Prevention of new HIV infection

HIV prevention strategies implemented focus on condom programming, male circumcision and programmes for KVP including AGYM, which are identified in the Tanzania Investment Case as effective strategies to prevent HIV in Tanzania. The focus is to build on past prevention approaches and enhance HIV prevention alongside the ambitious efforts to increase treatment coverage. Below are details of the different HIV prevention strategies.

Comprehensive Condom Programming

Tanzania developed a National Multi-sectoral Condom Strategy in 2016 which aims at strengthening condom forecasting, promotion and distribution in the country. Through this strategy, Tanzania embraced a total market approach to expand the provision of condoms in both the public and private sector.

Priority

• Strengthening the quantification, forecasting and procurement of condoms for the public and private sector.
• Improve the supply chain to ensure that adequate quantities are available, accessible and are equitably distributed
• Strengthening condom promotion activities including correct and consistence use of condom through mass media and social media strategies.
• Expand the distribution of public sector condoms using individual distributors beyond public health care facilities that is community-based outlets, workplaces and others.
• Strengthen oversight and support social marketing & private condoms distribution systems
• Increasing targeted condom distribution and promotion to high risk groups and hotspots
• Establish the national M&E system for condom programming to ensure timely collection and reporting of condom use.

Programming for KVPs

In Tanzania Mainland, key and vulnerable populations are at higher risk of HIV infection. In addition to known key populations namely, SW, MSM, PWUD and PWID, vulnerable groups such as OVC, AGYW, students in HLIs who live in rented accommodation outside campuses, mobile populations including long distance truck drivers, people in mining and construction industries, fisher folks and fishing communities, plantation workers, displaced people, people in closed settings, e.g. prisoners, and people with disabilities are also at risk

Priority

• Scale up provision of comprehensive HI prevention, care and support services to KVP groups.SHSP IV) 2017–2022 23
• Strengthen M&E system and operational research so as to inform policy makers and program implementers and to track interventions for KVP
• Ensure HIV/AIDS program integrated within opioid dependency treatment clinic/sober house and others
• Strengthen the existing National & Sub National coordination structures to ensure regular review of local data and identification of population groups or geographical locations and corresponding priority actions
• Strengthen and coordinate public-private partnerships with appropriate stakeholders working with KVP so as to ensure tangible investments
• Advocate for an enabling environment to facilitate access to services and promote health-seeking behavior among KVP.

Voluntary Male Medical Circumcision

A VMMC modeling exercise for 13 selected regions indicated that scaling up male circumcision among 10 – 29-year-olds would avert a substantial level of HIV infections. This modeling exercise also indicated that the optimal long-term effectiveness of VMMC by 2050 would best be achieved through the circumcision of men aged 15 – 29 years.

Priority

• Increase focus on priority regions that have not yet attained the saturation target of 80% VMMC coverage through a mix of static and outreach services.
• Ensuring sustainability in all regions through integration of VMMC and EIMC services in Health facilities.
• Mobilise resources for VMMC and EIMC services.
• Expand VMMC services for high risk groups and locations (including workplaces) in order to reach out to groups that are at high HIV risk but have low access to services.
• Scale up EIMC services in regions that have attained or are close to attain the 80% coverage target for adults and in non-priority regions as part of long-term sustainability.
• Create demand for VMMC services in priority regions through age-appropriate messages and developing SBCC materials that address myths and misconceptions associated with VMMC and EIMC.
• Strengthen continuous quality improvement of VMMC and EIMC services, by ensuring the services are safe and culturally acceptable, tracking adverse events resulting from the procedures

STI Management

Despite strong scientific evidence on the effectiveness of STI management for HIV prevention, the coverage of STI control services for the general population and particularly among high risk populations including KVP is low. Most programmes providing tailored services for KVP do not adequately integrate STI management. Tanzania has a high prevalence of viral STIs such as HSV-2, HPV, HCV and HBV that don’t have effective curative treatment and are not managed syndromically. The implementation of integrated management of STI/RTI in HIV care and reproductive health services is still weak.

Priority

• Strengthen STI management services for PLHIV and KVP as part of the standard package of HIV prevention.
• Strengthen integration of STI management into HIV care and treatment and KVP programming.
• Improve quality of STI services in RMNCAH as part of the quality improvement approach.
• Ensure availability of medical and pharmaceutical supplies for STI treatment in all health facilities.
• Mobilize resources to support STI management services.
• Scale up KVP and youth-friendly STI management services
• Strengthen STI’s M&E, research and surveillance services