HIV/AIDS and Malaria

The success of the HIV/STI programme at Geita gold mine in Tanzania is due in large part to the collaboration between Geita and African Medical and Research Foundation (AMREF) and the government of Tanzania. AMREF brings to the partnership a track record in the field of HIV research and HIV/STI programme implementation, specifically in Tanzania (see box); Geita contributed financially and in kind and is committed to ongoing HIV/AIDS prevention and control; and the state has contributed in its support for the programmes implemented, and in the roll-out of anti-retroviral therapy (ART) in the region (see box).

Says Dr Gerald Baldrey, at Geita, "The Lake Victoria zone of Tanzania has a relatively high prevalence rate of HIV and Sexually Transmitted Infections (STIs). Situated about 20 kilometres from Lake Victoria, Geita gold mine falls into this high-risk area. Aware of the pre-existing high HIV/STI incidence in the area and committed to fighting both, Geita joined forces with AMREF to establish HIV/STI programmes in the area a year after the mine was constructed in 2000. Geita provides funding to the AMREF mine health programme (MHP) , with support from Stanley Mining Services, African Mining Services (now DTP Terrassement) and other contractors. "

To establish baseline health data in the Geita mining community, in January 2001 an initial health survey was conducted by AMREF in and around the mine, including Geita town where the incidence of HIV is known to be high. The findings emphasised the urgent need for a comprehensive community health programme focusing on HIV/STI prevention, as well as malaria and tuberculosis (TB) prevention. As a result the AMREF mine health programme started at Geita in July 2001. The project, aimed at mineworkers, female bar/guest house workers, and the communities surrounding the mines targets the mine site, the community and district health facilities. Key objectives of the programme have been to:

• promote healthy behaviour with respect to HIV, STIs and malaria among the mine workforce through awareness workshops and the peer health educator (PHE) scheme;
• facilitate community participation in the prevention of HIV, STI, TB and malaria transmission as well as care of those already infected through training and supporting community health educators (CHE);
• implement focused interventions targeting female bar/guest house workers by promoting safe sex and treating STIs;
• manage a sustainable voluntary counselling and testing (VCT) service for mineworkers, their families and the community;
• support district health facilities in the provision of services; and
• measure the impact, and assess the effectiveness of this intervention

In 2002, with funds provided by Geita, AMREF opened the HIV Information Centre at the former Geita bus station. The Geita HIV Information Centre, offering sexual and reproductive health services, and VCT, is one of the first stand-alone VCT centres in Tanzania. In 2004 some 5,185 clients presented at the centre, of whom 2,128 requested HIV testing and 1,889 were treated for STIs. The VCT centre, with six full-time staff, three part-time staff and volunteer staff, works in partnership with the Geita district municipality.

A progress survey was conducted in 2004 to determine changes in the prevalence of HIV, STI and malaria and in high-risk behaviour patterns, since the baseline survey of 2001. Results showed an improvement in sexual health knowledge among mineworkers and community members. Condom use had increased and HIV prevalence had not risen significantly. HIV prevalence amongst both female community members and bar/guest house workers had decreased, though not significantly. STI incidence had decreased as had the number of men and women paying for sex.