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 aged 15e19 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 might augment the protective
features of the camps, while changing environmental features to reduce risk.
