PSI

The challenge

HIV/AIDS remains the leading cause of death among working age adults in Tanzania, despite a recorded reduction in national HIV prevalence from 6.7% to 5.7% between 2004 and 2008. HIV prevalence varies markedly across the country, but is highest in urban areas, and among women of all age groups. Less well known is that HIV prevalence is also highest among wealthier individuals. Condom use is increasing but still remains low, with around half of men reporting having used a condom the last time they engaged in high risk sex. Concurrent sexual partnerships (typically characterized by overlapping, long-term relationships with spouses, boyfriends/girlfriends, sugar daddies/mommies) are believed to be a significant driver of HIV in Tanzania. Experts suggest that even a relatively small reduction in concurrency has the potential to break up extensive and dense sexual networks and can significantly slow the spread of HIV. .

PSI/Tanzania’s condoms can be found in retail outlets in over 80% of rural villages throughout Tanzania

Our Response

PSI/Tanzania is supporting the work of the Tanzania Commission for AIDS (TACAIDS) to reduce the rate and number of new HIV infections by 25% by 2012 through targeted behavioural change initiatives, including a new campaign to address concurrent sexual partnerships, and through the national distribution and promotion of high quality, afordable male and female condoms under the Salama, Familia and Care brands.

Addressing people engaged in concurrent sexual partnerships

In 2009 PSI/Tanzania conducted qualitative research among urban adults exploring concurrency. The research helped to identify beliefs to reinforce and those to change, and to highlight effective strategies for how people can reduce concurrency. The resulting archetypes of Tabia and Majuto, below, are representative for both the female and male target audiences to be reached by this campaign in 2010.

Profile: Majuto– busy, average guy dissatisfied with his relationship with his wife Majuto is a 35-year-old married man in Dar es Salaam who has two children. He works in an office. His relationship with his wife is pragmatic but not passionate, they also argue.He gets sexual satisfaction and emotional support from his girlfriend and he gives her financial support. He sees that having one partner is a good way to avoid disease and save money and he does worry about HIV, the future of his life and being caught by his wife and family. He is proud of his family

Profile: Tabia – unfulfilled, ambitious woman looking for stability Tabia is a 33-year-old married women in Dar es Salaam who has two children. She has her own small business. Her husband is busy and often away during the week. She has taken on a second sexual partner for sexual satisfaction, and emotional and financial support. She is aware that having extra partners increases risk of HIV and worries about losing her image in society and her standing in her family if she’s found out.

Targeting condoms to vulnerable groups

In 2009, PSI/ Tanzania distributed over 70 million condoms, around half of all condoms distributed in Tanzania, and around three quarters of all condoms distributed through the private sector. PSI/Tanzania focuses on making condoms available at the places they are needed, and at critical moments. A nationwide survey in 2009 among ‘high risk’ outlets such as bars and guesthouses found that 81% had PSI/Tanzania’s condoms easily available during the evening. A second survey found that over 80% of villages in Tanzania have at least one outlet selling PSI/Tanzania’s condoms.

Other initiatives have included rolling out condom vending machines in regions of high HIV prevalance, and the targeting of vulnerable students in higher learning institutions.

Scaling up communication work to reach high risk groups

PSI/ Tanzania targets specific high risk groups through its activities. In urban areas, communications work is focused on bars and nightclubs for fun but educational events knows as Salama nights. In 2009 PSI/Tanzania implemented community interventions spread over more than 96% of all districts in Tanzania with community based messages about HIV, reaching over 2 million people directly with community based messages about HIV during mobile video unit events,

Ongea Zaidi na Salama - (Talk more with Salama) In 2009, PSI/Tanzania piloted an SMS based system in two districts of the country for tracking condom availability. Within each dispenser of condoms, retailers will find a scratch card with a unique number that they send via SMS to PSI, showing they have made that dispenser of condoms available in their outlet. The retailer is rewarded with a top-up cell phone credit. PSI/TANZANIA is then able to track the distribution of condoms, and compare the number of condoms available in any area with the population numbers, and against HIV prevalence. PSI/TANZANIA teams use this information to target communication and distribution activities towards the areas with the lowest density of condoms to ensure that they are reaching the areas that need them most. Based on the success of the pilot project, the programme is being rolled out nationally in 2010.

cultural shows, educational events in bars and nightclubs and youth sport events. Millions more were reached through mass media, including radio, television and billboards.

HIV PREVALENCE BY REGION:pdf file

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