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

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          Abstract

          Background

          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.

          Methods

          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.

          Results

          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.

          Conclusions

          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.

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          Bowling alone

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            Social trust and self-rated health in US communities: a multilevel analysis.

            This study assessed the contextual and individual effects of social trust on health. Methods consisted of a multilevel regression analysis of self-rated poor health among 21,456 individuals nested within 40 US communities included in the 2000 Social Capital Community Benchmark Survey. Controlling for demographic covariates, a strong income and education gradient was observed for self-rated health. Higher levels of community social trust were associated with a lower probability of reporting poor health. Individual demographic and socioeconomic predictors did not explain the association of community social trust with self-rated health. Controlling for individual trust perception, however, rendered the main effect of community social trust statistically insignificant, but a complex interaction effect was observed, such that the health-promoting effect of community social trust was significantly greater for high-trust individuals. For low-trust individuals, the effect of community social trust on self-rated health was the opposite. Using the latest data available on community social trust, we conclude that the role of community social trust in explaining average population health achievements and health inequalities is complex and is contingent on individual perceptions of social trust. Future multilevel investigations of social capital and population health should routinely consider the cross-level nature of community or neighborhood effects.
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              Income inequality and health: pathways and mechanisms.

              The relationship between income and health is well established: the higher an individual's income, the better his or her health. However, recent research suggests that health may also be affected by the distribution of income within society. We outline the potential mechanisms underlying the so-called relative income hypothesis, which predicts that an individual's health status is better in societies with a more equal distribution of incomes. The effects of income inequality on health may be mediated by underinvestment in social goods, such as public education and health care; disruption of social cohesion and the erosion of social capital; and the harmful psychosocial effects of invidious social comparisons.
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                Author and article information

                Contributors
                frumencegasto@yahoo.co.uk
                maria.emmelin@med.lu.se
                Malin.Eriksson@epiph.umu.se.umu.se
                gkwesigabo@yahoo.com
                jkillewo@yahoo.co.uk
                smoyo@muhas.ac.tz
                Lennarth.Nystrom@epiph.umu.se
                Journal
                Arch Public Health
                Arch Public Health
                Archives of Public Health
                BioMed Central (London )
                0778-7367
                2049-3258
                3 November 2014
                2014
                : 72
                : 1
                : 38
                Affiliations
                [ ]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
                [ ]Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, SE-901 85 Sweden
                [ ]Department of Biostatistics and Epidemiology, Muhimbili University of Health and Allied Sciences, PO Box 65015, Dar es Salaam, Tanzania
                [ ]Department of Microbiology, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
                Article
                5054
                10.1186/2049-3258-72-38
                4322460
                c4271cf2-717b-473d-804c-de9ecf3aeaaf
                © Frumence et al.; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 November 2013
                : 12 July 2014
                Categories
                Research
                Custom metadata
                © The Author(s) 2014

                Public health
                structural,cognitive social capital,hiv prevalence,tanzania
                Public health
                structural, cognitive social capital, hiv prevalence, tanzania

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