, especially for a group that’s been so ostracized, abused, marginalized,” Stillwell said. “And I’m just so impressed that Central Baptist Bearden has that ministry. And Wayne’s leadership in that—he’s just an awesome guy.”

Stillwell and Smith agreed that sharing God’s love was the primary impetus for their partnership and their respective ministries. And, in this way, they agreed too, that, together, there is hope aplenty.

“Keith and I both recognized this is an opportunity to re-energize this conversation in CBF life,” Smith said. “That’s what I hope for—that Together for Hope will give HIV/AIDS a little more of a voice in the conversation with CBF and then, of course, with the Appalachian network and Together for Hope globally, for all those folks, to see how poverty, Hepatitis C and HIV fit together.”

Learn more about the work of Samaritan Ministry at www.samaritancentral.org.This article first appeared in the Summer 2021 issue of fellowship! magazine. Read online and subscribe at www.cbf.net/fellowship.