Why women and girls are special groups in HIV/AIDS fights
As Tanzania strives to achieve the 95-95-95 goals of HIV epidemic control, especially among the most vulnerable communities, stakeholders’ concerted efforts are needed to address the challenges facing girls and women.
According to the Tanzania HIV Impact Survey 2022-2023 (THIS 2022-2023), HIV incidence among girls has doubled to 15.25 percent. In contrast, HIV prevalence among adults aged 15 and above is 4.5 percent, with women constituting 5.6 percent and men only 3 percent. Concerns have been raised about the current and future workforce of the country, as the study shows that among people living with HIV, 33 percent are youth aged 15 to 24. Of these affected youth, 78 percent are girls.
The THIS final report, released in September 2024, indicates a decline in HIV incidence among men of all ages. With THIS data and other findings related to HIV/AIDS, the Tanzania Commission for AIDS (TACAIDS) recently organized a stakeholder meeting in Dar es Salaam to focus on the national HIV/AIDS research and evaluation agenda.
Quoting the THIS 2022-2023 report, Dr. Samuel Sumba, a researcher with TACAIDS, stated that Tanzania has approximately 1.6 million people living with HIV.
However, there is good news: new cases among adults have declined by 16.7 percent, from 72,000 (THIS 2016-2017) to 60,000 (THIS 2022-2023). Still, the question remains: why are youth, particularly girls, the most vulnerable group?
Dr. Catherine Joachim, acting director of TACAIDS, explains that youth engage in sexual activity earlier, prompting the commission to collaborate with the Ministry of Education and Vocational Training to craft HIV awareness messages targeting primary and secondary school students.
“I was shocked to hear what these children were talking about. They know about sex, different styles, and openly discuss these topics—even in front of religious leaders—without fear,” Dr Catherine noted.
While children openly discuss sexual matters, parents, guided by tradition, often avoid such topics. This has led Dr. Catherine to encourage researchers to develop solutions for effectively reaching this group with appropriate messages to curb the spread of HIV/AIDS.
Furthermore, Dr. Catherine highlighted government efforts to ensure free condom distribution at public places, such as offices and bus stops, with branded condoms sold at discounted prices. Despite these initiatives, the THIS 2022-2023 report shows a decline in condom use during sex.
“Condoms are being distributed in public places using dispensers, and they are taken quickly. However, we are hearing that condom usage during sex has decreased. Researchers should investigate why people take condoms but fail to use them as a preventive measure,” she said.
Disparities in prevalence
While Tanzania celebrates achieving the second 95 target, with 25 percent of people living with HIV receiving treatment, disparities in regional HIV prevalence remain significant. According to THIS 2022-2023, Njombe has the highest prevalence at 12.7 percent, followed by Iringa (11.1 percent), Mbeya (9.6 percent), and Songwe (6.0 percent). Conversely, the regions with the lowest prevalence are Kigoma (1.7 percent) and Manyara (1.8 percent).
In the Isles, prevalence is strikingly low, with Pemba North at 0.2 percent, Pemba South at 0.5 percent, Unguja North at 0.7 percent, Mjini Magharibi at 0.4 percent, and Unguja South at 0.8 percent.
Mr Peter Masika, CEO and founder of the Tanzania Youth Alliance (TAYOA), urged researchers to investigate whether behavioral factors contribute to the significant differences in prevalence between regions with similar environmental conditions. He specifically cited Njombe and Kigoma, where girls face similar challenges, including economic hardship and agricultural engagement, yet their HIV prevalence rates differ.
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Dr. Ezekiel Luoga, a researcher with the Ifakara Health Institute (IHI), emphasized improving HIV-related information systems and their proper use to enhance service provision. “Most health practitioners do not use data to improve services,” he said, stressing the importance of education in addressing HIV challenges.
Government and stakeholder efforts
Omary Ilyas, from the Prime Minister’s Office (PMO), noted that researchers and academics have the opportunity to guide the government toward achieving independent health services as part of the country’s Agenda 2050.
“Without a healthy society, we cannot achieve our plans for the next 25 years,” he stated. He also called for better performance monitoring of workshops and the preparation of a matrix outlining priorities, responsibilities, and timelines for implementation.
TACAIDS’ Strategic Plan outlines effective strategies to coordinate and manage the national HIV/AIDS response, aiming to meet the 95-95-95 targets and end AIDS by 2030. This plan aligns closely with the Third Five-Year Development Plan (FYDP III) 2021/22–2025/26, which includes interventions to transform Tanzania’s economy in line with the ruling party’s 2020–2025 manifesto.
The stakeholders who were engaged at the meeting to discuss national HIV and AIDS research and evaluation agenda were from TACAIDS, National Institute for Medical Research (NIMR), Kairuki University, Hubert Kairuki Memorial University, Ifakara Health Institutes (IHI) and Muhimbili University of Health and Allied Sciences (MUHAS).
Progress in the fight against HIV
Vice President Dr Philip Mpango praised Tanzania’s progress in the fight against HIV/AIDS during the National World AIDS Day celebrations in Songea, Ruvuma Region, on December 1, 2024.
According to available data, 82.7 percent of people aged 15 and above living with HIV now know their status—a 22 percent increase from 61 percent five years ago. Additionally, 97.9 percent of those aware of their status have begun ART, compared to 94 percent five years ago. Viral suppression among individuals on ART has risen to 94.3 percent from 87 percent over the same period.
“These results show significant progress toward our goal of ending HIV/AIDS by 2030,” Dr. Mpango said. He also highlighted the global 95-95-95 targets for 2025, urging TACAIDS to collaborate with sector ministries, stakeholders, and communities to address factors driving HIV spread.
Dr Mpango commended partnerships with stakeholders, including the private sector, the Global Fund, PEPFAR, and UN agencies, for supporting HIV/AIDS programs in Tanzania. He urged young people, especially girls, to protect themselves from new infections and embrace education campaigns promoting behavioral change and the abandonment of harmful cultural practices.
“The new infections are often driven by risky behaviors such as excessive alcohol consumption, unprotected sex, multiple partners, and drug abuse,” he said.
The Vice President also called for eliminating stigma around people living with HIV, noting that stigma prevents many from accessing vital services like voluntary testing, counseling, and ART.
At the well-attended event, the Chairperson of the National Council of People Living with HIV, Ms Leticia Maurice, called for the elimination of stigma and drug abuse, which hinder the government’s efforts to fight the scourge.
She reaffirmed the council’s commitment to strengthening services tailored to the needs of vulnerable groups.
The 2024 World AIDS Day theme was “Choose the Right Path, End HIV,” encouraging everyone to actively participate in preventing new infections, supporting those affected and assisting orphans and children born with HIV.
THIS was led by the Government of Tanzania through Tanzania Commission for AIDS (TACAIDS), Zanzibar AIDS Commission (ZAC), MoH and Ministry of Health Zanzibar, National Bureau of Statistics (NBS) and Office of the Chief Government Statistician (OCGS) implemented the Survey.
The government collaborated with various institutions namely, National Health Laboratory Quality Assurance and Training Center (NHL-QATC), National AIDS Control Programme (NACP) Zanzibar Integrated HIV, Tuberculosis and Leprosy Program (ZIHTLP), U.S. Centers for Disease Control and Prevention (CDC) as well as ICAPat Columbia University.
