Community participation and sexual health – is there a relationship?

Is there a relationship between people’s degree of community involvement and participation and their sexual behaviour? If this is the case, it may help to identify possible areas of HIV/AIDS intervention at community level. Researchers from the London School of Economics (LSE) investigated this relationship in a mining town in South Africa. The results were mixed. Whereas some forms of community participation were associated with safer sexual behaviour and lower levels of HIV infection, others acted in the opposite way. The findings highlight the need for further research.

High levels of ‘civic engagement’ as reflected in membership of local voluntary groups have been deemed to be associated with positive health behaviours and outcomes.  But is this really the case? The researchers set out to investigate this hypothesis in relation to sexual health in general and levels of HIV infection in particular.

A survey was carried out among 1 211 residents of Khutsong, a South African mining town with a high prevalence of HIV. The survey included a medical part – with tests for HIV and other sexually transmitted diseases (STDs) – and a social component. This examined reported sexual behaviour and levels of membership to community organisations ranging from churches to political parties, trade unions, youth and sports clubs and residents associations. The investigation focused on whether or not membership to one of these groups was associated with HIV infection on the one hand, and positive health behaviour – such as using condoms – on the other. The findings were: 

• Among men, belonging to a church was associated with lower levels of alcohol consumption and fewer casual partners; belonging to a sports club was associated with lower levels of HIV.
• Among young women membership of sports clubs was associated with lower levels of HIV and higher levels of condom use: membership of youth clubs was associated with lower levels of HIV and fewer casual partners.
• Other forms of community membership were, however, associated with higher levels of HIV infection and unsafe sex practices. For example, men and women who belonged to ‘stokvels’ (voluntary saving and social clubs) were more likely to have casual, unsafe sex, to consume alcohol and to be HIV positive.

The research argues that although a link exists between associational membership and HIV infection, the picture is very mixed. This link is most significant for young people. The link can be very positive – as in the case of membership to sports clubs – or negative, as is the case with membership to stokvels. The study makes the following recommendations:

• Further research is needed to understand the links explored in this article.
• Future research should focus particularly on the younger age groups, since they are the ones most affected by unsafe health behaviour and higher levels of HIV infection.

Source(s):
'Is social capital a useful conceptual tool for exploring community level influences on HIV infection? An exploratory case study from South Africa', AIDS Care 14(1): 41-55, by C. Campbell et al, 2002
'Letting them die: why HIV/AIDS prevention programmes fail', by C. Campbell, Cape Town: Double Storey/ Junta, 2003
'How can HIV be prevented in South Africa? A social perspective', British Medical Journal 324: 229-232, by C. Campbell and Y. Mzaidume, 2002

Funded by: UK Department for International Development

id21 Research Highlight: 21 May 2003

Further Information:
Catherine Campbell
Social Psychology
London School of Economics and Political Science
Houghton Street
London WC2A 2AE
UK

Tel: +44 (0)20 7955 7701
Fax: +44 (0)29 7955 7565
Contact the contributor: c.campbell@lse.ac.uk

London School of Economics and Political Science, UK

Other related links:
'Friends in deed – preventing HIV through peer education in South African schools'

'Having their say – young people and sexual health in Nicaragua'

'A trouble shared. How people are learning to cope with HIV/AIDS the participatory way'

See id21's collection of links relevant to HIV/AIDS.

See id21's collection of links relevant to sexual and reproductive health.