South Africa, like many other sub-Saharan African countries, is experiencing a massive HIV epidemic. A critique of the global public health response suggests conventional approaches to risk reduction among individuals have had limited success in the face of profound structural factors that facilitate high rates of transmission within populations. These include poverty and economic underdevelopment, mobility and social disruption, and pervasive gender inequalities. Interventions that engage structural processes remain under-developed and under-researched. Better understanding of ‘the parts’ – including cellular and molecular mechanisms that cause disease, has brought with it the potential to marginalize broader discussions about ‘the whole’. However over the course of the past two decades, research questions, methods and tools have become increasingly sophisticated, and have collectively begun to disentangle the social, behavioural and biological links between ‘the environment’, health and disease. In this context, one significant emerging theme and key structural mediator of population health has been the concept of social capital. Social capital is defined as “the features of social organization, such as trust, norms and networks, that can improve the efficiency of society by facilitating coordinated action (Putnam, Leonardi et al. 1993).” A deeper understanding of social networks and social capital has substantial potential to influence perspectives on the structural determinants of HIV transmission within the South African context – through shaping social and cultural
norms, promoting the exchange of social and material resources, facilitating behaviour change though social support, and generating a collective response to the epidemic. In this way, strengthening a community’s stock of social capital has the potential to mitigate both the transmission and impact of HIV/AIDS. The aim of this research is to explore the links between social capital and HIV/AIDS within the rural South African context. The study is housed within a larger public health programme, the Intervention with Microfinance for
AIDS and Gender Equity (IMAGE). This intervention is an attempt to influence the structural determinants of HIV, including poverty and gender inequalities, through combining an intensive group-based economic intervention at the village level, with a health promotion strategy focusing on gender awareness and HIV education.