title: Access to HIV prevention services among gender based violence survivors in Tanzania.
abstract: BACKGROUND
  Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%.
  
  
  METHODS
  In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach.
  
  
  RESULTS
  Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection.
  
  
  CONCLUSIONS
  GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended.
authors: African Medical and Research Foundation, Dar es Salaam, Tanzania.
authors: Beati
authors: B
authors: Mboya
authors: Florence
authors: F
authors: Temu
authors: Bayoum
authors: B
authors: Awadhi
authors: Zubeda
authors: Z
authors: Ngware
authors: Elly
authors: E
authors: Ndyetabura
authors: Gloria
authors: G
authors: Kiondo
authors: Janneth
authors: J
authors: Maridadi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003376:Counseling / Q000379:methods; D003625:Data Collection; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D013240:Stereotyping; D011795:Surveys and Questionnaires; D017741:Survivors; D013636:Tanzania; D014505:Urban Population / Q000706:statistics & numerical data; D014754:Violence; D055815:Young Adult
keywords: Gender based violence; HIV; access; health services; people living with HIV; survivor