Abstract:

Background: HIV new infections in sub-Saharan Africa and in Tanzania have been decreasing following targeting intervention, however some populations remains at higher risk than the general population. Fishfolk populations in Africa and Asia have shown 4 to 14 fold HIV more infections as compared to their respective general populations. Despite of that, information on the magnitude of HIV infection, the associated eco-social and environmental factors and HIV/AIDS services uptake among fisherfolk in Islands of Lake Victoria Tanzania remains inadequately explored. This study therefore aimed at examining these groups and therefore give room for evidence based interventions.

Objectives: The study aimed at determining the magnitude of HIV infection, associated KAP and conduct HIV/AIDS curative and preventive need assessment among Fishfolk in Lake Victoria landing islands.

Methods: Prospective community based survey (N=456) retrospective cross-sectional study using VCT registered books (N=1744) were done. The community survey evaluated levels of HIV/AIDS knowledge, attitude and practice as well as point prevalence of HIV infection. Structured questionnaire and interview guides were used as research tools.

Results: HIV prevalence among fisherfolk was 14% with a variation from a low as 7.2% at Lunyanja to as high as 23.8% at Kasalazi. HIV prevalence was 12% (32/266) among men and 17.1% among women of which had no any significant statistical difference [OR = 0.662; 95% CI 0.388 – 1.129; p>0.05]. Fisherfolk at Buchosa district showed higher prevalence (18% (32/200) than their counterparts in Muleba where only 10.9% were infected (27/247) [x² =4.56; df=1; p<0.05]. The overall prevalence of HIV sero-positivity during Voluntary Testing and Counselling (VCT) was lower (9%) than the prevalence obtained from the community survey (14%). HIV infection among fisherfolk was found to be associated with: older age rank, marital status, education and occupation. Other were being not circumcised, never attended VCT for one at least one year, alcohol use, having sexual multiple partners and found working in Buchosa district. Final analysis (logistic regression) of the earlier mentioned variable found: alcohol use; occupation (fishing, business and employed); lack of formal education; being single; higher age rank as actual factors highly associated with increased with increased risk of acquiring HIV infection in the study area. Uptake of HIV.

VCT services within past year was done among 76% of the study participants and mostly in Muleba district. About half (47%) of the study participants never used condom consistently when meeting new sexual partners and 40% (5/14) of individuals found leaving with HIV infection had never started ART despite of knowing their status. Uptake of male circumcision was very good as 89% of the interviewed men were their circumcised. Distance, condom use inconsistency and misconception, lack of reliable ART access and poor ART adherence were mentioned as barriers to control of the disease.

Conclusion: The magnitude of HIV infection is alarming with 2 to 3 times that of the general population of the respective districts. The potential of continued HIV transmission in islands is spearheaded by some regulating economic and social factors. We recommend establishment of community based HIV/AIDS care and treatment centers for provision of ART preventive services.