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

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.

Social capital and health in the least developed countries: A critical review of the literature and implications for a future research agenda

“…All four studies used qualitative methods to explore the relationship between social capital and health. Using grounded theory to develop their theoretical model, Frumence and colleagues (2011) studied how structural and cognitive forms of social capital (e.g., group membership, trust, and social norms) may have influenced the progression of the HIV epidemic in three villages of Tanzania. Although it was unclear whether the study defined social capital as an individual or collective attribute, they found that both aspects of social capital protected against HIV infection by expanding access to formal and informal networks and empowering vulnerable groups to practice safer sexual behaviours.…”

“…All of the studies related to HIV and other infectious diseases were qualitative in nature (Frumence et al . 2010, 2011, Ware et al . 2009, Edgeworth and Collins 2006).…”

Access to social capital and risk of HIV infection in Bukoba urban district, Kagera region, Tanzania

“…In a previous qualitative paper [ 30 ], we explored different mechanisms through which social capital in the Kagera Region may have influenced sexual related behaviors. We hypothesized that social capital had facilitated the development of a conducive environment for members of social networks to reduce number of sexual partners, to abstain from sexual relations until marriage for the young generation, to have fewer opportunities for casual sex, and empowerment of community members to demand use of condoms.…”

Recovering disrupted social capital: insights from Lao PDR rural villagers’ perceptions of local leadership

“…In many less-developed, local leaders such as village heads, elders, and traditional authorities in Lao PDR are often key decision-makers for community development and health efforts [8, 9, 12, 23]. Especially village heads—who are elected every 3 years by receiving the highest number of votes among five candidates who were screened by district Party officials and the Governor’s office—can be influential enough to induce changes in the social and cultural behaviors of communities [10, 24]. Village heads are responsible for various administrative duties that include but are not limited to “solving conflicts, keeping village records, facilitating local development efforts, and more recently collecting taxes” [24].…”

“…In addition, where people are alike in terms of socio-demographic and economic conditions, they are likely to share similar social and cultural identities. Especially in a traditional society, they are influential enough to induce change in the social and cultural behaviors of communities [10]. In this setting, local leaders are in a better position to influence trust, solidarity, and effective community networks among villagers through various types of socio-economic involvements [11].…”