Addressing the drivers of HIV epidemic; experience of a mobile HTS services in the Southern highlands zone, Tanzania.

Background: Global HIV epidemic is disproportionately higher in SSA, accounting for more than 70% of the burden. Addressing specific drivers of the HIV infection through mobile HIV Testing Services (mHTS) targeting Key populations is essential to HIV epidemic control. We assessed the impact of mHTS to Key and Priority populations at addressing factors that increase risk of HIV transmission in selected hotspots within Mbeya and Songwe regions. Methods: Since 2016, NIMR-Mbeya through mHTS has been working with PEPFAR to support HIV interventions in identified hotspots and local health facilities. A comprehensive HIV prevention package which includes health education and screening for drivers of HIV infection is being offered to clients prior to HIV testing. Records of clients served by the mHTS from 2020 to 2021 were reviewed and analyzed using STATA version 15. Descriptive statistics were summarized as frequencies and percentages for categorical variables. Adjusted odds ratios with 95% CI for drivers of HIV epidemic were estimated using multivariable logistic regression models. Results: Of the 8853 clients served, 3717 (42%) were aged between 15 - 24 years. The median age was 25(18-36) years. The majority 5550 (62.7%) were male, most clients 7329 (82.8%) had primary education. Nearly half of the total clients 4332 (48.9%) were married. A total of 377 (4.3%) clients had at least one STI syndrome, genital discharge 281 (74.5%) was the most observed syndrome. Clients with STI syndrome were four times more likely to be HIV positive (AOR: 4.74, 95% CI, 1.16 - 19.39). After controlling for age, level of education and marital status Uncircumcised clients had twice the odd of being HIV positive compared to circumcised participants (AOR: 2.66, 95% CI, 1.62 - 4.37). Conclusion: The observed level of STI syndromes in this population is high. Circumcision status affected HIV positivity. Targeted and comprehensive Mobile HIV services may be employed as effective intervention in areas with high HIV prevalence. However, in low HIV prevalence, the suitability of this approach warrants further research. [ABSTRACT FROM AUTHOR]