Abstract
BackgroundKagera is one of the 22 regions of Tanzania mainland, which has witnessed a decline in HIV prevalence during the past two decades; decreasing from 24% in 1987 to 4.7 in 2009 in the urban district of Bukoba. Access to social capital, both structural and cognitive, might have played a role in this development. The aim was to examine the association between individual structural and cognitive social capital and socio-economic characteristics and the likelihood of being HIV infected.MethodsWe conducted a population-based cross-sectional study of 3586 participants, of which 3423 (95%) agreed to test for HIV following pre-test counseling. The HIV testing was performed using enzyme-linked immunosorbent assay (ELISA) antibody detection tests. Multiple logistic regression analysis was applied to estimate the impact of socio-economic factors, individual structural and cognitive social capital and HIV sero-status.ResultsIndividuals who had access to low levels of both structural and cognitive individual social capital were four and three times more likely to be HIV positive compared to individuals who had access to high levels. The associations remained statistically significant for both individual structural and cognitive social capital after adjusting for potential confounding factors such as age, sex, marital status, occupation, level of education and wealth index (OR =8.6, CI: 5.7-13.0 and OR =2.4, CI: 1.6-3.5 for individual structural and cognitive social capital respectively). For both women and men access to high levels of individual structural and cognitive social capital decreased the risk of being HIV infected. This study confirms previous qualitative studies indicating that access to structural and cognitive social capital is protective to HIV infection.ConclusionsWe suggest that policy makers and programme managers of HIV interventions may consider strengthening and facilitating access to social capital as a way of promoting HIV preventive information and interventions in order to reduce new HIV infections in Tanzania.
Highlights
Kagera is one of the 22 regions of Tanzania mainland, which has witnessed a decline in HIV prevalence during the past two decades; decreasing from 24% in 1987 to 4.7 in 2009 in the urban district of Bukoba
The HIV prevalence decreased with increasing access to high levels of individual structural social capital: 15.5% (CI: 13.5-17.5) for individual with access to low level of structural social capital, 11.4% (CI: 8.9-13.9) for those with medium level of structural social capital and 4.5% (CI: 3.2-5.8) for individual with access to high structural social capital (Table 2)
Women with low access to individual structural and cognitive social capital had a higher prevalence of HIV infection (19.0%, confidence intervals (CI): 16.1-21.9 and 20.7%, CI: 18.1-23.8) compared to women with high access (5.4%, CI: 3.3-6.7) and 8.4%, CI: 5.0-10.9)
Summary
Kagera is one of the 22 regions of Tanzania mainland, which has witnessed a decline in HIV prevalence during the past two decades; decreasing from 24% in 1987 to 4.7 in 2009 in the urban district of Bukoba. The aim was to examine the association between individual structural and cognitive social capital and socio-economic characteristics and the likelihood of being HIV infected. Several studies have examined the association between poverty, gender inequality, sexual behaviors and HIV infection to explain the development of the HIV/AIDS epidemic [1,2,3]. Tanzania is among the few African countries that have registered a decline in HIV prevalence. The government created the portfolio of a Deputy Minister for Disasters and HIV and AIDS under the Prime Minister’s Office and allowed many civil society organizations to be registered to involve themselves in the fight against the epidemic. The government increased the funding for HIV/AIDS activities both from government and donor resources and ensured that substantial funds reached the communities
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