New study links HIV and Vicoba in rural Tanzania

Dar es Salaam. In rural communities, being in a village community bank (Vicoba) amplifies your risk for extramarital affairs which, according to a new study, is associated with a new wave of HIV infections.

The study, which explores the link between gender, extramarital affairs and HIV, was conducted in the rural setting of Ifakara in Morogoro. Its scope covered over 3800 married partners.

Lead researcher Sally Mtenga from the Ifakara Health Institute (IHI) indicated they had found a higher risk of HIV transmission for members of village community banks because of a positive association between Vicoba membership and extramarital affairs.

 “The most interesting part is how being a member of Vicoba relates to the risk of engaging in extramarital affairs,” she says in an IHI briefing.

According to the study, there is a gender dimension to how HIV is linked to extramarital affairs.

Factors such as economic hardship – a key driver of Vicoba participation in Tanzania – tend to “disproportionately expose women to extramarital affairs and HIV infection.”

Consequently, the researchers believe microfinance projects could be used to drive gender-transformative approaches that combine economic empowerment with strategies to mitigate HIV risk.

“Vicoba could be a platform for HIV prevention interventions so that there is an interface between economic empowerment programs and HIV prevention interventions,” says Dr Mtenga.

“…Individual-centered approaches to HIV vulnerability such as health promotion are no longer adequate to address the multiple dimensions of sexual behaviors,” she notes, adding:

“Instead, approaches should be tailored within the broader determinants of risk behaviors including the context that contribute to it.”

There are key limitations to the study.

The researchers point out, for instance, that their study sample is not representative of the distribution of male and female community members within the Ifakara study area.

Moreover, self-reported data on extramarital affairs from over 12 months prior may lack accuracy, according to the researchers.

The study was published in the AIDS Research and Therapy journal on June 7, 2018 and was carried out by the IHI’s Dr Mtenga in partnership with scientists from the Swiss Tropical and Public Health Institute (Swiss TPH) in Basel, Switzerland.

In addition to identified HIV risks for Vicobas, the researchers flagged several other groups as ‘at-risk’ for extramarital affairs, such as those who have re-married, consumers of alcohol, those from the southern regions, non-Muslims, and those with older age.

In their recommendations, the scientists argue that future programs seeking to address risky sexual behaviours need to be cognizant of “context-sensitive interventions” that go beyond personal risk.

New HIV programs have to address issues such as “relationship quality, excessive alcohol behaviors, normative masculinity ideology and societal norms, that encourage women’s economic dependence and men’s engagement in multiple sexual partnerships,” according to the study.