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National Multisectoral HIV Prevention Strategy 2009 2012

Vision

Mission

Objectives
Empower young people with knowledge and skills to dialogue

about sexuality; adopt attitudes and practices that protect against HIV infection. Reduce risk of infection among those most vulnerable due to gender inequality, sexual abuse, and socio-cultural factors. Increase the proportion of public, private and informal sector enterprises developing and implementing comprehensive workplace interventions with attention to mobile workers. Expand quality, gender responsive, and youth friendly STI services including counselling and condom promotion to all health facilities and enhance utilization of services

Objectives
Increase the number of people who know their HIV status and

who adopt appropriate measures to protect themselves and their partners from HIV. Reduce the transmission of HIV from mothers to their children, during pregnancy, birth and/or breast-feeding and ensure entry into care and treatment for HIV-infected mothers and babies. Increase the proportion of the sexually active adults, especially in rural areas, who use condoms consistently and correctly and promote and expand the availability of Female condoms as a female is controlled and dual protection method.

Objectives
Reduce the risk of HIV transmission through blood, non-

observance of universal precautions, and use of contaminated instruments. Emerging prevention interventions are introduced based on international scientific evidence.

Key Points
The predominant mode of HIV transmission in the country is via

heterosexual contact between HIV-infected and uninfected individuals, accounting for approximately 80% of infections. Vertical infections from mothers to newborns and medical transmission account for 18% and 1.8% of infections, respectively. Most at risk populations (MARPs) include transactional sex workers and their clients, men and women who work away from home (such as transportation workers or miners), men who have sex with men (MSM), and injecting drug users (IDUs) Alcohol exacerbates the risk of becoming infected with HIV. Data from studies in Tanzania indicate that men who drink alcohol have a prevalence rate three times higher than those who do not drink (20% versus 7%). Women who drink alcohol have an HIV prevalence rate twice higher than for those who do not drink (14% versus 7%)

Key Points
There is growing recognition that gender norms and gender-

based violence are some of the most influential factors driving HIV transmission worldwide. Multiple concurrent sexual partnerships are perhaps the leading driver of the HIV epidemic in Tanzania. Therefore, one of the main priorities for the National Multisectoral HIV Prevention strategy is to promote reduction in the number of sexual partners, and increase mutual fidelity in both marriage and other types of relationships. Many youth, particularly females, engage in cross-generational sexual relationships and are often motivated by money, gifts or an aspirational social standing. Maganja et al (2007) found that youth exchanged sex for money and other materials in all types of sexual relationships, causal and long term.

Key Points
Transactional sexual relationship is defined as people who

receive money or goods as part of sex. Sex workers are often females who receive money or goods in exchange for sex, either regularly or occasionally and directly solicit for sex in exchange for money. This form of transactional sex is of particularly importance to HIV transmission owing to the complex set of sexual networks and the number of multiple concurrent partnerships involved. In Tanzania, sex work is particularly common in urban areas and other hot spots such as fish landing sites, truck stops on highways, mining towns, and border crossings.

Key Points
Male circumcision has been demonstrated in three clinical trials

in sub-saharan Africa to significantly reduce the risk of HIV acquisition by about 50-60% among men. It is estimated that if safe medical male circumcision was widely available, it could lead to reduction of at least six million new HIV infections and three million deaths in sub-saharan Africa (SADC, 2006) Prevention of HIV transmission through the transfusion of contaminated blood is a key component in the GoTs HIV/AIDS policy. Women and children are at greater risk than men because of the frequent transfusion of blood products due to pregnancy and delivery and the anaemia among young children due to malaria.

Key Points
Considering the multisectoral nature of HIV prevention, the

Prime Ministers Office is best placed to provide oversight of all HIV prevention activities. The MoHSW, through the National AIDS control programme (NACP), has significant role in implementing and providing technical leadership of substantial areas of HIV prevention, especially coordination of all biomedical interventions. In line with the principle of the three ones, TACAIDS has the core mandate of coordination, planning, resource mobilization, and advocacy for all HIV prevention activities.

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