Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

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SUMMARY OF FINDINGSThe 2007-08 Tanzania HIV/AIDS and MalariaIndicator Survey (THMIS) is the second population-based,comprehensive survey on HIV/AIDScarried out in Tanzania. The survey was commissionedby the Tanzania Commission for AIDSand the Zanzibar AIDS Commission. The 2007-08 THMIS was implemented by the NationalBureau of Statistics in collaboration with the Officeof the Chief Government Statistician, Zanzibar.Macro International Inc. provided technicalassistance through MEASURE DHS, a USAIDfundedproject providing support and technicalassistance for the implementation of populationand health surveys in countries worldwide. Otheragencies and organizations that facilitated thesuccessful implementation of the survey, throughtechnical or financial support, include the NationalAIDS Control Programme, the NationalMalaria Control Programme, the Ministry ofHealth and Social Welfare, the Zanzibar AIDSControl Programme, and Muhimbili UniversityCollege of Health Sciences.The 2007-08 THMIS is a nationally representativesurvey of 9,144 households selected from475 sample points throughout Tanzania. Allwomen age 15-49 and all men age 15-49 in thesehouseholds were interviewed individually. Thesample was designed to produce separate estimateson key indicators for the national level, forurban and rural areas, and for seven zones. Someestimates can be calculated at the regional level.The primary objectives of the 2007-08 THMISsurvey were to provide up-to-date information onthe prevalence of HIV infection among Tanzanianadults, and the prevalence of malaria infectionand anaemia among children under age fiveyears.HIV/AIDS AND OTHER STISAwareness of AIDS. Almost all Tanzanians age15-49 years have heard of AIDS. The proportionis on a par with results from both the 2003-04Tanzania HIV/AIDS Indicator Survey (THIS)and the 2004-05 Tanzania Demographic andHealth Survey (TDHS). Awareness of AIDS isvery high in both Mainland Tanzania and Zanzibar,amongst men and women in all age groups,and across background characteristics, with atleast 90 percent of people having heard of AIDS.Unfortunately, an in-depth understanding ofAIDS is less widespread. Only 40 percent ofwomen and 44 percent of men have comprehensiveknowledge about AIDS. In this survey,comprehensive knowledge is defined as knowingthat consistent use of condoms during sexual intercourseand having just one uninfected faithfulpartner can reduce the chances of getting HIV,knowing that a healthy-looking person can haveHIV, and rejecting the two most common localmisconceptions about HIV transmission and prevention.Comprehensive knowledge increases with increasinglevel of education and wealth quintile. Itis also considerably higher in urban areas than inrural areas. The lowest comprehensive knowledgeabout AIDS among men is found in Iringaand Zanzibar, while among women, the lowestlevels are found in Rukwa, Iringa, Shinyanga,Singida, and Pemba.Eight in ten women and seven in ten men age15-49 years know that HIV can be transmittedfrom mother to child through breastfeeding.However, only 53 percent of women and 44 percentof men know that HIV transmission risk canbe reduced if the mother takes special drugs duringpregnancy. Knowledge of both these facts iscomparatively higher among women and menwith higher education (completed primary andsecondary or more education) and those in thefourth and highest wealth quintiles, but it islower among those age 15-19, those who havenever married, and those who never had sex.HIV Testing and Counselling. In Tanzania, 37percent of women and 27 percent of men havebeen tested for HIV at some time and receivedthe results. A small proportion (4 percent ofwomen and 3 percent of men) were tested but didnot receive the results.Overall, the proportion of women and men age15-49 who have been tested for HIV and receivedresults in the 12 months before the surveyhas increased from 5 percent of women and 7Summary of Findings | xvii
percent of men reported in the 2003-04 THIS to19 percent of women and men reported in the2007-08 THMIS. These results point to the needto continue encouraging the general populationto find out their sero-prevalence status throughvoluntary counselling and testing (VCT) sitesthroughout the country.HIV testing is far more common among the mosteducated and wealthy respondents. Respondentsin urban areas are more likely than those in ruralareas to have been tested. Regional variations aresubstantial, and differ among women and men.HIV-Related Behaviour. Fourteen percent ofwomen age 20-49 first had sexual intercoursebefore they were 15 and almost six in ten (59percent) had first sex before the age of 18. Meninitiate sexual activity somewhat later thanwomen. Among men age 20-49, only 8 percenthad had sexual intercourse before they were age15, 41 percent before age 18, and 68 percent byage 20. The median age at first sexual intercourseis 17.3 years for women and 18.5 years for men.Women and men in Mainland Tanzania are muchmore likely than those in Zanzibar to have hadsex by age 15 years. Comparison of these resultswith data from the 2003-04 THIS indicates thatthere has been little change in age at sexual debut.Women are far less likely than men to reporthaving had two or more sexual partners in thepast 12 months. Only 3 percent of women reportedhaving had sex with more than one partnerin the 12 months preceding the survey, comparedwith 18 percent of men.In the context of this survey, higher-risk sex isdefined as sex with a nonmarital, noncohabitingpartner in the 12 months preceding the survey.Sixteen percent of women and 29 percent of menreported having sex in the 12 months before thesurvey with someone who was not a husband/wifeor cohabiting partner.Eight percent of men age 15-49 paid for sex inthe 12 months before the survey and 60 percentof these men reported that they used a condom attheir most recent paid sexual intercourse. Amongyoung male respondents age 15-19, 5 percentpaid for sex and more than half (56 percent) useda condom at their last paid sexual intercourse.Six percent of women and 7 percent of men whohad ever had sex reported having an STI or agenital discharge, genital sore, or ulcer in the 12months preceding the survey. This is a slight increasefrom the 2003-04 survey, in which 5 percentof women and 6 percent of men reportedhaving an STI or symptoms of an STI.HIV PREVALENCECoverage of Testing. A total of 17,670 adultsage 15-49 (9,735 women and 7,935 men) wereeligible for HIV testing in the 2007-08 THMIS.Overall, 85 percent (90 percent of eligiblewomen and 80 percent of eligible men) agreed toprovide a blood sample for HIV testing. Coverageof HIV testing in the 2007-08 THMIS ishigher than that in the 2003–04 THIS, increasingfrom 84 to 88 percent for women and from 77 to79 percent for men in Mainland Tanzania.In the 2007-08 survey, 6 percent of Tanzanianadults age 15-49 were infected with HIV. Theprevalence of HIV is higher among women thanmen (7 percent and 5 percent, respectively).These figures are slightly lower than those reportedin the 2003-04 THIS (7 percent overall, 8percent of women and 6 percent of men).For both sexes, urban residents have higher levelsof HIV infection than rural residents (9 and 5percent, respectively). HIV prevalence amongurban women (11 percent) is twice that of ruralwomen (5 percent). For men, the difference isnot so large (6 percent among urban men and 4percent among rural men).There are large variations in HIV prevalence byregion. The highest HIV prevalence rate is foundin Iringa (16 percent), followed by Dar es Salaam(9 percent) and Mbeya (9 percent). Regions onthe Mainland with the lowest HIV prevalence areManyara (2 percent), Arusha (2 percent), andKigoma (2 percent). The lowest prevalence,however, is found in Zanzibar, on the islands ofPemba and Unguja (both with less than 1 percentof adults HIV positive). In all regions exceptArusha, HIV prevalence is higher among womenthan men.Prevalence of HIV increases steadily as the numberof lifetime partners increases. For women,HIV prevalence increases from 3 percent amongthose who have had only one sexual partner to 22percent among women who have had 10 or morelifetime partners. The proportions for men are 1percent and 11 percent, respectively.xviii Summary of Findings
Page 1 and 2: TanzaniaHIV/AIDS and MalariaIndicat
Page 3 and 4: The 2007-08 Tanzania HIV/AIDS and M
Page 5 and 6: 3.5 Access to Mass Media ..........
Page 7 and 8: 12.2 Orphans and Vulnerable Childre
Page 9 and 10: Table 4.3Table 4.4Table 4.5Table 4.
Page 11 and 12: Figure 9.2 HIV Prevlence by Region/
Page 14: FOREWORDThis report presents the ma
Page 20 and 21: HIV prevalence among youth (women a
Page 23 and 24: xxii | Map of Tanzania
Page 25 and 26: 1.2 NATIONAL POLICY ON HIV/AIDSIn r
Page 27 and 28: To assess levels and trends in know
Page 29 and 30: 1.8 FIELDWORKData collection was ca
Page 31 and 32: Table 1.1 Results of the household
Page 33 and 34: Figure 2.1 presents a graphic pictu
Page 35 and 36: Table 2.3.1 Educational attainment
Page 37 and 38: Educational attainment is higher in
Page 39 and 40: 2.5.1 Energy SourcesTable 2.5 prese
Page 41 and 42: The most common items are agricultu
Page 43 and 44: The 2007-08 THMIS included aquestio
Page 45 and 46: Table 3.1—ContinuedBackgroundchar
Page 47 and 48: Education is positively related to
Page 49 and 50: Table 3.3.2 Employment status: MenP
Page 51 and 52: Table 3.4.1 Exposure to mass media:
Page 53 and 54: 3.6 CURRENT MARITAL STATUSMarriage
Page 55 and 56: Polygyny also varies by household w
Page 57 and 58: Four in ten women age 20-49 marry b
Page 59 and 60: There is a positive relationship be
Page 62 and 63: FERTILITY AND REPRODUCTIVE HEALTH 4
Page 64 and 65: Table 4.2 Fertility by background c
Page 66 and 67: infertility, 1 or the inability to
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4.3 ADOLESCENT FERTILITYAdolescent
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Table 4.7 Antenatal carePercent dis
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Table 4.8 Place of antenatal carePe
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Table 5.1 Knowledge of AIDSPercenta
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The use of condoms as an effective
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Table 5.3.2 Comprehensive knowledge
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more education) and those in the fo
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Table 5.5.1 Exposure to HIV educati
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5.6 KNOWLEDGE AND ATTITUDE CONCERNI
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Table 5.6.2 Knowledge and attitudes
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Table 6.1.1 Accepting attitudes tow
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Stigma is also found to vary with l
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6.3 ATTITUDES OF ADULTS TOWARDS EDU
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HIV/AIDS-RELATED BEHAVIOUR 77.1 INT
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Table 7.2.1 Recent sexual activity:
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Figure 7.1 Recent Sexual Intercours
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Table 7.3.2 Multiple sexual partner
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Table 7.4 Payment for sexual interc
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Table 7.5.1 Coverage of prior HIV t
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Figure 7.2 Prior HIV Testing by Edu
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7.7 PREVALENCE OF SEXUALLY TRANSMIT
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Figure 7.3 Prevalence of STIs and S
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Table 7.8 Prevalence of medical inj
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Table 8.1 Comprehensive knowledge a
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Table 8.2 Age at first sexual inter
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Never-married women and men age 15-
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Figure 8.3 Condom Use at Premarital
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Table 8.5.2 Higher-risk sexual inte
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Table 8.6 Age-mixing in sexual rela
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8.9 HIV TESTING AMONG YOUNG PEOPLEK
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HIV PREVALENCE 99.1 INTRODUCTIONPri
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Table 9.1 Coverage of HIV testing b
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Table 9.1—ContinuedBackgroundchar
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Table 9.3 HIV prevalence by ageAmon
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There are large variations in HIV p
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Table 9.5 shows that men who are cu
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Women who said they had higher-risk
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Table 9.8 shows data on HIV prevale
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Table 9.11 HIV prevalence by male c
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INFANT AND CHILD MORTALITY 1010.1 I
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As expected, the level of infant an
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category (1.41) is 41 percent highe
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11.1 OWNERSHIP AND USE OF MOSQUITO
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carrying mosquitoes. Much of the fi
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11.2 USE OF ANTIMALARIAL DRUGS DURI
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11.3 TREATMENT OF CHILDREN WITH FEV
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11.4.1 Type and Timing of Antimalar
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11.4.2 Availability of Drug at Home
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11.6 SOURCE OF MOSQUITO NETSUntil l
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In spite of steady increases in ITN
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ORPHANS AND VULNERABLE CHILDREN 12P
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12.2 ORPHANS AND VULNERABLE CHILDRE
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12.3.1 School Attendance by Survivo
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While there are no differences in p
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Table 12.7 Widows dispossessed of p
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Table 12.9 External support for orp
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REFERENCESAgot, K.E., J.O. Ndinya-A
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SAMPLE IMPLEMENTATIONAPPENDIX AAppe
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Table A.2 Sample implementation: Me
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Table A.4 Coverage of HIV testing a
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Table A.6 Coverage of HIV testing a
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where h represents the stratum whic
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Table B.2 Sampling errors for Natio
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Table B.4 Sampling errors for Rural
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Table B.6 Sampling errors for Mainl
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Table B.8 Sampling errors for Mainl
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Table B.10 Sampling errors for Zanz
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Table B.12 Sampling errors for Nort
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Table B.14 Sampling errors for Sout
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Table B.16 Sampling errors for East
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Table B.18 Sampling errors for Dodo
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Table B.20 Sampling errors for Kili
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Table B.22 Sampling errors for Moro
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Table B.24 Sampling errors for Dar
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Table B.26 Sampling errors for Mtwa
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Table B.28 Sampling errors for Irin
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Table B.30 Sampling errors for Sing
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Table B.32 Sampling errors for Rukw
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Table B.34 Sampling errors for Shin
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Table B.36 Sampling errors for Mwan
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Table B.38 Sampling errors for Many
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Table B.40 Sampling errors for Pemb
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216 | Appendix B
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Joyce MbambaYulitha MwakasoleRemigi
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QUESTIONNAIRESAppendix DAppendix D
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HOUSEHOLD SCHEDULEIntroduction and
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IF AGE 0-17 YEARSIF AGE 5 YEARS OR
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IF AGE 0-17 YEARSLINE SICK CARE SUR
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HOUSEHOLD CHARACTERISTICSNO. QUESTI
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NO. QUESTIONS AND FILTERS CODING CA
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SUPPORT FOR SICK PEOPLENO. QUESTION
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NO.QUESTIONS AND FILTERSSUPPORT FOR
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NO.QUESTIONS AND FILTERSCODING CATE
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CHILD 4 CHILD 5 CHILD 6502 LINE NUM
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515 CHECK 509:NUMBER OF CHILDREN WI
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UNITED REPUBLIC OF TANZANIATANZANIA
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213 214 215 216217 218219 220221222
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LAST BIRTH NEXT-TO-LAST BIRTH SECON
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LASTSEXUAL PARTNERSECOND-TO-LASTSEX
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SECTION 7 - HIV TESTTHIS PAGE TO BE
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