Background
FSW like other KVP have limited access to health services due to stigma and discrimination, increasing their vulnerability for HIV and other infections. There is evidence for community interventions to improve access to HIV services and linkage to care. Amref through Global Fund Support implemented a community peer model intervention among FSWs in nine regions of Tanzania from January 2021 to December 2023.
Methods
We identified 254 FSW peers, and trained and enrolled them in the program. Peer selection was based on diverse characteristics such as of age, geographical disparities, hotspots, and nearby health facilities. Interventions provided were community mobilization for HIV testing, linkage to care and treatment, and preventive interventions such as condom distribution and PrEP. Economic empowerment through income generation activities (IGA), social behavior communication, and strengthening FSW -led community-based organizations and networks were also integrated.
Results
Between the period of January 2021 to December 2023, we reached a total of 37,173 FSW who completed SBC training sessions (12 sessions for 3 visits) as part of a comprehensive package of HIV prevention services; we tested for HIV a total of 31,951 (103% of our target) and identified 2092 living with HIV which is 7% positivity rate, 94% were linked to ART services and 99% initiated ART. A total of 171 psychosocial groups were formed under peer supervision for HIV prevention messages and support, and 108 groups received funds with 887 FSWs benefiting for income -generating activities as part of HIV prevention strategies.
Conclusions
A broad package of community interventions including a combination of behavioral, peer support and structural activities designed with specific strategies to reach FSWs is effective and sustainable for epidemic control. It should be taken to scale to reach more FSW in the country.