HIV and AIDS is one of the major public health problems globally. In 2019,UNAIDS estimated that a total of 38.0 Million {31.6 million-44.5 million} people globally were living with HIV.

Of these,25.4 million{24.5 million-25.6 million} people were accessing antiretroviral therapy.

In terms of new infections, in 2019,an estimated 1.7 million { 1.2 million-2.2 million} people acquired HIV.Commulatively,75.7 million {55.9 million-100 million} people are estimated to be infected with HIV since the start of the epidemic.

In Zanzibar, since the first three cases were diagnosed at Mnazi Mmoja Hospital in 1986,there has been a marked increase in reported cases. However, the HIV epidemic has remained low(prevalence < 1%) in the general population.

In 2019,260 new cases were estimated, whereby 93% are adults above 15 years. The number of new HIV infections from 2010 shows downward trend across all age groups. The decline of new HIV cases indicates that HIV prevention and treatment interventions are bearing fruits.

Based on estimates from spectrum model(2020), an average of 7,524 people, including adults and children, were living with HIV in 2019. 72%(5,448) were in the age group of 15-49 years, while 4.7%(353) were children less than 15 years of age, and 1,724(23%) were adults of 50 years and above.

Over the last decade, the estimated number of deaths among PLHIV has decreased tremendously.

Zanzibar is typically characterized by a concentrated HIV epidemic with high HIV prevalence among female sex workers(FSWs),people who inject drugs(PWIDs), and men who sex with men (MSM).

According to the Integrated Bio-Behavioral Surveillance Survey(IBBSS) conducted in 2018/2019,HIV prevalence was estimated to be 12.1%,5.1% and 5.0% among FSWs, PWID, and MSM, respectively.

In accordance with this survey, the population size estimates for each group were as follows: 3,300 for PWID,5,554 for FSWs and 2,600 for MSM.

Tourism is the main factors which accelerate HIV new infection towards Female Sex Workers in Zanzibar, People injecting drugs and Men sex with men.

From 2017,following newer evidence, the Zanzibar Ministry of Health through Zanzibar Integrated HIV, Hepatitis, Tuberculosis and Leprosy Programme(ZIHHTLP) adapted the test and start approach to treating all HIV positive individuals.

The introduction of ‘Treat All’ has remarkably improved the enrollment of more HIV infected people on ART, and therefore vigorous effects are needed to:

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