Tanzania faces a mature, generalized HIV epidemic. In 2011, an estimated 1.6 million Tanzanians were living with HIV/AIDS, with 1.3 million being age 15 or older. Based on 2011 data, AIDS has resulted in an estimated 1.3 million orphaned children.
There is a widespread conception among Tanzanians and among some health workers that the 1979 Uganda–Tanzania War contributed to the spread of AIDS across the country. AIDS was first identified in Tanzania in 1984.
The Tanzania Commission for AIDS (TACAIDS) and the Zanzibar AIDS Commission authorized the Tanzania National Bureau of Statistics to conduct the Tanzania HIV/AIDS and Malaria Indicator Survey 2011–12. The survey was conducted in collaboration with the Office of the Chief Government Statistician (Zanzibar) and was funded by the United States Agency for International Development, TACAIDS, and the Tanzania Ministry of Health and Social Welfare. ICF International provided technical assistance during the survey.:pages: xiii, xv
The survey covered both mainland Tanzania and Zanzibar. Its objectives were to collect data on knowledge and behaviour regarding HIV/AIDS and measure HIV prevalence among women and men age 15–49.:page: xv The data was collected 16 December 2011 to 24 May 2012.:page: 7
The survey tested 9,756 women and 7,989 men in the 15 to 49 age group from every administrative region of Tanzania for HIV infection.
Overall, the survey found that 5.1 percent of those tested were HIV positive.:pages: 110–111 There was no statistically significant difference between this result and the result from the previous survey in 2007–08.:page: 111
Stratified by gender, 6.2 percent of women were HIV positive, which was significantly higher than the 3.8 percentage rate for men. These results were not statistically different from the results of the previous survey in 2007–08.:page: 111 Njombe region had the highest rate of positive women, 15.4 percent (240 tested), and men, 14.2 percent (200 tested).:page: 110 The rate for men was higher than for women in only two of Tanzania's 30 regions.:page: 110 The rate for both men and women was highest for people in the highest wealth quintile.:page: 110
The HIV positive rate for uncircumcised men was higher than for circumcised men in every five-year age group except for the 15–19 age group.:page: 119 This was also true when the survey results were stratified by urban versus rural areas instead of by age group.:page: 119
Among couples living in the same household (married or not), 4.6 were serodiscordant, where one was HIV positive and the other was negative. The Njombe region had the highest rate, 16.2 percent. The only other region above 10 percent was the Dar es Salaam region.:page: 121
The survey tested 3,852 women and 3,393 men in this age group from every administrative region of Tanzania for HIV infection. The survey found that 2.7 percent of women were HIV positive, which was significantly higher than the 1.2 percentage rate for men. Njombe region had the highest rate of positive women, 8.6 percent (75 tested), while Kigoma region had the highest rate for men, 3.6 percent (153 tested). The rate for men was higher than for women in only six of Tanzania's 30 regions. The rate for both men and women was highest for people in the highest wealth quintile.:page: 116
The survey tested 6,072 women and 4,209 men in this age group from every administrative region of Tanzania for HIV infection. The survey found that 7.5 percent of women were HIV positive, which was significantly higher than the 5.2 percentage rate for men. Njombe region had the highest rate of positive women, 18.6 percent (199 tested), and men, 21.4 percent (149 tested). The rate for men was higher than for women in only four of Tanzania's 30 regions.
Populations at high risk for HIV infection include sex workers, miners, police officers, prisoners, people in the transport sector, and the military. Injecting drug use is also increasing, highlighting the need to improve prevention efforts and expand access to treatment and care.
The greatest challenge facing the health sector is inadequate human resources to deliver quality health services to the Tanzanian population. Since the 1990s, structural adjustment policies and HIV/AIDS have greatly reduced the health-sector workforce. A second challenge is poverty, important because the cost of drugs and health services has constituted a financial barrier to access. Tanzania has formulated its second "Poverty Reduction Strategy" paper to reinforce its commitment to overcoming poverty. Tanzania also continues to struggle with the issue of corruption, with the health care sector being ranked as the second most corrupt sector in the country by the country's Economic and Social Research Foundation. Due in part to the vast size of the country, health services do not currently meet acceptable quality standards, and access to voluntary counseling and testing services varies greatly. Overall, while services may be available, the human and physical infrastructure is in need of improvement to allow for better quality patient care.