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Faculty 422
Health Topics 132

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Helping Tanzania Stop an HIV Epidemic Driven by Injection Drug Use

With support from the Centers for Disease Control and Prevention, the Ministry of Health and Social Welfare and Drug Control Commission approached Pangaea to assist in developing a national response to Tanzania’s HIV epidemic among people who inject drugs (PWID). These efforts resulted in the first national medication assisted treatment (MAT) program at Muhimbili National Hospital, now providing methadone to over 600 patients. Using an implementation science framework, we have identified inequities in the program - a lack of service utilization by females who inject drugs, many of whom also engage in sex work and experience high rates of violence - and through a community engagement approach, we have assisted in the development and implementation of improved strategies – integration of sexual and reproductive health services as well as night outreach with peer outreach workers - to address the inequities. In addition, we have assessed for characteristics associated with continued engagement in the methadone program and linkage to HIV services. Most notably, these analyses have identified that clients receiving higher doses of methadone are more likely to stay engaged in methadone and receive eligibility screening for HIV treatment.