HIV/AIDS in Tanzania: Prevalence and Prevention

This assignment examines the history and current state of HIV/AIDS in Tanzania. It highlights the initial high infection rates and subsequent decline due to government-led prevention and intervention programs. The analysis delves into relevant research, including studies on depression among men who have sex with men, the typology of female sex workers, and the role of key populations in the epidemic. Sources from books, journals, and online platforms are utilized to provide a comprehensive understanding of HIV/AIDS in Tanzania.

The impact of social determinants of health on
specific vulnerable group in two different
countries

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY..................................................................................................................................1
CONCLUSION................................................................................................................................4
REFERNCES...................................................................................................................................5

INTRODUCTION
Human immunodeficiency virus (HIV) is a cause of AIDS (Acquired Immuno Deficiency
syndrome). It is a condition which resultant life-threatening infections and cancers as a result of
immune system failure (Šehović, 2017). Social determinants of health encompass various
conditions in which people in a community grow, work and live. Power and resource
availability, monetary distribution, social gradient, exclusion, social support, addiction habits are
several circumstances which affect everyone’s health conditions. Sex worker is a specific group
of people that can be defined as an individual who earn money as a consideration in return for
rendered sexual services. This assignment aims at examining the impact of several social
determinates i.e. stigma, discrimination, social justice, gender and sexuality, living environment
and health care system on the health of sex workers as specific vulnerable group. Despite various
health awareness and promotional campaigns in Australia, HIV rate shows a rapid increase.
According to Australian Federation of AIDS, in 2015, there were 25,313 people recorded as HIV
positive out of these, 90% were diagnosed by the year end. Out of these, 68% cases reported
sexual contact between men as a key reason of HIV while 20% were caused by heterosexual sex
and 5% as a result of use of injected drugs. Although after a rise in 2012, new diagnoses
treatment stabilized the number of HIV positive people; still, there is a significant proportion of
people are HIV positive. In Tanzania, the number of HIV positive people is 1.4 million, out of
which, 4.7% are adults. According to 2016 statistics, 33,000 people dead due to AIDS and in the
year, 55000 people were discovered with new HIV infection (Ahaneku & et. al., 2016). Thus, the
present essay will discuss and critically examine the impact of social determinants of health on
sex workers in two different countries; Australia and Tanzania.
MAIN BODY
AIDS is not a disease as it comprises number of symptoms. If in an individual, some
serious infectious found and damage his immune system to a great extent, then it will be called
AIDS. It flows through three different stage including Acute HIV infection, chronic HIV
infection and AIDS at final stage (Whiteside, 2016). First stage develops within around 2-4 wks
after HIV infection and fever, rashes, headache are some of the common symptoms of it. In this
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stage, virus in human body destroys CD4 cells who fought against disease (Šehović, 2017).
Afterwards, in the following stage, asymptomatic HIV infection can be seen, in which, HIV rises
but at low level, at this stage, no other symptoms are found for around 10-15 years but virus
infect more cells in the body. Lastly, AIDS is the last stage and can be seen when HIV infection
damaged immune system totally and human body is unable to fight against opportunistic
infections. People whose CD4 cells are below 200 cells/mm3 are diagnosed with AIDS (Rock &
Joseph, 2017).
The rate of HIV infection is very high among sex workers compared to other people.
Mpondo, Gunda & Kilonzo (2017), research found that the risk of HIV infection among sex
workers in Tanzania is 14 times greater than general population. The study evident that after
PWID (people who inject drugs) @ 42%, HIV prevalence is highest among female sex workers
to 31.4%. Sexually Transmissible Infection (STI) reported that high rate of change of partners,
low usage of condom and multiple sexual relationships are the key risk factors behind HIV
among sex workers. However, in Australia, HIV infection is transmitted mainly due to sexual
intercourse without the use of condom and very less HIV cases recognised as use of needle and
syringe sharing and other injecting equipments. According to HIV In Australia (2015), HIV
prevalence is low among brothel-based sex workers because they are very less involved in usage
of drugs, high condom usage rate and very low level of STIs. Sydney based workers also
reported very low rate of STIs i.e. trichomoniasis, syphilis, HIV, chlmydia, gonorrhoea and
others.
Gender inequality is the key reason behind high rate of HIV prevalence among women.
According to UNAIDS, there are currently 780,000 women as HIV positive aged just 15 or
above. The rate of HIV is 5.8% among Female Sex Workers (FSWs) comparatively lower then
men at 3.6% only. There are 25000 FSWs reported HIV infected with only 20,000 men lies in
the age group of 15-24 years. It is because of early age marriage and also they face difficulties in
negotiating with their life partner for safe sex due to gender inequality and discrimination.
Stigma and discrimination fear arise difficulty for the sex workers to check such infection and
get better heealther-care facilities. Due to discrimination, social assistance does not exist, in
addition, partner does not allow FSW to use condom, even they are ready to pay double charges
to have sex without condom usage. As they give high priority to their children and family
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requirement, therefore, they need to accept the client proposal caused HIV. Although the HIV
prevalence is declining, still, it remains high among female workers.
https://www.ncbi.nlm.nih.gov/pubmed/23139959
However, in Australia, discrimination and stigma are the powerful drivers of high
prevalence of HIV transmission; still, it are not about gender inequality like Tanzania. According
to Cameron (2014), sex working is misunderstood by others, and as a result, they are
discriminated and stigmatised. Prejudice is taking place for so long years, this in turn, sex
workers are experiencing undeserved reputation. Sensationalist media also plays a great role in
it, and the group have no legal protection for their occupation as a sex worker (Sex workers, HIV
and AIDS, 2017).
Economical conditions of the sex workers is another reason for HIV infection, In
Tanzania, “Sugar daddy” culture is extremely popular wherein female involved in sexual
relationship with older aged men just for satisfying their monetary requirement and social
advancement as well. At the same time, their life partner’s violent acts also are a key concern
which encourages them to involve in sexual relationship with others. As per the UNAID report,
30% of married female in the age group of 15-24 years experiences sexual and/or physical
violence which affects their health adversely as they involved in sexual advancement with others
caused HIV infection. Thus, poor economic situation is a main concern for the FSWs which
increased HIV rate.
Evidencing it, HIV and AIDS in Tanzania. (2017), in a party at Mkinga District, a young
lady said that “she has a child and when she involved in sexual advancement with the other men,
then such men give her something to buy milk for the child”. Besides this, As per the study of
Kamazima (2012), 32 FSWs in Dar-es-Salaam were interviewed and it is found that need for
money, type of sexual services, and availability of clients are the main risky factors of HIV. It
clearly demonstrates that sex working became a necessity for the FSWs to meet their basic
needs.
Unlike this, in Australia, although earlier, due to stigma and prejudice against sex
workers, they were unable to access best vaccination and treatment (Australian Institute of
Criminology, 2015). However, now the situation is changed, as government made wonderful
efforts by introducing various HIV interventions and prevention ways targeting specially sex
workers, as a result, now they are engaged in regular testing and home-based testing i.e. TasP
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(Trevention as prevention) and PrEP (Pre Exposure Prophylaxis) to reduce HIV testing barrier.
This help nation to reduce their HIV infected people from 1082 to 1025 in 2015 (Australian
Federation of AIDS Organization, 2017). The rate is too low among FSWs to 0.1% only.
Now, the situation is changed, in Tanzania, Gaff (2016), prostitution is treated as an
illegal act. Recently, there were 800 workers arrested as a suspect in prostitution crackdown, out
of which, 500 were being seized and 300 were sent to jail. Out of these, many were young
women in Dar-es-Salaam who demand $4.58 (10,000 shillings) from the clients. Sex work
settings started using HIV prevention strategies such as antiretroviral medication, rising use of
condom, counselling, HIV testing and others, still, stigma and gender inequality are the key
barriers in HIV reduction (HIV and AIDS in Tanzania, 2017). In contrast, Australia reported
good progress in HIV reduction through Peer education, prevention programes, harm reduction
i.e. syringe and needle programme are the efforts made by Government to render healthcare
facilities to the sex workers. As per 7th HIV strategy, it is targeted to eliminate HIV transmission
totally by the end of 2020.
CONCLUSION
From the discussion made, it is understood that discrimination between male and female
and poor economic conditions are the two main reasons behind why FSWs are reported as HIV
infected. Due to discrimination, even FSWs are not being allowed by their partner to involve in
safer risk through the use of condom which increase the rate of HIV. In contrast to this, in
Australia, stigma and discrimination is the main reasons which raises HIV infection rate,
however, various prevention and intervention strategies launched by government to reduce the
HIV transmission brought exceptional results and reduced HIV prevalence in the nation.
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REFERNCES
Books and Journals
Ahaneku, H. & et. al. (2016). Depression and HIV risk among men who have sex with men in
Tanzania. AIDS care. 28(sup1). 140-147.
Kamazima, S. R. (2012). The Typology of Female Sex Workers in Dar-es-Salaam: Implications
to HIV and AIDS Interventions Targeting Female Sex Workers in Tanzania. East
African journal of public health. 9(2). 62-69.
Mpondo, B. C., Gunda, D. W., & Kilonzo, S. B. (2017). HIV Epidemic in Tanzania: The
Possible Role of the Key Populations. AIDS research and treatment, 2017.
Rock, L., & Joseph, D. D. (2017). Topic: addressing HIV and AIDS in the English-speaking
Caribbean: theoretical approaches, intervention and education. Social Work Education.
36(4). 345-358.
Šehović, A. B. (2017). HIV and AIDS. In Coordinating Global Health Policy Responses.
Springer International Publishing. pp.41-63.
Whiteside, A. (2016). HIV & AIDS: A very short introduction. Oxford University Press.
Online
Australian Federation of AIDS Organization. (2017) HIV prevalence in Ausralia. Available
through: < https://www.afao.org.au/wp-content/uploads/2017/04/HIV-in-Australia-
2017.pdf>.
Australian Institute of Criminology. (2015). The Australian sex industry. [Online]. Available
through: <
http://www.aic.gov.au/publications/current%20series/rpp/121-140/rpp131/05_aus_indus
try.html>.
Cameron, C., 2014. Being a HIV+Sex worker in Australia. [Online]. Available through: <
http://talkabout.positivelife.org.au/previous-editions/183-february-2015/7-being-a-sex-
worker-in-australia>.
Gaffy, C. (2016). Tanzaia arrests 800 sex work suspects in prostitution crackdown. [Online].
Available through: < http://www.newsweek.com/tanzania-arrests-800-sex-work-
suspects-prostitution-crackdown-437375>.
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HIV and AIDS in Tanzania. (2017). [Online]. Available through:
https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/tanzania.
HIV In Australia. 2015. [Online]. Available through: < http://www.hivmediaguide.org.au/hiv-in-
australia/hiv-statistics-australia/>.
Sex workers, HIV and AIDS. (2017). [Online]. Available through:
https://www.avert.org/professionals/hiv-social-issues/key-affected-populations/sex-
workers.
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