ASUTA was founded in 2008 on a single conviction: marginalised communities deserve services designed with them, not for them. In September 2012, that conviction met its first major grant.
The Rapid Funding Envelope for HIV/AIDS (RFE), managed by Deloitte Consulting on behalf of a pooled donor group — DANIDA, USAID, NORAD, the European Union and DFID — awarded ASUTA TZS 299,975,800 across Rounds 9 and 10 to deliver comprehensive HIV/AIDS prevention services in Bagamoyo District.
The target — and the gap
Bagamoyo's HIV profile in 2012 was driven by the same forces still visible today: long-distance trucking corridors, a transient fishing and migrant population, and entrenched stigma against the women who service that economy. The RFE design names the populations directly: Commercial Sex Workers, Injecting Drug Users (IDUs), barmaids, migrants, and the wider community at risk through them.
ASUTA's mandate from RFE was to design preventive measures that meet these groups where they actually are — in guesthouses, at bus stages, in the bars that line the coast road — not in clinics they will never enter.
The four-pillar approach
- Social Behavioural Change — demand creation, condom distribution at mobilisation events, community-level dialogue
- Structural intervention — Income Generating Activity (IGA) groups, entrepreneurship training, life skills
- Biomedical intervention — HIV testing, STI/GBV/TB/FP screening, linkage and treatment
- Monitoring & Evaluation — internal Data Quality Assurance, monthly reviews with peer educators and providers
What the start year delivered
By the end of Year 1, ASUTA had trained 62 Peer Health Educators and reached 256 sex workers, barmaids and migrants with STI, HIV/AIDS and condom-use sessions. A first batch of 50,000 condoms entered distribution. The IGA pipeline began with sewing machines for women exiting sex work, carpentry tools for recovering drug users and seed capital for mama-ntilie food vendors.
The model was not new. The discipline of delivering it — week after week, across the same hotspots, with the same trusted peer educators — was. That discipline is what carried RFE to its close in 2015, and it is the discipline ASUTA has carried into every project since.