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Social venues that protect against and promote HIV risk for young men in Dar es Salaam, Tanzania

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  • Yamanis, Thespina J.
  • Maman, Suzanne
  • Mbwambo, Jessie K.
  • Earp, Jo Anne E.
  • Kajula, Lusajo J.

Abstract

Developing effective place-based health interventions requires understanding of the dynamic between place and health. The therapeutic landscape framework explains how place-based social processes and physical geography interact and influence health behavior. This study applied this framework to examine how venues, or social gathering places, influenced HIV risk behavior among young, urban men in Tanzania. Eighty-three public venues where men aged 15-19 met new sexual partners were identified by community informants in one city ward. The majority (86%) of the venues were called 'camps', social gathering places that had formal leaders and members. Observations were conducted at 23 camps and in-depth interviews were conducted with 36 camp members and 10 camp leaders in 15 purposively selected camps. Geographic and social features of camps were examined to understand their contributions to men's behaviors. Camps were characterized by a geographic space claimed by members, a unique name and a democratic system of leadership and governance. Members were mostly men and socialized daily at their camp. They reported strong social bonds and engaging in health-promoting activities such as playing sports and generating income. Members also engaged in HIV risk behaviors, such as meeting new sexual partners and having sex in or around the camp at night. Some members promoted concurrent sexual partnerships with their friends and resisted camp leaders' efforts to change their sexual risk behavior. We conclude that camps are strategic venues for HIV prevention programs for young Tanzanian men. They served as both protective and risk landscapes, illustrating three domains of the therapeutic landscape framework: the built environment; identities of landscape occupants; and sites for collective efficacy. The framework and data suggest HIV intervention components might augment the protective features of the camps, while changing environmental features to reduce risk.

Suggested Citation

  • Yamanis, Thespina J. & Maman, Suzanne & Mbwambo, Jessie K. & Earp, Jo Anne E. & Kajula, Lusajo J., 2010. "Social venues that protect against and promote HIV risk for young men in Dar es Salaam, Tanzania," Social Science & Medicine, Elsevier, vol. 71(9), pages 1601-1609, November.
    • Handle: RePEc:eee:socmed:v:71:y:2010:i:9:p:1601-1609
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    References listed on IDEAS

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    1. Maman, S. & Mbwambo, J.K. & Hogan, N.M. & Kilonzo, G.P. & Campbell, J.C. & Weiss, E. & Sweat, M.D., 2002. "HIV-positive women report more lifetime partner-violence: Findings from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania," American Journal of Public Health, American Public Health Association, vol. 92(8), pages 1331-1337.
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    5. Gesler, Wilbert M., 1992. "Therapeutic landscapes: Medical issues in light of the new cultural geography," Social Science & Medicine, Elsevier, vol. 34(7), pages 735-746, April.
    6. Cummins, Steven & Curtis, Sarah & Diez-Roux, Ana V. & Macintyre, Sally, 2007. "Understanding and representing 'place' in health research: A relational approach," Social Science & Medicine, Elsevier, vol. 65(9), pages 1825-1838, November.
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    Cited by:

    1. Katharine J McCarthy & Ruchi Mehta & Nicole A Haberland, 2018. "Gender, power, and violence: A systematic review of measures and their association with male perpetration of IPV," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-27, November.
    2. Hill, L.M. & Moody, J. & Gottfredson, N.C. & Kajula, L.J. & Pence, B.W. & Go, V.F. & Maman, S., 2018. "Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania," Social Science & Medicine, Elsevier, vol. 196(C), pages 77-85.
    3. Masunga K Iseselo & Idda H Mosha & Japhet Killewo & Linda Helgesson Sekei & Anne H Outwater, 2019. "Can training interventions in entrepreneurship, beekeeping, and health change the mind-set of vulnerable young adults toward self-employment? A qualitative study from urban Tanzania," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-18, August.
    4. Mulawa, Marta & Yamanis, Thespina J. & Hill, Lauren M. & Balvanz, Peter & Kajula, Lusajo J. & Maman, Suzanne, 2016. "Evidence of social network influence on multiple HIV risk behaviors and normative beliefs among young Tanzanian men," Social Science & Medicine, Elsevier, vol. 153(C), pages 35-43.

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