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BACKGROUND: According to the 2016-2017 Tanzania HIV Impact Survey, 55% of men diagnosed with HIV during the survey self-reported that they were unaware of their HIV status. As a response, the Government of Tanzania launched a Test and Treat campaign in June 2018 with a focus on reaching men and developed the 2018-2020 Male Catch-Up plan. This article reports (1) the enablers and barriers of HIV testing services (HTS) uptake among men (2) and describes the strategies that were proposed as part of the Male Catch-Up Plan to address some of these barriers. METHOD: Qualitative in-depth interviews were conducted with 23 men in Dar es Salaam to explore HTS enablers and barriers. To develop the Male Catch-Up Plan strategies, a desk review of published studies, and analyses of national implementers of HIV/AIDS interventions were conducted. An additional 123 interviews were also carried out with key implementers of HIV/AIDS interventions, healthcare workers, secondary school boys and members of the community in Iringa and Tanga. RESULTS: Enablers of HTS included the desire to check one's health, high HIV risk perception, wanting to protect oneself if tested negative, and being encouraged by their sexual partners. Barriers of HTS were fear of a positive test result, and low HIV risk perception. Proposed strategies from the Male Catch-Up Plan to address these barriers included non-biomedical and biomedical approaches. Non-biomedical strategies are social and cultural approaches to promote an enabling environment to encourage health seeking behavior, safe behavior, and providing peer education programs and social marketing to promote condoms. Biomedical approaches consisted of expanding targeted HIV testing, HIV self-testing, and integrating HIV services with other health services. CONCLUSION: A number of barriers contribute to the low uptake of HTS among men in Tanzania. National strategies have been developed to address these HTS barriers and guide the national Test and Treat campaign focusing on increasing HTS uptake among men.
Assuntos
Infecções por HIV/diagnóstico , Planejamento em Saúde , Acessibilidade aos Serviços de Saúde , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Pesquisa Qualitativa , Parceiros Sexuais , Tanzânia , Adulto JovemRESUMO
Although several international and national HIV/AIDS conferences exist, there was not a national conference in Tanzania focusing on HIV/AIDS disseminating and implementation research conducted in the country and abroad. This created a missed opportunity for researchers to share their research findings with local policymakers and HIV program implementers who can influence the adoption and implementation of promising research in public health and clinical practice settings. In response, the first HIV/AIDS D&I Research Forum designed to enhance local D&I efforts for HIV research, was organized in Tanzania in 2018. This paper explores the perceived benefits of the HIV/AIDS D&I Research Forum and potential challenges of developing similar forums and recommendation for future HIV research D&I conference in Tanzania. During the second day of the Forum, which was held in September 2018 in Morogoro, Tanzania, a 1-hour structured brainstorming session was conducted with the Forum attendees (n = 50), including researchers, medical professionals, policymakers, representatives from different ministries. Transcription of the brainstorming session was analyzed to identify benefits of the Forum, perceived challenges for organizing similar HIV/AIDS research dissemination events, and recommendations for addressing the challenges. Overall, participants perceived the forum to be beneficial because it provided opportunities for strategic collaborations between researchers, policymakers, and other stakeholders and for them to discuss challenges for D&I efforts. Forum attendees also identified several potential challenges for future D&I research forums such as the abstract requirement which may deter non-researchers, costs, meeting frequencies, and lack of funding and coordination between organizations involved in D&I research efforts. To address these concerns, a recommendation was made to host a biennial national conference in order to allow more time for ethical review and feedback that can enhance contribution of the project to D&I efforts and to raise funds. The benefits identified for the Forum highlight the importance of organizing similar D&I meetings for HIV-related research at the national level in Tanzania. However, the potential challenges discussed need to be addressed in order to develop a sustainable national D&I research conference by incorporating recommendations that forum attendees proposed.
RESUMO
Evidence has demonstrated that immediate HIV treatment initiation upon a positive HIV test, referred to as Test and Treat, can help people living with HIV live longer, healthier lives and prevent HIV transmission. Although Tanzania adopted the evidence-based Test and Treat strategy since 2016, men were not being adequately reached for HIV services. A national campaign was launched to promote the new HIV services with a focus on men. To inform the development and implementation of the campaign, we conducted formative audience insights-gathering (AIG) sessions to assess facilitators and barriers to accessing HIV Test and Treat services and inform the concepts and materials for the campaign. Qualitative AIG interviews and focus group discussions were conducted with 54 people who were unaware or aware of their HIV status and currently or not currently on treatment, as well as health workers. Facilitators and barriers included a fear of testing positive, the desire to belong, control their narratives, and reinvent themselves to achieve their dreams and live a happy life. The campaign played off a My Happiness! creative concept to position antiretroviral therapy (ART) as a solution to fears around what life would be like after a positive HIV diagnosis. The development and implementation of the campaign were informed by the AIG sessions and national stakeholders, leading to strong partners' buy-in that supported the scale-up of the ongoing campaign from 12 to 26 regions via the collaborative efforts of government, donors, and implementing partners.