Submission ID 129567
| Issue/Objective | Persistent inequities in HIV outcomes in low- and middle-income countries are driven by structural and social determinants, including poverty, stigma, and limited access to community-based support. Traditional HIV programs often prioritize clinical service delivery, with insufficient attention to these upstream drivers of inequity. In a context of fragmented health systems and limited resources, there is an urgent need for integrated, equity-driven approaches addressing both biomedical and social determinants. This study examines the effectiveness of a holistic, community-based HIV care model in improving outcomes and advancing health equity in Tanzania. |
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| Methodology/Approach | A cohort-based program was implemented across 30 community centers in Dar es Salaam and Mwanza, supporting 2,400 people living with HIV over a structured 9-month cycle. The model integrated clinical adherence support, psychosocial counseling, economic empowerment, and community-based follow-up through trained community health volunteers. Routine program data were collected using KoboToolbox and validated through multi-level verification processes. Comparative analysis of key indicators between 2024 and 2025 was conducted. Findings are based on routine program data and may be subject to reporting and selection biases. |
| Results | The program achieved high retention (99%) and strong clinical outcomes, including viral load suppression (94%) and adherence improvement (94%). HIV status disclosure increased to 98%, indicating strengthened psychosocial support and reduced stigma. Among adolescents and young people, retention reached 98%. Economic empowerment interventions enabled 61% of clients to establish income-generating activities, with savings mobilization reaching TZS 64.0 million. Targeted recruitment ensured that 93% of enrolled clients met vulnerability criteria. Key indicators improved between 2024 and 2025, including retention, adherence, viral suppression, and disclosure. |
| Discussion/Conclusion | Integrating clinical care with psychosocial, economic, and community-based support improves HIV outcomes and advances health equity by addressing structural barriers to care. This model demonstrates how community-led systems translate evidence into impact in resource-constrained settings. It also highlights the importance of aligning community-based interventions with national health systems to strengthen sustainable and equitable service delivery. Scaling such approaches offers a practical pathway for strengthening resilient and inclusive health systems. |
| Presenters and Affiliations | Baraka Leonard Mfilinge Untold Foundation Vivian Calvin Kombe Untold Foundation Baraka Leonard Mfilinge Untold Foundation |
