HIV/AIDS has rolling back decades of socio-economic development in Sub Saharan Africa. While there are indications of declining HIV infection rates in the general population, men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWIDS), now called Key Populations (KP) for HIV epidemic have 2-20 times higher infections rates and contributes up to 30% of new HIV infection. Despite of such high infection rates, only a third has access to health services due to stigma and discriminations. Because access to health services is a human right, many countries including Tanzania have adopted the UNAIDS comprehensive HIV intervention package (CHIP) to address the epidemic among KPs. However, these populations are hard to reach and National AIDS programs lack the know-how on the modalities to improve access to CHIP. This project therefore aim to work with KP communities to increase access to health services through studying factors which influence the use of health services (pull and push factors) and test the effectiveness of CHIP delivery modalities with and for them in Tanzania. The project will build research and training capacities related to KPs and strengthen the health system and the KPs communities. A step-wise approach involving both quantitative and qualitative methods will be employed. As part of situational analysis, a survey of 300 participants from each of the three KPs (MSM, FSWs, PWIDS) will be done followed by a qualitative community organizing/dialogue to identify the preferred CHIP delivery modalities. The identified modalities will be tested for effectiveness using a quasi-experimental design. The study will be conducted in Dar es Salaam and Tanga, regions with evidence of large numbers of KP communities in Tanzania. The results are expected to improve access to services among KPs as a human right, reverse HIV infection rates among KPs and the general population, and improve social and economic wellbeing
Midterm report 2018:
Key population are at higher risk of HIV and Hepatitis B and C infection and substantial proportion practice risk behaviours. Awareness and access to preventive and curative health services is poor. Stigma, violence, discrimination, low perceived risk of infection among key population contributes to limited service access. Health system factors includes lack of knowledge about key population services (package), occasional stock-out of preventive commodities and negative attitudes of health providers towards key population. Key population services are being integrated in the existing health system and training of health providers are highly needed.