The amount of trust, reciprocity and cooperation among community
members working together to achieve common goals—referred
to as “social capital” by behavioral scientists—is
a predictor for sexually transmitted infectious diseases and risky
sexual behaviors, according to an Emory study.
The investigators found that lower amounts of social capital were
associated with higher rates of AIDS and other sexually transmitted
diseases, as well as with higher rates of risky adolescent sexual
behaviors. The research was reported last month at the 14th Inter-national
AIDS Conference in Barcelona, Spain.
“Although the amount of social capital in a particular society
previously has been
correlated with violence and mortality, its relationship to infectious
diseases has received little attention,” said David Holtgrave,
professor of behavioral science and health education in the Rollins
School of Public Health and one of the study investigators. “In
making that connection for the first time, we found that social
capital is a very good predictor of infectious diseases including
AIDS and sexually transmitted diseases, as well as a predictor of
adolescent risk for these diseases.”
In 1999, the investigators examined the relationship between social
capital, poverty and income inequality, AIDS case rates and STD
rates (syphilis, gonorrhea and chlamydia) in the 48 contiguous U.S.
states. They found that social capital was a significant predictor
of all four diseases, explaining 25–45 percent of the variance
in the rate of each disease.
They also found that social capital was a significant predictor
of 10 out of 14 behavioral variables, including current sexual activities,
early sexual debut and greater number of partners. Poverty and income
inequality were much less strong predictors of these disease and
behavior outcomes.
In order to measure social capital, the investigators used Putnam’s
measure of state-level social capital. The measure is a composite
of 14 different variables, some of which include the number of social
organizations in a state; the reported level of participation in
those social activities with friends; the extent to which individuals
report trusting each other; and overall voting rates.
The investigators measured disease rates using Centers for Disease
Control and Prevention (CDC) surveillance system measures of state-level
AIDS cases, gonorrhea, syphilis and chlamydia. Behavioral outcome
measures were obtained through the CDC’s Youth Risk Behavior
Survey, which includes seven aspects of adolescent HIV-related sexual
risk behavior.
“Our findings tell us that the amount of trust and cooperation
in a society—social capital—should be considered in
the development of HIV and STD prevention interventions,”
Holtgrave said. “We also have to extend our study of social
capital beyond sexually transmitted diseases to all the nationally
notifiable infectious diseases, including, among others, tuberculosis
and hepatitis.”
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