Availability and utilization of Youth-Friendly Services on HIV testing and counselling among youth in three districts of Tanzania Wahida Ramadhani1, David P. Ngilangwa1, Emilian Michael1, Rita Noronha1 1 Amref Health Africa, Dar es Salaam, Tanzania The International Conference on AIDS and STIs in Africa (ICASA) Rainbow Towers Hotel & Conference Centre, Harare, Zimbabwe 29th November to 4th December 2015

Outline Background Methods Results Discussion and conclusions Acknowledgments

Background In Tanzania, youth aged 10-24 years accounts for 32% of the population (TDHS 2010) More than 50% of them are sexually active Sexual and reproductive health (SRH) including HIV testing and counseling (HTC) services is pertinent for their long-term health Majority of them are denied or declined to access HTC services due to stigma by: (Brittain et al: 2015) Community members and service providers Thus, 39% and 25% of young men and women of 15-24 years who had sex have been tested for HIV (TDHS 2010)

Background (Ct’n) Developing Youth-Friendly Services (YFS) sites where youth can access and utilize HTC services comfortably will reduce; Unwanted pregnancies Unsafe abortion Sexually transmitted infections including HIV Baseline survey aimed at understanding availability, awareness and utilization of YFS in three selected districts Availability awareness and utilization of YFS in three selected districts Purpose: To inform Amref Health Africa prior implementation of the intervention targeting youth

Methods Study design Study population and sites Sampling Data analysis A mix methods quasi-experimental baseline assessment Study population and sites Youths aged 15-24 years in three districts of Tanzania namely Makete, Namtumbo and Temeke in August 2013 Sampling A multistage sampling technique Sampled and enrolled 346 participants Data collection A standardized questionnaire Interviews guides Data analysis Descriptive analysis SPSS version 16 Qualitative data was analysed manually

Results Socio-demographic characteristics of participants 171 (49.4%) and 175 (50.6%) youths from the intervention and comparison sites respectively Of them, more than half 204(58.96%) were female Their mean age was 17 The majority 46.5%(161) had completed secondary school

Results (Ct’n) 77% of youth from both arms were unaware of the availability of YFS in their nearby health facility (HF) 50% of youth who were aware have ever used YFS 36.8% in treatment and 29.1% control had ever tested for HIV in YFS in one of the nearby HF Most preferred place of VCT testing were: Standalone VCT: 49(77.4%) 28(48.4%) for intervention and control respectively Inside HF: 26(41.0%) and 20(34.6%) for intervention and control respectively 50(79.3) and 44 (86.2%) youth from treatment and comparison respectively received their results the same day

Results (Ct’n) More than 80% from both arms shared their HIV results with their partners HIV prevalence was 15.8% and 15.6% for treatment and control respectively Young girls contributing for more than 80% for both arms Some areas were reported to have active YFS whereas others not due to lack of personnel and funds “We have five (5) centres including Yombo, Temeke hospital, Kizuiani and Kigamboni. We also have YFS that have been supported by UNICEF for a long time...” (KII/Temeke) “We had such services in 2006 – 2007 but currently we don’t have ….because the health care providers who were providing such services were transferred. But we are now planning to resume the services” (KII/Makete)

Discussion and conclusions Findings suggest that availability and accessibility of YFS is relatively low This is despite of readiness of youth to utilize them Recommendations Support CHMTs to scale up and promote YFS sites to reach many marginalized youths

Acknowledgements UNICEF Study respondents Amref Health Africa Staff