Cross-Sector HIV and AIDS Interventions and other Innovative Investments

Stigma, Discrimination and Gender Based Violence (GBV)

Reduction of stigma and discrimination are core elements in the National HIV and AIDS response. The scale up of care and treatment services has enabled individuals to return to normal life and contribute to family and national income on the one hand, while partly addressing stigma associated with chronic illness and disability among PLHIV.

Priority

• Promote an enabling policy environment for HIV prevention, care and treatment for all PLHIV
• Enhance institutional capacities to promote interventions aimed at reducing stigma and discrimination into comprehensive HIV and AIDS prevention, treatment, and care and support
• Address stigma and discrimination among community leaders, health care providers and among PLHIV themselves
• Enhance implementation of MER to track different forms of stigma
• Continue to scale up and integrate interventions that address gender inequality and GBV to facilitate safe disclosure

Targeted Social and Behavior Change Communication (SBCC)

Multiple channels of communication are used including mass media campaigns, school-based education, and community-based social mobilization. SBCC interventions are also implemented using various forms of Information Communication Technologies (ICT) such as social media and mobile phone applications including WhatsApp and text messaging. HIV/AIDS and RH programs have successfully used text messaging to influence behaviour change.

Health Sector Workplace Interventions

Workplace health programmes focus on occupational health and safety of workers in the health sector and beyond. The MOHCDGEC advises on safety measures to prevent injuries and diseases and performs workplace inspections to enforce legislation. The Ministry prioritizes high-risk sectors where exposure to hazardous situations and substances is high, e.g. in the mining industry. As part of the national response towards the AIDS epidemic, prevention and control of workplace HIV, TB and Hepatitis B Virus was initiated to prevent transmission of these communicable diseases

Priority

• Expand HIV workplace intervention to incorporate NCDs, access to occupational health and safety services among the health workforce, emergency responders, and economic empowerment interventions
• Establish a routine combined HTS HIV prevention campaign in workplaces including the informal sector and hard-to-reach communities such as mining areas, fishing camps, and plantation workers
• Strengthen access to and increase awareness of HIV prevention interventions including ART HIV test kits, Syphilis tests and workplace condom programming
• Increase sensitization and advocacy for HIV social protection programmes (TASAF PSSN, NHIF, CHF, WCF etc.) to maximize the impact on HIV prevention among workers
• Strengthen Infection Prevention (IP) screening, PEP services, vaccination programmes for workplace for viral Hepatitis and treatment for infected health workers according to the national guideline
• Improve monitoring of HIV interventions at the workplace and support health workers living with HIV and other work-related diseases or injuries

Adolescents and Young People

In Tanzania, HIV prevalence is higher among women than men (6.2 % and 3.1%, respectively). Young women and girls are particularly vulnerable to HIV due to several cultural, economic and biological factors. It has also been noted that HIV prevalence among young women aged 20-24 is higher (3.4%) than that of men (0.9%) in the same age group. AGYW are at a higher risk of HIV infection, they have limited access hence low uptake of HIV and reproductive health services compared to adults (TDHS 2015-16). The Tanzanian population is predominantly youth, with over two thirds (63%) of the total population below 24 years.

Priority

• Ensure enabling environment for the provision of adolescent and youth friendly HIV and SRH services
• Scale up provision of adolescent friendly health services
• To strengthen coordination of adolescent –youth friendly services at all levels
• Strengthen the provision of comprehensive sexuality education at community and school levels
• Support adolescent girls with essential package and ensure a safe environment (boarding/ hostels, uniforms, pads, etc.) to keep them in school
• Strengthen linkage mechanisms for facility and community based services to increase retention in care and treatment services for adolescents and youth
• Improve coordination among stakeholders working on adolescent and youth HIV and SRH services
• Improve provision of quality prevention, care and treatment services for adolescents and youth living with HIV and expand access to and utilization of integrated quality HIV and AIDS services by adolescents and youth
• Expand coverage of girl-centred combination HIV prevention approaches such as cash transfer / socioeconomic strengthening, SRH education, safe spaces, etc. to maximize the impact of HIV prevention among vulnerable AGYW
• Strengthen operational research and M&E systems for adolescent and youth HIV and AIDS Services

Male Involvement

Male involvement is now considered a best practice in reproductive and child health and specifically in HIV prevention, care and support interventions, following evidence of a stronger impact on the outcomes where men have been involved and empowered to make informed decisions. Experience in implementing family planning and reproductive health interventions has shown that men play a critical role in decisions that determine a woman’s ability to seek health care, yet, more often than not, they are uninformed about women’s reproductive health needs as well as their own needs.

Priority

• Consolidate lessons and best practices on male involvement to support the design of a national SOP on male involvement in sexual, reproductive, maternal and child health
• Expand workplace programmes that sensitize men to participate in sexual, reproductive, maternal and child health for better health outcomes of their families
• Introduce services for men, such as screening for prostatic cancer or non communicable diseases (NCDs) in reproductive and child health services, especially for spouses of PMTCT clients
• Engage male community leaders to address the needs and role of men in sexual, reproductive, maternal and child health services both as peer motivators and influencers
• Increase the number of services that encourage male participation in sexual, reproductive, maternal and child health services, such as, joint clinics that will cater for both men’s and women’s needs. For example, partners/spouses of women receiving PMTCT services to receive their ARVs at the PMTCT site until their partner/spouse graduates then they will continue at the CTC together.