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

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 ages 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 that might augment the protective features of the camps, while changing environmental features to reduce risk.

Anxiety and depression strongly associated with sexual risk behaviors among networks of young men in Dar es Salaam, Tanzania

“…Participants in this study are male members of 59 “camps” within 4 wards of Dar es Salaam (Yamanis, Maman, Mbwambo, Earp, & Kajula, 2010). These camps were identified by the study team as groups occupying designated physical spaces where young men meet to socialize (Yamanis et al, 2010). Camps are stable social units; those included in the trial have been in existence for an average of eight years.…”

“…Camps are stable social units; those included in the trial have been in existence for an average of eight years. Men typically belong to only one camp and often pay membership fees to belong to that camp (Yamanis et al, 2010). Most camp members are not formally employed and spend several hours each day at their camp (Yamanis et al, 2010).…”

Young Men’s Social Network Characteristics and Associations with Sexual Partnership Concurrency in Tanzania

“…Previous research identified stable social networks of mostly young men in Dar es Salaam, Tanzania who socialize regularly in what they call “camps” [23]. Camps consist of between 10 and 80 members and have elected leadership, membership fees, and a physical space to meet.…”

Perceived Cost Advantages and Disadvantages of Purchasing HIV Self-Testing Kits among Urban Tanzanian Men: An Inductive Content Analysis

“…Camps are social gathering places where networks of mostly men frequent and have about 30-35 members and an average lifespan of 8 years [66]. They typically have elected leadership and some require membership fees to belong.…”