HIV and AIDS

HIV is a virus that attacks the immune system, progressively destroying CD4 cells. Without treatment, it leads to AIDS, a stage of severe immunodeficiency marked by opportunistic infections. Tanzania has a generalised HIV epidemic, and free testing and treatment services are available nationwide.

• Acute infection may cause a brief flu-like illness (fever, sore throat, rash, swollen glands).
• Chronic infection is often asymptomatic for years.
• Advanced disease can present with recurrent infections, unexplained weight loss, chronic diarrhoea, oral thrush, tuberculosis, and other opportunistic infections.

• Transmitted through unprotected sexual contact with an infected person.
• Transmitted from mother to child during pregnancy, delivery, or breastfeeding.
• Transmitted through contact with infected blood, such as transfusion of unscreened blood or sharing of needles.
• Occupational exposure to infected blood or body fluids.

• Diagnosed using the national rapid HIV antibody testing algorithm, with a confirmatory second test.
• Testing is offered routinely at antenatal clinics, TB clinics, and on request at health facilities.
• CD4 count and viral load testing are used to monitor people already on treatment.

All people diagnosed with HIV are eligible for lifelong antiretroviral therapy (ART) regardless of CD4 count, and treatment is started as soon as possible after diagnosis ("treat all" policy).

The first-line ART regimen for most adults and adolescents in Tanzania is a dolutegravir-based combination (tenofovir, lamivudine, and dolutegravir), with alternative regimens used for young children, pregnant women, or people with specific contraindications.

Cotrimoxazole preventive therapy is given to eligible patients with advanced disease or low CD4 counts to reduce the risk of opportunistic infections.

Regular viral load monitoring is used to assess treatment success and adherence.

• Consistent and correct condom use.
• HIV testing and counselling for both partners.
• Antiretroviral therapy during pregnancy and breastfeeding to prevent mother-to-child transmission.
• Voluntary medical male circumcision.
• Pre-exposure prophylaxis (PrEP) for people at substantial ongoing risk.
• Post-exposure prophylaxis (PEP) started as soon as possible after a possible exposure.