Villagers of South Unguja Pete acquiring knowledge about the fight against AIDS through Jihadhari magazine released by Zanzibar AIDS Commission
Children at ZAPHA+
ZAC Monitoring and Evaluation Coordinator Mr. Ali Kimwaga in one of the M&E meeting
Theatre for Social Development (THESODE) on the stage
Group Picture during World AIDS day climax 2015
Participants attended National Youth Forum in Zanzibar
Group Picture during World AIDS day climax, 1 December 2016
Waziri wa Nchi Ofisi ya Makamu wa Pili wa Rais Mhe. Mohamed Aboud Mohamed akizungumza na Watendaji wa Wizara yake ikiwemo Tume ya UKIMWI ambayo imehamishiwa Wizara hiyo.

ZAC Chairperson

Welcome to the Zanzibar AIDS Commission (ZAC) Website. We hope that the ZAC website will serve to give a closer picture about ZAC...Read More

STIs can infect you in many ways. They can be caused by bacteria. They can be viruses. They can even come in the form of parasites like pubic lice. STIs are found on the body, in blood and in body fluids like semen (cum) and vaginal fluids. Sometimes, STIs like genital warts and herpes can be spread through skin-to-skin contact - simply kissing someone with a herpes blister may be enough to infect you. STIs are spread from person to person during sex - and that means oral sex and anal sex as well. Injection drug use (IDU), tattooing or body piercing can also spread an infection if the needles and equipment aren't clean. An STI can be passed from a mother to her baby during pregnancy, at the time of delivery and through the process of breastfeeding. Most STIs can be cured, but some will never go away and require lifelong treatment. And make no mistake: having an STI puts you at a greater risk of getting HIV/AIDS.

Yes. It's just another term used to describe infections that are spread through sexual contact

It's not always easy to recognize the signs of an STI in you or your partner. In fact, some STI's have no symptoms at all, so you may not even know you have one unless you get tested. You might have an STI if you experience any of these signs: * Burning feeling in your genitals or when you pee. * Sores, small bumps or blisters on or near your penis, vagina or anus. * Itching around your penis, vagina or anus. * Unusual discharge - like a different colour, smell or amount - from the vagina or penis. * Lower abdominal pain. * Pain in the testicles. * Bleeding after intercourse or between periods. * Pain during sex or masturbation. * For women, unusual bleeding during your period. Think you might have an STI? Check out What do I do if I have an STI? REMEMBER: Using condoms every time you have sex can lower your chances of getting an STI and HIV/AIDS

Chancroid (pronounced SHANG-chroid), also called soft chancre, is a curable bacterial disease that is characterized by painful sores on the genitals. There is an alarming connection between chancroid and human immunodeficiency virus (HIV) infection. HIV causes AIDS (acquired immunodeficiency syndrome) and is easily spread from person to person through chancroid ulcers. Uncircumcised men with chancroid ulcers have a 48% risk of acquiring HIV from sexual contact. Women with chancroid ulcers are also at a greater risk of being infected with HIV during sexual contact. Genital ulcers seem to act as doorways for HIV to enter and exit.

Ways of Transmission Sexual transmission of chancroid occurs through skin-to-skin contact with open sore(s). For women, the sore is usually not painful, and may not be noticed; but in men, the ulcer can be very painful. Symptoms Symptoms of chancroid are one or more genital ulcers and painful lymph glands in the groin. The ulcer begins as a tender bump that becomes a pus-filled, open sore. It is soft (unlike a syphilis chancre that is hard or rubbery to touch). Common locations for chancroid sores (ulcers) in men are the shaft or head of the penis, foreskin, the groove behind the head of the penis, the opening of the penis, and the scrotum. In women, common locations are the labia majora (outer lips), labia minora (inner lips), perianal area (area around the anal opening), and inner thighs. It is rare for the ulcer(s) to be on the vaginal walls or cervix. Testing Diagnosis is made by evaluating the ulcer(s) and presence of swollen lymph nodes, and by obtaining a culture from the base of the ulcers. There are no serological tests for chancroid such as those available for syphilis.

Treatment Chancroid can be treated with antibiotics. Successful treatment cures the infection, symptoms go away and it's no longer contagious (able to be spread to another person). It is important to take all the antibiotics from start to finish. If you do get chancroid, avoid touching the infected area to prevent the chance of autoinoculation (re-infecting yourself somewhere else on your body). Prognosis Chancroid can resolve spontaneously. However, some people may experience months of painful ulceration and draining. Antibiotic treatment usually results in rapid clearing of lesions with a minimal to small amount of scarring. Prevention The best prevention for chancroid is abstinence (avoidance of any sexual contact) or being in a monogamous relationship with a disease-free partner. If abstinence is not an option, using a condom properly during each sexual intercourse another preventive measure. To prevent the spread of chancroid, it is important that all sexual partners of the patient are identified and treated

Syphilis is caused by the bacterium Treponema pollidum. If untreated, it goes through three stages, with different symptoms at each stage. During the first stage, a single chancre (painless sore) forms on your genitals, rectum, or mouth or throat. It will disappear on its own in three to six weeks, without treatment. The second stage occurs about six months later. Sores and a rash may occur anywhere on your body. You may feel like you have the flu, with headache and aches and pains in your joints or bones. You may also experience hair loss and flat, wart-like growths inside your anus or vagina. Without treatment these symptoms may come and go.

Symptoms of the third stage may take 10 to 20 years to develop. They can be very serious and can result in blindness, heart or brain damage, and, in some cases, death. People with HIV and AIDS seem to develop third stage syphilis much faster than others. Syphilis is diagnosed by a series of blood tests. The first test, called the VDRL, is a screening test. Usually, if this test is negative, you don't have syphilis. However, people with HIV and AIDS may have false-negative VDRL tests. If you suspect you have been exposed to syphilis, you may want to ask your doctor to run two other tests, called the FTA-ABS and the MHA-TP. Syphilis is treatable with antibiotics, and should be treated as soon as possible.

Chlamydia is a very common STD caused by bacteria. It is particularly common among teens and young adults. Ways of Transmission Bacteria transmitted during sex cause Chlamydia. If a mother is infected, she can pass Chlamydia on to her baby during delivery. Symptoms Chlamydia is known as the "silent epidemic" because three quarters of the women and half of the men with the disease have no symptoms. If symptoms do appear in women, they can include vaginal discharge, pain during urination (peeing), pain during sex, pain in the lower abdomen and bleeding between menstrual periods. Men often have a discharge from the urethra, the opening in the penis. It may also burn or hurt to urinate. Symptoms can vary from person to person -- from being mild to severe. Men also may not have symptoms.

Testing: There are two kinds of test for Chlamydia. One involves collecting a small amount of fluid from an infected site (cervix or penis) with a cotton swab. These tests are universally available. New tests, which use only urine samples, will be available soon and will make testing much easier and less painful. Treatment: There has been major progress in the treatment of Chlamydia with antibiotics over the past few years. Early antibiotic treatment is extremely successful and may prevent the development of long-term complications. However, if it is left untreated, in a woman, Chlamydia (like gonorrhea) can grow into a more serious illness called pelvic inflammatory disease (PID) and can keep her from being able to have children in the future.

Prevention: You can get and spread Chlamydia through unprotected vaginal and anal sex. Preventing Chlamydia means approaching sexual relationships responsibly: exercise, abstinence, stay in a monogamous relationship or limit the number of your sex partners, use condoms properly each time you have sexual intercourse, and if you think you are infected, avoid any sexual contact and visit a local health clinic, hospital, or your doctor. Be sure your partner is treated to avoid becoming reinfected.

Gonorrhea is also known as "the clap" or "the drip." It is a commonly occurring, curable sexually transmitted infection (STI) caused by a bacterium called Neisseria gonorrhoeae. These bacteria can infect the genital tract, the mouth, and the rectum. In women, the opening to the uterus, the cervix, is the first place of infection. An important increased in gonorrhoea rates has been seen in Eastern Europe, in the newly independent states of the former soviet union, with the highest rate in Estonia, Russia and Belarus (111, 139 and 125 per 100 000 respectively).

Ways of Transmission Gonorrhea is spread during sexual intercourse. Infected women also can pass gonorrhea to their newborn infants during delivery, causing eye infections in their babies.

Symptoms The early symptoms of gonorrhea are often mild. Symptoms usually appear within 2 to 10 days after sexual contact with an infected partner. A small number of people may be infected for several months without any symptoms. Women often have no symptoms at all or very mild ones. If symptoms appear, they may include burning during urination and/or a vaginal discharge. Men may have a yellow discharge from the urethra, opening in the penis. It may also burn or hurt to urinate. Symptoms vary from person to person -- from being mild to severe. Men also may not have any symptoms. Symptoms of rectal infection include discharge, anal itching, and occasional painful bowel movements with fresh blood on the faeces.

Testing: Laboratory tests by doctors or other medical personnel are necessary to diagnose Gonorrhea. The three options include: staining samples directly for the bacterium, detection of bacterial genes or DNA in urine, and growing the bacteria in laboratory cultures. Many medical practitioners prefer to use more than one test to increase the chance of an accurate diagnosis. Treatment Antibiotics or penicillin can easily cure gonorrhea if treated early. Gonorrhea and Chlamydial infection, another common STI, often infect people at the same time. Therefore, doctors usually prescribe a combination of antibiotics, which will treat both diseases.

Prognosis Untreated gonorrhea infections, the bacteria can spread up into the reproductive tract, or more rarely, can spread through the blood stream and infect the joints, heart valves, or the brain. If it is left untreated in women, gonorrhea (like Chlamydia) can progress into a more serious illness called pelvic inflammatory disease (PID) and can keep women from being able to have children in the future. If it is left untreated in men, it can make them sterile (unable to have children). During pregnancy, a gonorrhea infection can cause problems such as stillbirth or blindness for the baby.

Rarely, untreated gonorrhea can spread through the blood to the joints. This can cause an inflammation of the joints, which is very serious. Gonorrhea increases risk of getting HIV infection. Prevention You can get and spread Gonorrhea through unprotected vaginal and anal sex. Preventing Gonorrhea means approaching sexual relationships responsibly: exercise abstinence, stay in a monogamous relationship or limit the number of your sex partners, use condoms properly each time you have sexual intercourse.

Pelvic inflammatory disease (PID) is, next to AIDS, the most common and serious complication of all STIs in women. PID can affect the uterus, ovaries, fallopian tubes, and other related structures. Many different microorganisms can cause this disease, but most cases are associated with gonorrhea and Chlamydial infections. Scientists have found that bacteria normally present in small numbers within the vagina and cervix may also play a role.

Ways of Transmission PID is usually caused by a sexually transmitted infection, but gynaecological surgical procedures such as abortion or the insertion of an intra-uterine device (IUD) can cause the infectious agents to spread upwards from the cervix and vagina. One study found that 12% to 14% of all PID cases had been caused by gynaecological procedures within 6 weeks of admission. IUDs may increase the risk of PID because the string attached to the device, which extends down into the vagina acts as a wick for infection, allowing bacteria to ascend more easily into the upper genital tract. The relative risk of PID for sexually active young women using IUDs is one-and-a-half times greater than for young women not using IUDs. The chance in those women who are using barrier methods (i.e. condoms and diaphragms) is about half that of those who do not use barrier methods, which is not to say that use of condoms should be stopped, as it prevents transmission of other STIs, including HIV. Women using oral contraception appear to have one-third the risk of those who do not use oral contraception.

Symptoms The most prevalent symptoms of PID are lower abdominal pain and abnormal vaginal discharge. Other potential symptoms are fever, pain in the right upper abdomen, painful intercourse, and irregular menstrual bleeding. PID, particularly when caused by Chlamydial infection, may produce only minor symptoms or no symptoms at all, even though it can seriously damage the reproductive organs. Testing Testing for the major causative organisms must be undertaken. However, sometimes laparoscopy (investigation by minor surgery) will be required to correctly diagnose PID. Treatment Outpatient care may be sufficient for women with mild symptoms, who can be treated by antibiotics and close monitoring, but hospitalisation is necessary for women with more severe infection. It is imperative that regular male partners are tested for STDs and treated if necessary.

· In men, symptoms can be mild or non-existent so they may not present for testing or treatment. Prognosis In 15% of cases, the initial antibiotic therapy fails, and 20% experience a recurrence of PID at some time during the reproductive years. The risk for ectopic pregnancy (tubal; cervical; or abdominal pregnancy) increases from 1 in 200 to 1 in 20 after having PID. This type of pregnancy is life threatening to the mother, and almost always fatal to her fetus. Infertility risks also increase: * 15% risk of infertility following the 1st episode of PID * 30% risk of infertility following 2 episodes of PID * 50% risk of infertility following 3 or more episodes of PID Infertility, chronic pelvic pain, and scarring occur in approximately one out of every five women who have had PID. Prevention * The use of condoms during penetrative sexual intercourse. * The use of condoms if an IUD is in place. * Sexual practices other than intercourse carry less risk of transmitting the infections that cause PID. * Where infection has occurred, it is important to avoid sexual contact involving the genitals during the course of treatment until a negative test result is obtained. * This will aid healing and prevent transmission.

Trichomoniasis (referred to as trich) is a common sexually transmitted infection (STI) caused by a protozoan, Trichomonas Vaginalis, a parasite that can infect both the vagina and the urinary tract. In men, the infection will only occur in the urethra.

Ways of Transmission Trichomoniasis is a sexually transmitted infection (STI) that is spread through penis-to-vagina intercourse or vulva-to-vulva contact with an infected partner. Women can acquire the disease from infected men or women, whereas men usually contract it only from infected women. Trichomoniasis is the most common curable STI in young, sexually active women.

Symptoms Most men with Trichomoniasis do not have signs or symptoms. Men with symptoms may have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation. Many women do have signs or symptoms of infection. In these women, Trichomoniasis causes a frothy, yellow-green vaginal discharge with a strong odour. The infection may also cause discomfort during intercourse and urination. Irritation and itching of the female genital area and, in rare cases, lower abdominal pain can also occur. Symptoms usually appear within 5 to 28 days of exposure in women. Testing To diagnose Trichomoniasis, a health care provider must perform a physical examination and laboratory test. In women, a pelvic examination can reveal small red ulcerations on the vaginal wall or cervix. Laboratory tests are performed on a sample of vaginal fluid or urethral fluid to look for the disease-causing parasite. The parasite is harder to detect in men than in women.

Treatment Trichomoniasis can usually be cured with the prescription drug metronidazole given by mouth in a single dose. The symptoms of Trichomoniasis in infected men may disappear within a few weeks without treatment. However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eliminate the parasite. Persons being treated for Trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms. Prognosis Trichomoniasis in pregnant women may cause premature rupture of the membranes and preterm delivery. The genital inflammation caused by Trichomoniasis might also increase a woman's risk of acquiring HIV infection if she is exposed to HIV. Trichomoniasis in a woman who is also infected with HIV can increase the chances of transmitting HIV infection to a sex partner. Prevention Abstinence, mutual monogamy with an uninfected partner and limiting the number of sex partners are effective ways of preventing or lowering risk of getting trichomoniasis.

Hepatitis is a viral infection of the liver which had been referred to as parenterally transmitted "non A, non B hepatitis" until identification of the causative agent in 1989. HCV is found in the blood of persons who have this disease and is spread by contact with the blood of an infected person.

Ways of Transmission HCV is spread primarily by direct contact with human blood. Transmission through blood transfusions that are not screened for HCV infection, through the reuse of inadequately sterilized needles, syringes or other medical equipment, or through needle-sharing among drug-users, is well documented. Sexual and perinatal transmission may also occur, although less frequently.There is a very low chance of spreading HCV through sexual activity. Other modes of transmission such as social, cultural, and behavioural practices using percutaneous procedures (e.g. ear and body piercing, circumcision, tattooing) can occur if inadequately sterilized equipment is used. HCV is not spread by sneezing, hugging, coughing, food or water, sharing eating utensils, or casual contact.

In both developed and developing countries, high risk groups include injecting drug users, recipients of unscreened blood, haemophiliacs, dialysis patients and persons with multiple sex partners who engage in unprotected sex. In developed countries, it is estimated that 90% of persons with chronic HCV infection are current and former injecting drug users and those with a history of transfusion of unscreened blood or blood products. Testing There are several blood tests that can be done to determine if you have been infected with HCV. Diagnostic tests for HCV are used to prevent infection through screening of donor blood and plasma, to establish the clinical diagnosis and to make better decisions regarding medical management of a patient. antigens is often used as a supplemental test for confirmation of a positive EIA result.

Testing for HCV circulating by amplification tests RNA (e.g. polymerase chain reaction or PCR, branched DNA assay) is also being utilized for confirmation of serological results as well as for assessing the effectiveness of antiviral therapy. A positive result indicates the presence of active infection and a potential for spread of the infection and or/the development of chronic liver disease. Symptoms Many people with an acute HCV infection have no symptoms (asymptomatic), although some will have jaundice (yellowing of the skin & eyes) or mild flu-like symptoms. Most people with chronic HCV will have only mild to moderate liver disease, with symptoms such as: jaundice, fatigue, loss of appetite, nausea (the urge to vomit or squeamishness of the stomach), malaise (a vague feeling of discomfort that can't be pinned down but is sensed as just not right), abnormalities in liver enzyme levels that can change a lot. If cirrhosis (scarring) of the liver develops, symptoms may be more obvious, including muscle weakness, itching, dark urine, fluid retention & abdominal swelling.

Treatment Antiviral drugs such as interferon taken alone or in combination with ribavirin, can be used for the treatment of persons with chronic hepatitis C, but the cost of treatment is very high. Treatment with interferon alone is effective in about 10% to 20% of patients. Interferon combined with ribavirin is effective in about 30% to 50% of patients. Ribavirin does not appear to be effective when used alone. Prevention There is no vaccine against HCV. Research is in progress but the high mutability of the HCV genome complicates vaccine development. In the absence of a vaccine, all precautions to prevent infection must be taken including: * Screening and testing of blood and organ donors; * HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms* correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B. * Promotion of behaviour change among the general public and health care workers to reduce overuse of injections and to use safe injection practices; * Risk reduction counselling for persons with high-risk drug and sexual practices.

HIV is a virus that causes AIDS. The virus attacks and breaks down the body's immune system, so that the human body cannot fight off different diseases it normally would.

H - Human - because this virus can only infect human beings.

I - Immuno-deficiency - because the effect of the virus is to create a deficiency, a failure to work properly, within the body's immune system.

V - Virus - because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.

HIV is a virus that causes AIDS. The virus attacks and breaks down the body's immune system, so that the human body cannot fight off different diseases it normally would.

H - Human - because this virus can only infect human beings.

I - Immuno-deficiency - because the effect of the virus is to create a deficiency, a failure to work properly, within the body's immune system.

V - Virus - because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.

Your body's health is protected by its immune system which is a network of chemicals, cells, tissues, and organs found throughout your body. These work together to protect you from germs. Your immune system can distinguish the difference between what belongs in your body and what does not belong. When your immune system detects something foreign, it tries to destroys and remove it to keep you healthy.

White blood cells (part of the immune system) called lymphocytes (B cells and T cells) protect the body from germs such as viruses, bacteria, parasites and fungi.

The two main types of T-cells are T-4 (CD-4) cells and T-8 (CD-8) cells.

When a germ or virus or bacterium enters your body the immune system recognises it as foreign to the body and potentially harmful. The T-4 cells begin the attack against infections by activating killer T-cells and antibody-producing B-cells while the T-8 (CD-8) cells end the immune response.

Another way your immune system protects you is by the production of antibodies against what is not part of your body. The activated B-cells try to destroy any foreign particles not recognised as belonging to your body by creating antibodies to attack and destroy these foreign particles. This occurs when a virus such as HIV infects you. Your body recognises HIV as being foreign and potentially dangerous and therefore produces antibodies against it. Although effective at first, the antibodies do not eliminate the infection.

Some HIV are killed but many more viruses will infect T-4 cells, the very same cells that are supposed to co-ordinate the defence against the virus. Infected T-4 (CD-4) cells become virus factories, which if activated, will produce viruses instead of triggering the production of more antibodies against it.

The main route of HIV transmission is through:

* Unprotected sexual contact with an infected person

* By sharing needles with an infected person and

* From an infected mother to child during pregnancy, during birth or while breastfeeding

For HIV transmission to occur the following criteria must be met:

1. HIV must be present

2. There must be a sufficient quantity of HIV present

3. It must go into the bloodstream

Note: HIV is most concentrated in blood.

It is possible to become infected with HIV through oral sex, however the risk of becoming infected in this way is lower than for unprotected sexual intercourse with a man or woman. When giving oral sex to a man (sucking or licking a man's penis) a person could become infected with HIV if infected semen gets into any cuts, sores or receding gums they might have in their mouth. Giving oral sex to a woman (licking a woman's clitoris or vagina) is considered relatively low risk. Transmission could take place if infected fluids from a woman get into the mouth of her partner. The likelihood of infection occurring might be increased if there is menstrual blood involved or if the woman is infected with another STI, which causes breaks in the skin, therefore increasing exposure to blood.

Deep or open-mouthed kissing is a very low risk activity in terms of HIV transmission. There has been only one documented case of someone becoming infected with HIV through kissing; a result of exposure to infected blood during open-mouthed kissing.  If you or your partner have open wounds in your mouth, you should avoid kissing until the wound has healed.

When visiting the barber there is no risk of infection unless the skin is cut (which may occur if the barber accidentally cuts you) and if there is a transfer of infected blood.  If the instruments are contaminated with infected blood and are not sterilised between clients there is a risk of HIV transmission. To reduce the risk of blood-borne infections such as hepatitis and HIV ensure that the razor/instruments used are new or have been properly sterilised. However, people who carry out body piercing, tattoos, or hair-dressing should follow procedures called "universal precautions", which are designed to prevent the transmission of blood-borne infections such as HIV and hepatitis B.

HIV is transmitted sexually regardless of your sexual preference. Note however, that world wide there is a higher prevalence of the virus in certain groups because of their sexual practices and therefore having unsafe sex with someone from one of these groups places you at a higher risk of contracting the virus.

Men who have sex with men, commercial sex workers, and people who have a sexually transmitted infection are examples of such groups.

By following safe sexual practices (using a condom every time) you can reduce your chances of becoming infected.

Generally the fragile nature of the virus prevents it from surviving for a substantial amount of time in the open air. The length of time HIV can survive outside the body is dependent on the amount of HIV present in the body fluid and the conditions the fluid is subjected to.

Note that HIV is fragile and many common substances such as hot liquid, soap, bleach, alcohol, and the gastric juices found within your stomach can destroy the virus.

The only studies on the survival of HIV outside the body have been conducted in the laboratory under controlled scientific conditions. These studies found HIV is not affected by extreme cold, but it is inactivated by heat and is destroyed after 30 minutes at 60oC.

Scientific studies have found that HIV can sometimes survive in dried blood at room temperature for up to six days. It is extremely difficult to assess exactly the length of survival of HIV outside the body in a non- laboratory setting.

The symptoms of initial HIV infection are not very specific. Initial symptoms include a dry cough, shortness of breath and a flu-like illness. During this very early period of infection only a small minority of people experience symptoms, which are serious enough to require a doctor's attention. During this stage, which is also called acute infection, the virus multiplies rapidly. You might test negative for HIV antibodies during this stage, but you can still pass HIV on to someone else. This is called the window period of roughly three months from the time of infection to the time when you will show antibodies against HIV. HIV antibodies begin to show in an infected person's blood when they seroconvert.

The "window period" is the time it takes for a person who has been infected with HIV to seroconvert (test positive) for HIV antibodies. The Centers for Disease Control (CDC) says about the window period: "Antibodies generally appear within three months after infection with HIV, but may take up to six months in some persons." The three month window period is normal for most of the population. Many people will have detectable antibodies in three or four weeks. Very, very rarely (i.e., only a few cases ever), a person could take six months to produce antibodies.