title: Sexual and reproductive health and HIV in border districts affected by migration and poverty in Tanzania.
abstract: OBJECTIVE
  To assess HIV knowledge, attitudes, sexual practices and sexual and reproductive health (SRH) service delivery in border areas of Tanzania, with a view to support the prioritisation of SRH interventions in border areas.
  
  
  METHODS
  The target sample comprised randomly selected people living near the border, aged 15 to 49 years. To gather information, we utilised: (i) a standardised questionnaire (n = 86; 42 men and 44 women) previously used in national household surveys conducted by the Tanzanian government; (ii) focus group discussions (ten male groups, n = 47; ten female groups, n = 51); and (iii) semi-structured interviews with service providers (n = 37).
  
  
  RESULTS
  The mean number of sexual partners, frequency of multiple concurrent partnerships and engagement in transactional sex were significantly higher in the border community than in the national population. Knowledge about HIV was comparable with that in the general population. Access to SRH services was limited in the border areas.
  
  
  CONCLUSIONS
  Efforts to reduce HIV transmission and to improve SRH in the border areas should focus on gaps in service delivery rather than education and information activities alone. In addition, multi-sectorial efforts spanning the health, social, legal and private sectors addressing gender imbalances and poverty alleviation are imperative for reducing poverty-driven unsafe transactional sex.
authors.affiliation: * Department of Obstetrics and Gynaecology , Næstved Sygehus , Denmark.
authors.forename: Josephine
authors.initials: J
authors.lastname: Obel
authors.forename: Markus
authors.initials: M
authors.lastname: Larsson
authors.forename: Morten
authors.initials: M
authors.lastname: Sodemann
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D011203:Poverty; D012098:Reproduction; D060728:Reproductive Health; D034121:Reproductive Health Services; D012725:Sexual Behavior; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D013636:Tanzania; D055815:Young Adult
keywords: HIV; Migration; Reproductive health; Tanzania