Poster from the 2012 International AIDS Conference

1. PLACE-Lite to identify gaps in HIV prevention coverage in Iringa,
Tanzania
Sharon Weir1, Jess Edwards* 1,2, Dawne Walker3, Zaddy Kibao3, and Prudence Masako 3
1 MEASUREEvaluation, Carolina Population Center, UNC Chapel Hill, NC
2 Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC
2 MEASURE Evaluation, Dar es Salaam, Tanzania
1. Background and Objective 7. Results: Step 3
• HIV prevalence in Iringa, Tanzania is estimated to be 16% Figure 2. Types of venues where people meet new Figure 3. Study area illustrated by 484 venues where
sexual partners in Iringa, Tanzania, PLACE-Lite, 2011 people meet new sexual partners visited by the study
• Concerns about the adequacy and effectiveness of current
(N=484) team, PLACE-Lite, Iringa, Tanzania, 2011
HIV programming
• USAID implemented Priorities for Local AIDS Control Efforts
(PLACE) Lite in 2011 to identify gaps in prevention
2. Study Sample
• PLACE-lite was implemented in Iringa between February 14th
and April 27th, 2011
• Sampled villages and urban areas in Iringa, Tanzania, with
probability proportional to population size
• Included areas where contextual factors suggested high risk
behaviors were common, such as truck stops, plantations,
and road construction sites
3. The PLACE-Lite Method
Table 1. Steps in the PLACE-Lite method utilized in Iringa,
Tanzania compared to steps in the standard PLACE method Figure 4. Many sampled venues in Iringa, Tanzania reported Figure 5. Few sample venues had condoms onsite, PLACE-
transactional sex, PLACE-Lite, 2011 Lite, Iringa, Tanania, 2011
Step PLACE Step PLACE Lite Most male
patrons Venues
Iringa identified as a priority were where
buying sex condoms
Identify Priority Prevention prevention area, villages and
1 are
Areas (PPAs) mtaa sampled for inclusion Some available
in the study male
Within PPAs, identify places patrons
In each sampled area, 9-12 buying Venues
where people meet new
2 community informant sex without
sexual partners and/or condoms
interviews No male
inject drugs
patrons
Visit, map & characterize all buying sex
Interviewers visit, a sample
3 places and assess on-site
of venues
prevention
Interview and HIV test
4 workers and patrons at a Not performed Figure 6. Little condom availability, despite widespread outreach activities,
Venue patrons included in all districts of Iringa, Tanania, PLACE-Lite, 2011
sample of places • Local and mobile populations
Feedback results to Feedback results to • Military
5
community community • Truck drivers
• Miners
4. Results: Step 1
• Migrant workers
Table 2. Comparison between population in sampled areas and
total population of Iringa by location, PLACE-Lite, Iringa, • Young people
Tanzania, 2011 • Alcohol consumption occured at most
places where people meet new sexual
Total Population Proportion of partners
Total • Commercial sex work was common
village/ in sampled population living
Population • MSM activity was rare, but does exist in
mtaa areas in sampled areas
Iringa
Urban • Injecting drug use was reported in all
231 308,108 43,361 0.14 districts
areas
Rural Figure 7. Most venues catered to male patrons,
681 1,155,535 143,550 0.12 PLACE-Lite, Iringa, Tanania, 2011 Conclusions
areas
Most • Setting in Iringa is ripe for transmission of HIV
5. Results: Step 2 patrons • Poverty
were male
• Mobile populations
• 1333 community informants named 2314 unique venues and More men
1533 events in 136 sampled areas • Commercial sex work
than
women • Lack of prevention services
Figure 1. Frequency of community informants by type, PLACE- • Little availability of condoms
Lite in Iringa, Tanzania, 2011 More
women • PLACE-Lite worked well to describe the places where people meet
than men new sexual partners and highlight gaps in prevention coverage
Most • Representative sampling
patrons • Low cost
were women • Rapid
• Efficient method for identifying priority prevention areas and
areas for future research
8. Acknowledgements • Limitations
• No individual testing of patrons or workers; true prevalence
remains unknown
We thank the Iringa Region administrative secretary, district
executive officers, district medical officers, community health • Individual risk behaviors have not been fully characterized
AIDS coordinators, ward/village executive officers, village • Next Steps
• According to community informants, 44% of villages/mtaa did health/peer educators, community informants, and village
NOT have recognizable presence of HIV prevention outreach • Engage community partners to identify immediate solutions
chairpersons for their support to the Priorities for Local Control
activities Efforts (PLACE) activity team • Assess the need for more information
• 26% of villages and mtaa did not have condoms available (for • Behavioral interviews with patrons
purchase or freely dispensed)
• HIV/STI testing of venue patrons