SAUTI launches in Dar: HIV prevention reframed around adolescent girls and young women

In April 2016, ASUTA joined the SAUTI Programme — a five-year USAID-funded HIV prevention initiative awarded to Jhpiego and partners EngenderHealth, Pact and the National Institute for Medical Research (NIMR), with implementation across Temeke, Kinondoni and Kigamboni districts of Dar es Salaam.

SAUTI's central commitment is the one ASUTA has spent a decade making: Key and Vulnerable Populations (KVP) — vulnerable Adolescent Girls and Young Women (vAGYW), Female Sex Workers (FSW), Men who have Sex with Men (MSM), and their partners — should have access to a single, vulnerability-tailored package of prevention services, with strong and traceable linkages to care.

SAUTI is not an awareness campaign with a clinic bolted on. It is a combination prevention model — biomedical, behavioural and structural — built around six objectives:

• Community mapping of hotspots, hangouts and partner resources ward by ward
• Community-based behaviour change education on HIV, family planning and gender norms
• Demand creation and active linkage for AGYW, FSW, men and other vulnerable populations into biomedical, SBCC and economic-strengthening services
• Biomedical services delivered at hotspots and inside SBCC and WORTH+ groups
• Combination prevention support at LGA-recommended resource centres
• Routine M&E and research activities to feed the evidence base

ASUTA owns the community layer. That means the mapping; the peer educators; the WORTH+ savings groups; the SBCC group sessions; the escorted referrals into care and treatment clinics; and the post-GBV social, legal and medical linkages for survivors. It also means a deliberate gender focus — engaging male community-based health service providers (CBHSPs) to shift the norms that drive AGYW vulnerability in the first place.

Year 1 is for foundation: mapping hotspots and WORTH+ catchments across the three districts, recruiting and training the first cohorts of male and KVP peer educators, and establishing the daily data feedback loop that will let Jhpiego, NIMR and ASUTA tune service delivery in near real time. By the end of the project in 2019, SAUTI aims to have moved the needle on four outcomes that have proven stubborn in Tanzania: timely uptake of HIV prevention and FP services, positive behaviours at individual and community levels, reduced vulnerability through structural interventions, and sustainable KVP-focused prevention services.