Adult HIV prevalence in Tanzania is estimated at 4.5 percent (UNAIDS 2021), with regional HIV prevalence ranging from 0.5 percent (Zanzibar) to 11.4 percent (Njombe). Tanzania has a generalized HIV epidemic but there are also concentrated sub-epidemics among key populations. Women and girls continue to be disproportionately affected compared to men, with adolescent girls and young women accounting for 80 percent of all new HIV infections. USAID works to mitigate the impact and spread of Tanzania’s HIV epidemic in partnership with the Government of Tanzania, other U.S. Government agencies, and a wide range of implementing partners through the President’s Emergency Plan for AIDS Relief (PEPFAR).
Adult HIV prevalence in Tanzania is estimated at 4.5 percent (UNAIDS 2021), with regional HIV prevalence ranging from 0.5 percent (Zanzibar) to 11.4 percent (Njombe). Tanzania has a generalized HIV epidemic but there are also concentrated sub-epidemics among key populations. Women and girls continue to be disproportionately affected compared to men, with adolescent girls and young women accounting for 80 percent of all new HIV infections. Tanzania’s goal is to reach HIV epidemic control by 2030, with 95 percent of people living with the disease aware of their HIV status, 95 percent of those diagnosed receiving sustained antiretroviral therapy (ART), and 95 percent of those on ART virally suppressed. While the Government of Tanzania remains committed to responding to and mitigating the effects of HIV and AIDS, gaps in human resources, domestic financing, health infrastructure, the supply chain for commodities and stigma and discrimination continue to challenge progress.
USAID works to mitigate the impact and spread of Tanzania’s HIV epidemic in partnership with the Government of Tanzania, other U.S. Government agencies, and a wide range of implementing partners through the President’s Emergency Plan for AIDS Relief (PEPFAR). Tanzania’s 2023 PEPFAR targets include:
● Ensuring over 5 million people and over one million pregnant women receive HIV testing.
● Providing HIV treatment to over 1.7 million HIV-positive individuals.
● Providing voluntary medical male circumcision to over 600,000 men.
● Supporting over 740,000 orphans and vulnerable children affected by the HIV epidemic; and
● Providing combination HIV prevention services to over 630,000 key and vulnerable populations.
CHALLENGES
As the program continues to provide lifesaving interventions, key components of the health system need further strengthening. There are critical gaps in the number, quality, and distribution of health care workers, especially in rural areas. More domestic financing is needed to build sustainability, as well as greater harmony between health information systems, improved commodity security for facilities and an enabling environment for HIV services to be accessed free from stigma and discrimination.
IMPACT
PREVENTION
USAID supports a comprehensive package of HIV combination prevention interventions to key and vulnerable populations. This includes targeted HIV testing services and immediate initiation to ART, Pre-Exposure Prophylaxis (PrEP) for people at substantial risk of HIV, condom promotion and provision, Voluntary Male Medical Circumcision (VMMC), Social Behavioral Change and structural interventions. Over 140,000 adolescent girls and young women were reached in FY 2022 through the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) initiative in Tanzania. During the same period, USAID ensured over 450,000 pregnant women knew their HIV status and over 14,200 HIV- positive pregnant women received ART to protect their unborn children and slow the spread of HIV in the body. In addition, male circumcision services were provided to over 75,000 men.
TREATMENT
USAID supports access to quality HIV care and treatment services. In FY 2022 over 46,000 people began ART. By the end of FY 2022, nearly 470,000 clients were on ART treatment through USAID support. USAID worked with the Government of Tanzania to adopt the “test and start” approach, where patients begin ART treatment the same day after being diagnosed as HIV positive, no matter how far the disease has advanced.
USAID also adopted multi month drug dispensing to minimize congestion in care and treatment clinics and improve quality of care. The rollout of routine viral load testing, which measures the progression of HIV by determining the amount of virus in a blood sample, serves as a tool for monitoring patients’ adherence to ART. Patients found with high viral loads are assessed and given enhanced adherence counseling.
CARE
USAID supports the delivery of health and social services to mitigate the impact of AIDS on HIVpositive Tanzanians and children orphaned or affected by the epidemic. The programutilizes three main strategies: (1) supporting policy development as well as improving national coordination and technical leadership; (2) strengthening systems of service delivery among local government and civil society; and (3) providing critical health and social services to HIV-affected households.
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