The general population HIV prevalence stands at 5.1%(THMIS 2011/12) down from 18% in 1990. HIV and STIs prevalence are also high among KP's, HIV is 31.4% while other STI has an average of 26% prevalence. The number of KP's is not known, although there are fledgling groups of KP's which have started advocating for the Right to Health of KP's including protection against HIV infection, care and treatment to PLHIV KP's.

1. The United Rep. of Tanzania Presentation
THE SITUATION OF KEY POPULATION
(KP’s)
Tanzania.

2. Content
• Current HIV/AIDS epidemic in Tanzania
• KP’s programming
• Legal Framework
• Best Practices and Lessons Learnt
• Current Services

3. The Current HIV/AIDS Epidemic in
Tanzania

4. Epidemiology of HIV and STIs
among Key Population
• The general population HIV prevalence stands at
5.1%(THMIS 2011/12) down from 18% in 1990.
• HIV and STIs prevalence are also high among KP's,
HIV is 31.4% while other STI has an average of 26%
prevalence.
• The number of KP's is not known, although there are
fledgling groups of KP's which have started advocating for the
Right to Health of KP's including protection against HIV
infection, care and treatment to PLHIV KP's.

5. Prevalence of HIV and STIs among
KP's in Dar

6. KP's Programming
• KP's have been invisible in the planning processes of
intervention against HIV/AIDS until recently, when Tanzania
recognized the need to include the group after identifying them as
Most at Risk Populations (MARPs).
• The current NMSF acknowledged the vulnerability of sex
workers and men who have sex with men and advocate for their
access to HIV preventive information and services and for the
decriminalization of their activities.
• Tanzania’s National Strategic Plan mentions KP's as a MARPS
and goes further to recommends decriminalization of activities’
that put KP's at risk.

7. Legal Framework for KP's Programming
• There is hostile environment for KP's Programming for both social
and political environment .
• In Tanzania mainland, Sex work & Anal sex is considered an
Illegal.These environment made the entire KP’s community to operate
underground.
• Despite the legal situation, KP's has been included into the National
HIV/AIDS Plan under MARP (NMSF)
• At community level, individuals KP's face health disparities linked to
societal stigma, discrimination, and denial of their human rights.
• Weak coordination and oversight at Regional and Local Government
Level
• Weak and sporadic interventions, particularly at community level
• Low coverage of interventions targeting KPs in the country
(concentrated in Dar.

8. Best Practices and Lessons Learnt
• Legal frameworks institutionalize discrimination against KP’s , this only
fuels the epidemic and prevents cost-effective interventions. We must ensure
that AIDS responses are based on evidence, not ideology, and reach those most
in need and most affected.
• Fear of arrest and the ensuing police brutality- because same sex practice is
a criminal offence has driven KP's (who comprise a major portion of sexual
minorities) underground and few HIV/AIDS Programs reach them. The
programs that do reach them are mainly missionary oriented in content which
the ‘rescue and rehab’ brigade believe would make this group stop their
same sex practice and become ‘normal’.
• The need to conduct Operational Research as there are limited information
on KP's in Tanzania. This would first provide baseline information to the
program regarding this population.
• Strengthening the capacities of KP's groups and organization working with
this group at the community level on HIV/STI’s targeting KP's/TG
communities

9. • Providing adequate knowledge and education that can
empower KP's to make an informed decision.
• Address stigma and discrimination among families and the
community with KP's as care and support starts at family.
• Addressing the issue of quality services to KP's by establishing
and providing friendly clinical health services to the groups.
Services like the VCT, CTC and other HIV related services.
• Capacity to increase reach KP's PLHIV: KP's are among the
most marginalized groups in society. It becomes worse when they
are LHIV and are afraid to access ART. This should be
counteracted with counseling techniques which are specifically
designed to deal with the anger of KP's who face Triple stigma-
of being KP's, Rejection and of being PLHIV.

10. Current Services
• CSOs responses to KP's Rights and Needs fall broadly into
three categories:-
– HIV/AIDS Intervention;
– Human Rights and KP's Empowerment Initiatives have started emerging
– Rescue and Rehabilitation;
• These efforts need to be built upon and strengthened to ensure that
they get support and advance the rights of KP's to Information;
Education and Resources like condoms and lubricants in order to
Scale up the National Response to HIV/AIDS.
• Inclusion of all KP’s in HIV/AIDS Programming and Planning
Processes.
• Capacity building to service providers and the community to
apply innovative approaches in National response.
• CSOs

11. Way Forward/needs
• Strengthen of KP's organization to Increase uptake
and reach.
• Develop stigma reduction guide for KP's & HWs
• Targeted condom & Lubricants programming,
IEC,BCC
• Ensure inclusion of KP's surveillance activities in
the National HIV Surveillance Plan.
• Developing a Comprehensive massage on KP’s
which will be use with different actors

12. Way Forward/needs
• Develop SOPs for peer educators and outreach
programs for KP's.
• Create enabling environment for KP's
- Advocacy and community engagement to
address barriers,
- vulnerability,
- stigma and discrimination
Develop Safety and Security Strategy.
Research: Monitoring, Documenting and Reporting

13. THANK YOU.
AHSANTE SANA