Exploring the role of cognitive and structural forms of social capital in HIV/AIDS trends in the Kagera region of Tanzania — a grounded theory study

  • Gasto Frumence
  • Malin Eriksson
  • Lennarth Nystrom
  • Japhet Killewo
  • Maria Emmelin

Abstract

The article presents a synthesis of data from three village case studies focusing on how structural and cognitive social capital may have influenced the progression of the HIV epidemic in the Kagera region of Tanzania. Grounded theory was used to develop a theoretical model describing the possible links between structural and cognitive social capital and the impact on sexual health behaviours. Focus group discussions and key informant interviews were carried out to represent the range of experiences of existing social capital. Both structural and cognitive social capital were active avenues for community members to come together, empower each other, and develop norms, values, trust and reciprocal relations. This empowerment created an enabling environment in which members could adopt protective behaviours against HIV infection. On the one hand, we observed that involvement in formal and informal organisations resulted in a reduction of numbers of sexual partners, led people to demand abstinence from sexual relations until marriage, caused fewer opportunities for casual sex, and gave individuals the agency to demand the use of condoms. On the other hand, strict membership rules and regulations excluded some members, particularly excessive alcohol drinkers and debtors, from becoming members of the social groups, which increased their vulnerability in terms of exposure to HIV. Social gatherings (especially those organised during the night) were also found to increase youths’ risk of HIV infection through instances of unsafe sex. We conclude that even though social capital may at times have negative effects on individuals’ HIV-prevention efforts, this study provides initial evidence that social capital is largely protective through empowering vulnerable groups such as women and the poor to protect against HIV infection and by promoting protective sexual behaviours.

Keywords: Africa, behaviour change, community empowerment, health behaviour, HIV/AIDS, sexual behaviour

African Journal of AIDS Research 2011, 10(1): 1–13

Author Biographies

Gasto Frumence
Muhimbili University of Health and Allied Sciences, Department of Development Studies, PO Box 65454, Dar es Salaam, Tanzania; Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, SE-901 85 Umeå, Sweden
Malin Eriksson
Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, SE-901 85 Umeå, Sweden
Lennarth Nystrom
Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, SE-901 85 Umeå, Sweden
Japhet Killewo
Muhimbili University of Health and Allied Sciences, Department of Biostatistics and Epidemiology, PO Box 65015, Dar es Salaam, Tanzania
Maria Emmelin
Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, SE-901 85 Umeå, Sweden; Lund University, Department of Clinical Sciences, Social Medicine and Global Health, SE-205 02 Malmö, Sweden
Section
Articles

Journal Identifiers


eISSN: 1608-5906
print ISSN: 1727-9445