The influence of social capital on HIV prevention with refugees from Bukavu / Democratic Republic of Congo living in Durban, South Africa.
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The study focused on the influence of social capital on HIV prevention with French speaking refugees living in Durban, South Africa. The overview of the existing literature shows a growing attentiveness to the role of social and environmental influences on HIV risk behaviours. The understanding of HIV-risk behaviours has moved from an earlier consideration of individual risk to ecological models with the understanding that behaviours are rooted in the economic, environment, and social structure. Overall, the data from interviews and focus group discussions in this study confirms that it is necessary to take a broad ecological perspective when considering HIV risk and protection. Social capital is clearly important but needs to be considered in relation to the complexities highlighted in the study in order to add vital insight into the considerations of what will add value to HIV intervention work with the refugee community. The overall objective of the study was to contribute to an understanding of how social capital, specifically on a social bonding level, operates as a risk or protective factor for the spread of HIV amongst French speaking refugees from Bukavu, DRC, living in Durban, South Africa. More specifically the researcher wanted to understand how the elements of social capital (trust, norms, reciprocity and networks) on a social bonding level, act as risk or protective factors in the spread of HIV in relation to condom use, HIV counselling and testing and stigma. The research found that social capital can act as both a protective factor in some circumstances and a risk factor in others. Trust, norms, reciprocity and social networks are complex elements in the refugee community and influenced by a myriad of factors including the past and present stressors that are prevalent in the community. In turn these all have an effect on HIV prevention and need to be understood clearly. Without such a clear understanding, interventions offered to the community may well not lead to behaviour change that helps in the prevention of HIV. These findings are important as generally the impression is that the lack of policy and interventions to include refugees in services is the reason for high HIV risk. In addition literature shows that higher social capital leads to better health status. From the data in the current study one can conclude that any interventions and policy guidelines would have to be tailored to meet the specific needs and complexities inherent in this target group. Findings in this study confirm the complexity of issues relating to HIV prevention. It became clear that the answers are not simple. While social capital has been found to be a useful component in generating support in a community, binding relations and having an overall positive effect; it appears that the situation is not this simple. The elements of social capital (trust, reciprocity, norms and social networks) were all apparent in the community, particularly at a bonding level, but at times worked in support of members and at other times appeared to work against them. This was especially the case in relation to issues surrounding HIV.