Department of Development Studies, Muhimbili University of Health and Allied Sciences, PO Box 65454, Dar es Salaam, Tanzania.
Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö, SE-205 02 Sweden.
Arch Public Health. 2014 Nov 3;72(1):38. doi: 10.1186/2049-3258-72-38. eCollection 2014.
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. 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.
We 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.
Individuals 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.
We 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.
卡盖拉是坦桑尼亚大陆的 22 个地区之一，在过去的二十年中，该地区的艾滋病毒流行率有所下降；从 1987 年的 24%下降到 2009 年布科巴市区的 4.7%。获得结构性和认知性社会资本可能在这一发展中发挥了作用。目的是研究个人结构性和认知性社会资本与社会经济特征之间的关联，以及它们与艾滋病毒感染的可能性。
我们对 3586 名参与者进行了一项基于人群的横断面研究，其中 3423 名（95%）在接受预测试咨询后同意接受艾滋病毒检测。艾滋病毒检测使用酶联免疫吸附测定（ELISA）抗体检测试验进行。应用多因素逻辑回归分析来估计社会经济因素、个人结构性和认知性社会资本以及艾滋病毒血清阳性率的影响。
与拥有高水平结构性和认知性个人社会资本的个体相比，拥有低水平结构性和认知性个人社会资本的个体感染艾滋病毒的可能性分别高出四倍和三倍。在调整了年龄、性别、婚姻状况、职业、教育水平和财富指数等潜在混杂因素后，个人结构性和认知性社会资本的相关性仍然具有统计学意义（OR=8.6，95%CI：5.7-13.0 和 OR=2.4，95%CI：1.6-3.5）。对于女性和男性而言，获得高水平的个人结构性和认知性社会资本可以降低感染艾滋病毒的风险。这项研究证实了先前的定性研究，表明获得结构性和认知性社会资本可以预防艾滋病毒感染。
我们建议艾滋病毒干预措施的政策制定者和项目管理人员可以考虑加强和促进社会资本的获取，以此作为促进艾滋病毒预防信息和干预措施的一种方式，以减少坦桑尼亚的新艾滋病毒感染。
