An Overview of HIV Prevention Interventions for People Who Inject Drugs in Tanzania.

In the past decade, Tanzania has seen a rapid rise in the number of people who inject drugs (PWID), specifically heroin. While the overall HIV prevalence in Tanzania has declined recently to 5.6%, in 2009, the HIV prevalence among PWID remains alarmingly high at 35%. In this paper, we describe how the Tanzania AIDS Prevention Program (TAPP), Médecins du Monde France (MdM-F), and other organisations have been at the forefront of addressing this public health issue in Africa, implementing a wide array of harm reduction interventions including medication-assisted treatment (MAT), needle and syringe programs (NSP), and "sober houses" for residential treatment in the capital, Dar es Salaam, and in Zanzibar. Looking toward the future, we discuss the need to (1) extend existing services and programs to reach more PWID and others at risk for HIV, (2) develop additional programs to strengthen existing programs, and (3) expand activities to include structural interventions to address vulnerabilities that increase HIV risk for all Tanzanians.

An urgent need to scale-up injecting drug harm reduction services in Tanzania: prevalence of blood-borne viruses among drug users in Temeke District, Dar-es-Salaam, 2011.

BACKGROUND: Injecting drug use (IDU) is a growing concern in Tanzania compounded by reports of high-risk injecting and sexual risk behaviours among people who inject drugs (PWID). These behaviours have implications for transmission of blood-borne viruses, including HIV and hepatitis C (HCV). METHODS: We recruited 267 PWID (87% male) from Temeke District, Dar-es-Salaam through snowball and targeted sampling. A behavioural survey was administered alongside repeated rapid HIV and HCV antibody testing. HIV and HCV prevalence estimates with 95% confidence intervals (CIs) were calculated. RESULTS: Among PWID, 34.8% (95%CI 29.1-40.9) tested HIV positive (29.9% of males and 66.7% of females); 27.7% (95%CI 22.0-34.0) tested HCV antibody positive. Almost all (97%) participants were aware of HIV and 34% of HCV. 45% of male and 64% of female PWID reported a previous HIV test; only five (2%) PWID reported a previous HCV test. Of HIV and HCV positive tests, 73% and 99%, respectively, represented newly diagnosed infections. CONCLUSION: High prevalence of HIV and HCV were detected in this population of PWID. Rapid scale-up of targeted primary prevention and testing and treatment services for PWID in Tanzania is needed to prevent further transmission and consequent morbidities.