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July 11, 2002


Lower Degrees of "Social Capital" Predict Higher Rates of Sexually Transmitted Diseases, According to Emory University Study

BARCELONA— 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 of sexually transmitted infectious diseases and risky sexual behaviors, according to research by Emory University investigators. 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 Thursday at the 14th International 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, Ph.D., professor of behavioral science and health education in Emory's 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, in 48 of 50 states (excluding Alaska and Hawaii), the investigators examined the relationship between social capital, poverty and income inequality, AIDS case rates and STD rates (syphilis, gonorrhea and chlamydia). They found that social capital was a significant predictor of all four diseases, explaining between 25% and 45% 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. That measure is a composite of 14 different variables, including, among others things, 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 the 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," Dr. 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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