Inadequate access to harm reduction services may cause higher HIV prevalence among women who use drugs in Tanzania

In his current research at the Muhimbili University of Health and Allied Sciences, and in collaboration with researchers from University of Copenhagen, Samuel L. Likindikoki examines the prevalence of HIV among people who use drugs in Tanzania. The study assesses the determinants of access to HIV prevention interventions. In finding these results, Samuel studied a sample of people who use drugs in two coastal cities in Tanzania.

The higher prevalence of HIV may be due to inadequate access to harm reduction services. We observed relatively low access to comprehensive HIV services such as condoms, sterile needles, syringes, peer-to-peer services, and testing for infectious diseases.

Among Samuel's main findings are the decrease in HIV prevalence, determinants of access to HIV prevention services, and the fact that specific groups are more at risk:

“People who use drugs are mostly affected by HIV compared to the general population in Tanzania. In the last few years, the prevalence of HIV among people who use drugs has decreased but women who use drugs are disproportionately more affected.”

In explaining what causes this difference between the general population and people who use drugs, Samuel highlights the lack of access to HIV prevention services:

“The higher prevalence of HIV may be due to inadequate access to harm reduction services. We observed relatively low access to comprehensive HIV services such as condoms, sterile needles, syringes, peer-to-peer services, and testing for infectious diseases.”

Determinants of access to HIV prevention strategies included; level of education, income, individual perception of HIV risks, drug use stigma, the experience of violence, conflict with laws, availability of facilities, and health care workers providing uniquely needed services to people who use drugs. 

Samuel also pointed out that there is a general lack of research on the determinants of HIV prevention services.

“Generally, there is a scarcity of data that looks comprehensively at the determinants and levels of access to HIV prevention services among people who use drugs.”

According to Samuel, these results emphasize the need for change.

“Urgent actions are needed to scale up HIV prevention strategies among people who use drugs in Tanzania. In addition, the ongoing implementation of the comprehensive services should be tailored and use a people-centered-approach and address social enablers in mitigating HIV among people who use drugs.” 

In addition, the study shows that well-implemented interventions can reduce HIV transmission among people who use drugs.

“We were able to show that HIV prevalence is decreasing in this population and link it with the ongoing interventions in Tanzania. We were also able to identify important, modifiable factors that, if well implemented, would significantly reduce HIV transmission among people who use drugs.”

In finding these results, Samuel conducted two samples in Tanzania.

“We sampled people who use drugs in two coastal cities of Tanzania. We took blood samples to determine the prevalence of HIV and also administered the bio-behavioral survey to understand the predictors of HIV, the determinants, and levels of access to HIV prevention services.”