Social Capital and Women's Reduced Vulnerability to HIV Infection in Rural Zimbabwe

Abstract

Social capital—especially through its “network” dimension (high levels of participation in local community groups)—is thought to be an important determinant of health in many contexts. We investigate its effect on HIV prevention, using prospective data from a general population cohort in eastern Zimbabwe spanning a period of extensive behavior change (1998–2003). Almost half of the initially uninfected women interviewed were members of at least one community group. In an analysis of 88 communities, individuals with higher levels of community group participation had lower incidence of new HIV infections and more of them had adopted safer behaviors, although these effects were largely accounted for by differences in socio-demographic composition. Individual women in community groups had lower HIV incidence and more extensive behavior change, even after controlling for confounding factors. Community group membership was not associated with lower HIV incidence in men, possibly refecting a propensity among men to participate in groups that allow them to develop and demonstrate their masculine identities—often at the expense of their health. Support for women's community groups could be an effective HIV prevention strategy in countries with large-scale HIV epidemics.

O Programa Nacional de Controle do Tabagismo (PNCT) na perspectiva social: a análise de redes, capital e apoio social

“…O capital social tem, destarte, importante impacto sobre a saúde, visto que a qualidade das relações sociais está associada a várias enfermidades, sendo considerado um importante determinante social para a saúde [81][82][83] . Eriksson 84 afirma que um indivíduo inserido em redes tem mais chances de acesso a diferentes formas de capital social e o envolvimento em diferentes redes resulta na criação de normas de reciprocidade e, consequentemente, confiança entre pessoas.…”

Investing in Communities Achieves Results

“…However, it appears that the type of group matters; results vary by gender (the result of reduced HIV incidence in Zimbabwe was only present for women), with decreased HIV incidence only among women); and the stage of the HIV epidemic may impact the size of the effect. Source: Gregson et al 2011. Reprinted with permission from the Population Council.…”

“…Participation in community groups enables members to engage in critical dialogue about HIV and AIDS. Source: Gregson et al 2011. Reprinted with permission from the Population Council.…”

“…Evidence from this evaluation suggests that group membership played an important role in the decline in national HIV prevalence. Strong associative evidence was found that participation in a community group was associated with reduced HIV incidence for women (aIRR = 0.64, CI: 0.43-0.94) during the period 1998-2003 (Zimbabwe Evaluation Report 2011b and Gregson et al 2011). New findings from the Zimbabwe Evaluation Report indicate that for HIV incidence, (i) there was a dose effect in 1998-2003; and (ii) the effect of group membership disappeared in the subsequent period (2003)(2004)(2005)(2006)(2007)(2008).…”

“…However, this effect is dependent on gender and setting. Source: Gregson et al 2011. Reprinted with permission from the Population Council.…”