HIV Status in Zanzibar
The HIV pandemic has not spared any continent and/or region of the world. Sub-Saharan countries have been the hardest hit, resulting in significantly higher negative outcomes including in ill-health, many deaths and reduced economic productivity. Generally, the United Republic of Tanzania and Zanzibar have not been spared from the challenges and effects of the HIV epidemic either. Each part of the Republic has witnessed and documented variations in the character and pattern of the HIV epidemic. The HIV epidemic in Mainland Tanzania is of the generalised type, largely driven by heterosexual transmission. Based on HIV surveillance surveys both at the National and ANC level, and subsequent assessment of some sub-populations, the HIV epidemic in Zanzibar has signs of being inclined to the concentrated type, and largely driven by MARPs. In-depth analysis of other diseases with a similar transmission profile, such as Hepatitis C, is suggestive of the fact that Zanzibar is not yet experiencing a mature concentrated HIV epidemic. And to ensure the full character of the HIV epidemic in Zanzibar is well characterized and understood to help in better planning and effective implementation of interventions, there is need to undertake an in-depth assessment of risk factors or drivers of the HIV epidemic in the country. This could be done through a national mode of HIV transmission study.
In 1986, the Isles of Zanzibar documented the index case of AIDS at Mnazi Mmoja Hospital. Henceforth, the country has continued to witness a growth in the cumulative number of PLHIV. Initial surveillance reports suggested the potential factors driving the epidemic in Zanzibar as being similar to those witnessed in countries/areas with generalised HIV epidemic. Hence, heterosexual HIV transmission was initially predominantly singled out as the sole mode of transmission on the Isles. The HIV epidemic has spread to all districts in Zanzibar but at unequal pace, levels and magnitude. With limited institutionalised surveillance system and available evidence characterizing the epidemic as generalized, the efforts made to combat the HIV epidemic were targeted at the addressing only the risk of heterosexual transmission.
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