Theme VI

HIV/AIDS and Development

 HIV&AIDS and DEVELOPMENT

At the end of this theme you will be able to:

I. Explain the meaning, causes, symptoms and transmission
of HIV and AIDS
II. Analyze the state of HIV and AIDS globally, regionally, and
in Tanzania
III.Explore the impact of HIV and AIDS on socio-economic
development
IV.Evaluate efforts made in combating HIV and AIDS in
Tanzania
V. Discuss challenges of combating HIV and AIDS
VI.Plan for future successful strategies for combating new
HIV infections
 HIV&AIDS and DEVELOPMENT CONT....

I. HIV and AIDS- meaning, causes, symptoms

and transmission
• HIV- Human Immunodeficiency Virus
• It is the virus which causes disease known as
AIDS.
H = Human - Infects only Human beings
I = Immunodeficiency - virus weakens the
immune system and increases the risk of
Infection.
V = Virus - that attacks the body of human being
 HIV&AIDS and DEVELOPMENT CONT
• The human immune system cannot get rid of
HIV. This means once you have HIV, you have
it for life.
• HIV can hide for a long period of time in the
cells
• HIV attacks a key part of your immune system-
called as T-cells/CD4 cells
• Once they invades T- cells/CD4 they multiply
in human bodies.
Cont ...
• Destroyed immune system cells cannot
fight infections and disease anymore

• HIV infection can lead to AIDS the final

stage of HIV infection

• However, with proper antiretroviral therapy

(ART) the level of HIV virus in the body
can remain low such that cannot proceed
to AIDS.
 HIV Mode of Transmission

• HIV is spread directly from host to host through

three major ways;
i. Blood
ii. Semen
iii. Vaginal fluid
• The modes of transmission are primarily three
fold; i. Sexual intercourse
ii. Sharing needles and other objects like
razorblade with infected persons
iii. Mother to child (exposure of fetus or
infant via child birth and breastfeeding
 Signs and symptoms of HIV

• Early HIV symptoms generally arise within 1 to 2

months of infection, but they can arrive as early
as two weeks after exposure (U.S. Department
of Health and Human Service)

• Nevertheless, some people experience no early

symptoms after they have been infected with HIV
• They vary, depending on the individual and in
what stage of the disease a person is.
Signs and symptoms (cont..)
• Early signs of HIV include:
Headache
Fever
Tiredness
Swollen lymph nodes
Sore throat
Skin rashes
Muscle and joint pain
Loss of body weight
Signs and symptoms (cont..)
• This is followed by a period of no symptoms
called asymptomatic infection

• Asymptomatic infection can last for months

or up to 10 years

• Then comes the early symptomatic HIV and

AIDS
 AIDS
• AIDS - Stands for Acquired Immune
Deficiency Syndrome

• AIDS is a disease which is caused by the

virus known as HIV
A = Acquired, not inherited
I = Immune system – Weakens
D = Deficiency of CD4+ cells in the immune
system – created by virus attack
S = Syndrome - a collection of symptoms
and signs of diseases or set of diseases
 AIDS Cont…
• AIDS - is a syndrome rather than a single
disease because it is a complex illness with a
wide range of complications and symptoms
• Epidemic = A widespread occurrence of an
infectious disease in a community
 AIDS
• AIDS-is the final stage of HIV infection

• By the time HIV develops into AIDS, severe

damage has been done to the immune system

• A person becomes vulnerable (exposed) to

attacks from the germs (e.g. bacteria, fungi,
protozoa) that are encountered daily

• Infection may progress to serious illness like

cancer, tuberculosis.
 HIV&AIDS Cont…
Signs and symptoms of AIDS
 Rapid weight loss
 Recurrent fevers and night sweats
 Unexplained tiredness
 Swelling of lymph glands in the armpits, groin
or neck
 Long standing diarrhea
 Sores of the mouth, anus or genitalia
 Pneumonia
 Skin patches
 Loss of memory
 HIV&AIDS Cont...
Mostly affected population groups
1. Women
2. Children
3. Mobile and displaced populations
4. People who inject drugs PWIDs
5. Adolescents
6. Men who sex with men
7. Commercial sex workers
8. Heterosexual sex accounts
Majority (80%) of all HIV infections in Tanzania is
through heterosexual
Tanzania HIV and AIDS Status
• Tanzania faces a mature, generalized HIV
epidemic.
• An estimated 1.6 million Tanzanians were
living with HIV/AIDS in 2011
• 1.3 million being age 15 or older.
• AIDS has resulted in an estimated 1.3 million
orphaned children
 HIV & AIDS Cont..
• In 2016, 1.4 million people were living with
HIV in Tanzania. This equates to an
estimated HIV prevalence of 4.7%
• In the same year, 55,000 people were
newly infected with HIV, and 33,000 people
died from an AIDS-related illness.
 HIV & AIDS Cont..
• Women are heavily burdened by HIV in
Tanzania where 780,000 women aged 15
and over are living with HIV.
• In 2016 UNAIDS reported, HIV prevalence
for women as 5.8%, compared to 3.6% for
men.
• In 2012, women aged 23-24 were also
twice as likely to be living with HIV than
men of the same age.
 HIV & AIDS Cont…
• HIV prevalence among women ranged from
1% among those aged 15-19 to 10% among
women aged 45-49.
• In 2016, more than 25,000 women aged 15-24
became infected with HIV, compared to
around 20,000 men of the same age,
• Women tend to become infected earlier,
because they have older partners and get
married earlier.
• They also experience great difficulty in
negotiating safer sex because of gender
inequality.
 HIV & AIDS Cont…
• The ‘sugar daddy’ culture is widespread in
Tanzania.
• Women will often accept the sexual advances
of older men for a variety of reasons including
money, affection and social advancement.
• Intimate partner violence is also an issue with
more than 30% of married or partnered
women aged 15–24 experiencing physical or
sexual violence from a male partner
 Cont...
• The severity of the epidemic varies across
the country. Some regions report an HIV
prevalence of around 1.5% (Manyara) while
other regions have prevalence as high as
14.8% (Njombe).
• Overall, the epidemic has remained steady
because of on-going new infections,
population growth and increased access to
treatment.
 HIV&AIDS Cont....
Factors Facilitating HIV Transmission
1. Risky Sexual Behaviors
• Having multiple sexual partners
• Changing partners
• Having sexual contact with casual
partners/casual sex workers
• Not practicing safe sex (not using condoms
due to dislike, availability, affordability,
prohibited by cultural/religious beliefs)
• Alcohol and drug abuse resulting to impaired
wise decision-making in sexual matters
 HIV&AIDS and DEVELOPMENT CONT.....
2. Socio-economic factors
• Occupation (professions that force persons to be
away from their sexual partners for a long time)
• Exchanging sex for money, materials and
favours
• Lack of information on STIs (including HIV)

3. Cultural factors
• Female Genital Mutilation (FGM)
• Rituals such as widow cleansing, widow
inheritance
HIV&AIDS and DEVELOPMENT CONT.....

4. Biological factors
• Age (adolescence/youth are at most risk)
• Gender (females are more likely to be infected
compared to males)

5. Political factors
• War and political instability create mobility and
migration that adversely influences change in
sexual behaviour
 HIV & AIDS Cont….

Prevention of HIV Transmission

1. Strategies to prevent HIV transmission
● Personal strategies
● Public health strategies
2. Safe practices: Avoid risk of HIV
transmission
3. Risk reduction: There is chance to reduce
but does not eliminate risk
 HIV&AIDS Cont....
Impact of HIV Globally

● Negative economic impact on countries

● Overstrained healthcare systems

● Decreasing life expectancy

● Reversal of child survival gains

● Increased numbers of orphans

HIV&AIDS and DEVELOPMENT CONT......
III. The impact of HIV and AIDS on socio-
economic development
• Increased cost for health services
• Reduced economic productivity in all sectors
• Relationship/marriage problems
• HIV&AIDS is associated with stigma and
discrimination of infected people
• HIV&AIDS affects the success of other health
programmes
• Hence, the control of HIV&AIDS is a public health
priority
 HIV&AIDS and DEVELOPMENT CONT....

IV. HIV and AIDS combating efforts in Tanzania

• As country´s response to HIV epidemic, various
national efforts have been taken to control the
spread of HIV

• The initial efforts were mainly implemented by

the Ministry of Health (MOH)

• Then after, there has been gradual involvement

of other public sectors, NGOs, FBOs and
Community-Based Organizations (CBOs)
HIV&AIDS and DEVELOPMENT CONT....

In Tanzania HIV and AIDS combating efforts

include:
1. Information, Education and Communication
(IEC) activities and family life education for the
prevention of HIV transmission
2. The development of a National Policy on
HIV/AIDS in 2001 to widen and strengthen the
national response against HIV epidemic
3. VCT- Voluntary Counseling and Testing services
were first initiated in 1989 in Tanzania
 HIV&AIDS and DEVELOPMENT CONT.....
 Since 2003, the number of VCT sites reached
2134 across the country
 Community Based VCT (CBVCT) involves mobile
VCT services and community-based support
services
 CBVCT is used in areas where VCT uptake is low

4. Condoms
 Use of condom is made an integral part of the fight
against HIV epidemic in Tanzania
HIV&AIDS and DEVELOPMENT CONT.....
5. Voluntary medical male circumcision (VMMC)
• Male circumcision is an effective HIV prevention strategy
• It reducing a man’s risk of acquiring HIV by approximately
60%.
• When used in combination with other prevention
measures, circumcision is an important addition to HIV-
prevention options for men.
• In 2010 the government prioritised 11 regions including
Tabora and Shinyanga for scaling VMMC and set a target
of 2.8 million circumcisions by 2016.
• By the end of 2015, more than 1.3 million VMMCs were
conducted
6. Prevention of mother-to-child
Transmission of HIV (PMTCT)
• Nearly 1/5 of all HIV new infections in
Tanzania are due to mother to child
transmission
• To avoid it, antiretroviral treatment for both
mother and baby as well as safer feeding
practices must be integrated into routine
reproductive health services
 HIV&AIDS and DEVELOPMENT CONT......
7. Sex education for youth (esp. 15-24 age
group)
• Youth Alive Club in Tanzania is promoting
behaviour change for HIV prevention
• Sex education is vital to avoid new HIV infection
in the coming years
• Thus, the government and civil society
organizations have to work hard to make sure
youth in remote areas get access to sex
education
HIV&AIDS and DEVELOPMENT CONT....
8. HIV and AIDS treatment in Tanzania
• Provision of free Anti RetroViral (ARV)
treatment for HIV infected persons
• This helps to reduce pains and complication
associated with HIV and AIDS
• It also reduces social stigma among PLA
HIV&AIDS and DEVELOPMENT CONT.....
9. Fight against Stigma and discrimination
• Stigma and discrimination due to lack of
knowledge about HIV and AIDS is a big
challenge
• Stigma and the beliefs can lead to reduced
motivation to seek treatment
• Hence, fight against stigma reduces chances
of new HIV infection
HIV&AIDS and DEVELOPMENT CONT.....
V. Challenges of combating HIV and AIDS
• Shortage of a skilled health workers
- It requires financial support to training new
workers and retraining of existing workers
• Lack of sustainable, stable financing for
HIV/AIDS initiatives
- Only 30% of fund for prevention programs,
treatment, care and support activities come
from domestic sources
HIV&AIDS and DEVELOPMENT CONT.....

• Inadequate infrastructure development and

logistics management
- E.g. unavailability of health centers, stable
electricity supply, and access to proper
sanitation and water supplies hinder smooth
service delivery
• The inability of political leaders and policy
makers to successfully cooperate with
religious leaders in the fight against
HIV/AIDS
HIV&AIDS and DEVELOPMENT CONT.....

• Poor legal protection and legal enforcement of

fundamental human rights of individuals living
with and at-risk of HIV
- e.g. there should be strict laws on gender
equity, rape, intimate partner violence and
sexual harassment to protect girls and women
• Stigma and discrimination against individuals
living with HIV/AIDS
-E.g at work place, lack of confidentiality at
hospitals record keeping
HIV&AIDS and DEVELOPMENT CONT.....

• Countries dealing with conflicts, face difficulties

in implementing efforts against HIV/AIDS instead
of post-conflict infrastructure and social
development needs
 Cnt…
Review Questions Topic vi
1. Why is it important to study HIV and AIDS and
development?
2. Why certain groups of the population are described as
the most at risk?
3. Critically analyze HIV and AIDS epidemic statistics
globally, regionally and in Tanzania.
4. Using different sectors of your choice in Tanzania show
the impact of HIV and AIDS