Tanzania continues to battle high HIV infection rates, according to the new Tanzania AIDS Indicator Survey (THIS). Seven percent of adult men and women are infected with HIV. Nationwide, prevalence is higher in urban areas. The regions of Iringa and Mbeya have the highest prevalence rate at 13 percent.
The 2003-2004 Tanzania HIV/AIDS Indicator Survey (THIS) includes interviews and blood tests for HIV infection among a nationally representative sample of over 12,000 women and men aged 15-49. The survey was designed to measure regional and national HIV prevalence, to assess knowledge and behavior about HIV/AIDS, and to collect information on chronically ill adults and orphans.
Women are slightly more likely to have HIV infection than men, according to the Tanzania HIV/AIDS Indicator Survey. Overall, 7.7 percent of women have HIV compared to 6.3 percent of the men. Most women get infected between ages 20 and 34. In the 15 to 19 year age group about 2 percent of both men and women are HIV positive. Prevalence among women then rises steadily and peaks at 13 percent for women age 30 to 34. HIV infection among men is lower than among women until age 35 to 39 and then peaks at 12 percent at age 40 to 44.
Tanzanians living in cities are twice as likely to be infected with HIV as their neighbors in rural areas. Infection rates also vary widely in different regions of Tanzania. Over 13 percent of men and women, age 15-49 living in Mbeya and Iringa regions carry HIV infection. In Dar es Salaam 11 percent of adults are infected with HIV. In all regions, men and women with higher levels of education and wealth are more likely to have HIV.
HIV infection is associated with alcohol use and the number of sexual partners. Women who used alcohol during their last sexual encounter are more likely to have HIV than those who did not use alcohol. Women with 2 or more extramarital partners in the past year were two times more likely to be infected than those without.
Knowledge of HIV transmission and prevention as well as safer sexual behavior are increasing in Tanzania, the report shows. For example, the proportion of women who know that mosquito bites do not transmit HIV has increased from 54 percent in the 1999 Tanzania Reproductive and Child Health Survey to 71 percent in the THIS. Similarly, the proportion of women who know that sharing food does not transmit HIV has increased from 58 percent in 1999 to 76 percent in 2003-04. The 1999 survey asked a nationally representative sample of women and men questions about HIV knowledge and sexual practices but did not carry out HIV testing.
Safer sexual behavior is also increasing. “Young women and men are waiting longer to have sex, and fewer women and men report having multiple sexual partners compared to the national survey carried out 5 years ago,” notes Major General (Retired) Herman C. Lupogo, the Executive Chairman of TACAIDS. Compared with 1999, women are delaying first sex by almost a full year, the report notes. The proportion of men having multiple sexual partners has also declined from 27 percent to 20 percent in 2003-04. “These changes are good news and suggest that our HIV prevention programs are bearing fruit,” said Major General Lupogo.
Despite the impressive increases in knowledge, most Tanzanians are unaware that maternal to child transmission of HIV can be prevented, the survey found. Only about 17 percent of women and men surveyed know that if an infected woman takes anti-retroviral therapy (ART) during pregnancy and breast-feeding, she can reduce the risks of passing the virus to her child. In addition, the proportion of women who know that breastfeeding transmits HIV to babies has not changed since 1999. These results suggests that increased efforts are needed to educate women and men about maternal to child transmission and prevention.
Young women and men are the least educated about HIV, the survey shows. Less than half of young women age 15 to 19 could name the major means of HIV transmission and prevention. Moreover, only 23 percent of young women and 26 percent of young men, age 15 to 19, used a condom at first sex. These results suggest that more programs need to address youth age 15 to 19.
The HIV/AIDS Indicator Survey is the first survey in Tanzania to carry out HIV testing on a representative sample of the population. HIV testing was done through anonymous, voluntary blood tests. The Tanzania Commission for AIDS (TACAIDS) initiated the survey, which was funded by the United States Agency for International Development (USAID) and the Development Cooperation of Ireland. The Tanzania National Bureau of Statistics conducted the survey with technical assistance from the MEASURE DHS project led by ORC Macro in Calverton, Maryland in the United States.