Social Capital, High-Risk Sexual Behaviors, and Sexually Transmitted Infections in Agricultural Plantation Residents in Tanzania

Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) are leading causes of mortality and morbidity in many countries of the world. The practice of having concurrent sexual partners is an important risk factor for STI transmission. Social capital is a target area for improving sexual health. Social capital describes the ways in which individuals are connected to resources that can influence their behaviors, and provides methods of coping with stressors. Previous studies have yielded contradicting findings about the effects social capital has on sexual health behaviors and STI prevalence. Our study aims to investigate social factors, namely social capital and support, which may play a role in reducing STI prevalence and the practice of concurrent partnerships. We conducted secondary data analysis from a study of 623 agricultural plantation residents in Tanzania to assess this relationship, hypothesizing that higher social capital would be associated with less concurrent sexual partnerships and less prevalent STIs (including HIV, HSV-2, and syphilis). We used principal component analysis to convert seven variables related to social capital into a smaller set of uncorrelated factors. The resultant 3 factors – reciprocity, trust, and decision-making – were used as predictors in multiple regression models for both concurrent sexual partnerships and prevalent STI, stratified by gender. We found that having positive social capital in the ‘network’ dimension was associated with being less likely to have concurrent sexual partnerships among women (AOR=0.47, 95% CI 0.23-0.87) and that having positive social capital in decision making was associated with being more likely to have a prevalent STI among men (AOR=2.13, 95% CI 1.02-4.52). Transactional sex was significantly associated with both outcomes in women. Suggested initiatives for improvement of sexual health include creating community groups that encourage unity and fellowship among women in order to decrease the prevalence of risky sexual behaviors. More research is necessary to create a uniform definition of social capital that can be applied in future studies that examine the relationship between this concept and sexual health.No embargoAcademic Major: Public Healt