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The HIV/AIDS problem in Tanzania

Tanzania has not being spared by the HIV/AIDS/STD epidemic. The country has been highly affected by the epidemic since the first cases were reported in 1983. An estimate at national level suggests HIV prevalence of about 10%. Several studies conducted in the country have provided evidence of devastating effect of HIV/AIDS in Tanzania. HIV/AIDS is currently one of the leading cause of mortality and morbidity as shown by the Adult Morbidity and Mortality study in Morogoro, Dar-Es-Salaam and Hai district and the Tanzania Essential Health Intervention Project (TEHIP) in Rufiji district. In the Kisesa Open Cohort in Magu district, HIV prevalence is currently 7.3% and the epidemic is associated with nearly 50% of deaths among adult 15-44 years (Urassa et al., 2000).

The HIV/AIDS problem in Simanjiro district

The discovery of Tanzanite mining in Simanjiro district has attracted a large population. There is commercial mining through South Africa's participation as well as small-scale mining mainly by Tanzanians from all over the country as well as neighbouring countries. This influx of people has meant that there are more men than women since mining has a gender bias. In terms of HIV/AIDS, the mere rapid congregation of people and mainly of the same sex (men) creates an explosive situation for the rapid spread of HIV. The few women in this area have multiple sexual partners. Furthermore, there is a large population of people whose livelihood is dependent on cattle raising. They have to be mobile to find pastores for their livestock. Yet there is very little information on prevalence and incidence of the disease considering e.g. its impact in terms of widows, orphans and vulnerable children. Therefore, we need evidence-based planning and development of practical and cost-effective interventions in the district for these groups.

The role played by Afya Bora to address HIV/AIDS problem in Simanjiro

Due to this, Afya Bora requested the Center for Health Policy, Systems and Analysis for Development (CEhPRAD) to conduct a KAPB study on HIV/AIDS so as to provide up-to-date-information about knowledge, attitude, practice and behavior fuelling HIV transmission. The study strongly recommended the following:

Considering the magnitude of the HIV/AIDS problem in Simanjiro, immediate preventive, care and support as well as impact mitigation actions need to be taken to rescue the situation

A serious Information-Education-Communication (IEC) program should be launched in Simanjiro and should start from the grassroots level and should consider district coverage

Sexually tailored Maasai traditions should be one of the focuses of the IEC program in Simanjiro. This should be done through existing structure within the Maasai traditions (age sets)

The IEC should be carefully prepared and structured to address all the factors fuelling HIV transmission in the district and should target all population sub-groups

Involvement of the community members in drawing up the IEC and other intervention activities is crucial for ownership and sustainability reasons

Limited resources available in the district should be spent cautiously/effectively to realize maximum output

Few NGOs in the District should be seen to work for total district coverage rather than concentrate in one area of the district

Strong care and support program should be developed considering the magnitude of HIV/AIDS problem

Sexual Transmitted Diseases (STDs) management services should be strengthened across the district and proper counseling should be extended to patients

In order to have realistic and reliable HIV/AIDS records, the district need to develop clear and credible HIV monitoring systems. HIV monitoring can be done through different populations and approaches. Antenatal Clinic Surveillance could be one of several options

Voluntary Counceling and Testing (VCT) services need to be introduced in the health facilities across the district according to the National AIDS Control Program/Ministry of Health (NACP/MOH) plan

In order to bring the concept of multisectoralism in dealing with the HIV pandemic in the district, the district council should look into possibility of forming the Council AIDS Multisectoral Committee as soon as possible according to guidelines set by TACAIDS

Consideration should be made to form district NGOs forum to bring together all HIV/AIDS tailored NGOs in the district

The district need to be given capacity building to be able to develop participatory and Multisectoral HIV/AIDS Action Plan (MAAP)