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Purpose: The purpose of this study is to evaluate and compare the extent and potential correlates of sexual risk taking behaviors related to condom use and number of sexual partners among Haitians aged 15 to 49 years old living in the urban and rural areas. Methods: Data were obtained from the 2005-2006 cross-sectional survey conducted by the Demographic Health survey. Our study population (15143) was analyzed based on the Health Belief Model (HBM) theory using a bivariate and multiple logistic regression analysis with SPSS for windows. Results: In both rural and urban areas dwellers had an accurate knowledge of the disease. However, a small proportion in both areas used condoms during their last sexual intercourse. Perceiving the disease's severity was more likely associated with condom use in the urban (OR 1.36, p ≤ .01) and in the rural areas (OR 1.45, p ≤.05). Strong associations have been found between some variables of the HBM and condom use but none have been found associated with zero or one sex partner. Findings were similar in both areas Conclusion: Holistic approach should be considered in the prevention strategy conducted in Haiti to tackle other factors that may contribute in delaying responsible sexual behavior in that country.

Background The role of social capital for promoting health has been extensively studied in recent years but there are few attempts to investigate the possible influence of social capital on HIV prevention,particularly in developing countries. The overall aims of this thesis are to investigate the links between social capital and HIV infection and to contribute to the theoretical framework of the role of social capital for HIV prevention. Methods Key informant interviews with leaders of organizations, networks, social groups and communities and focus group discussions with members and non-members of the social groups and networks were conducted to map out and characterize various forms of social capital that may influenceHIV prevention. A quantitative community survey was carried out in three case communities toestimate the influence of social capital on HIV risk behaviors. A cross-sectional survey was conducted to estimate the HIV prevalence in the urban district representing a high HIV prevalence zone to determine the association between social capital and HIV infection. Main findings In early 1990’s many of the social groups in Kagera region were formed because of poverty and many AIDS related deaths. This formation of groups enhanced people’s social and economic support to group members during bereavement and celebrations as well as provided loans that empowered members economically. The social groups also put in place strict rules of conduct, which helped to create new norms, values and trust, which influenced sexual health andthereby enhanced HIV prevention. Formal organizations worked together with social groups and facilitated networking and provided avenues for exchange of information including healtheducation on HIV/AIDS. Individuals who had access to high levels of structural and cognitive social capital were more likely to use condoms with their casual sex partners compared to individuals with access to low levels. Women with access to high levels of structural social capital were more likely to use condoms with casual sex partners compared to those with low levels. Individuals with access to low levels of structural social capital were less likely to be tested for HIV compared to those with access to high levels. However, there was no association between access to cognitive social capital and being tested for HIV. Individuals who had access to low levels of both structural and cognitive social capital were more likely to be HIV positive compared to individuals who had access to high levels with a similar pattern among men and women. Conclusion This thesis indicates that social capital in its structural and cognitive forms is protective to HIV infection and has played an important role in the observed decline in HIV trends in the Kagera region. Structural and cognitive social capital has enabled community members to decrease number of sexual partners, delay sexual debut for the young generation, reduce opportunities for casual sex and empower community members to demand or use condoms. It is recommended that policy makers and programme managers consider involving grassroots’ social groups and networks in the design and delivery of interventions strategies to reduce HIV transmission.

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