1. Temporal Trends in Clinical Characteristics and Outcome of Patient’s enrolled in ART program, 2004-2011 in Dar es Salaam, Tanzania. Retroviruses and Novel Drugs Chicago, USA June 08-09, 2015 David Sando MDH Retrovirus conf, Chicago, June 09, 2015 1

2. Outline Overview of country HIV/AIDS epidemic Key national programs to fight the epidemic MDH overview Methods Results Summary Acknowledgements Retrovirus conf, Chicago, June 09, 2015 2

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6. HIV Counseling and Testing Retrovirus conf, Chicago, June 09, 2015 6

7. Condom use and HIV Retrovirus conf, Chicago, June 09, 2015 7

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9. MDH HIV clinic in DSM

10. Key supported program areas  HIV care and treatment  PMTCT and HIV early infant diagnosis  Infrastructure improvement  Capacity building/trainings/ mentorships  ARVs and health commodities management  Strengthening laboratory services  Quality Improvement initiatives  Data Mng for M&E and Strategic Information  Community linkage and tracking  Nutritional support  Promotion of HIV prevention and PWP  Public Health Evaluations and Evidence-Based Programming

11. Scaling up of Care and treatment services 11

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13. Methods Study period: October 2004 – September 2011 Socio-demographics, clinical and immunological data at enrollment were collected Their outcome data, such as still active on ART, LTF and dead were also collected on routine basis. Year of enrollment was treated as independent variable Binomial logistic regression model was used for trend tests. P-values under 0.05 were considered significant. Retrovirus conf, Chicago, June 09, 2015 13

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20. Summary Overall, there has been increase in enrollment of HIV patients over time Despite an early observed worsening of clinical features, recent years new patients presents in less advanced stage of disease LTF has been persistent high over the years since start of the program There has been decrease in overall 12-month mortality rate Retrovirus conf, Chicago, June 09, 2015 20

21. Acknowledgements The gov’t of Tanzania through Ministry of Health and Social welfare The Dar es Salaam regional secretariat and its municipal councils health management teams Management and Development for Health staff This study has been supported by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through Centers for Disease Control and Prevention under the terms of SHAPE Project Award # GH11 ‐ 112703CONT13 21

22. Retrovirus conf, Chicago, June 09, 2015 22 THANK YOU FOR LISTENING