The success of the HIV/STI programme at Geita gold mine in Tanzania is due in large part to the collaboration between Geita and
African Medical and Research Foundation (AMREF) and the government of Tanzania. AMREF brings to the partnership a track record in the field of HIV research and HIV/STI programme implementation, specifically in Tanzania
box); Geita contributed financially and in kind and is committed to ongoing HIV/AIDS prevention and control; and the state has contributed
in its support for the programmes implemented, and in the roll-out of anti-retroviral therapy (ART) in the region
Says Dr Gerald Baldrey, at Geita, "The Lake Victoria zone of Tanzania has a relatively high prevalence rate of HIV and Sexually Transmitted Infections (STIs). Situated about 20 kilometres from Lake Victoria, Geita gold mine falls into this high-risk area. Aware of the pre-existing high HIV/STI incidence in the area and committed to fighting both, Geita joined forces with AMREF to establish HIV/STI programmes in the area a year after the mine was constructed in 2000. Geita provides funding to the AMREF
mine health programme (MHP) , with support from Stanley Mining Services, African Mining Services (now DTP Terrassement) and other contractors. "
To establish baseline health data in the Geita mining community, in January 2001 an initial health survey was conducted by AMREF in and around the mine, including Geita town where the incidence of HIV is known to be high. The findings emphasised the urgent need for a comprehensive community health programme focusing on HIV/STI prevention, as well as malaria and tuberculosis (TB) prevention. As a result the AMREF
mine health programme started at Geita in July 2001. The project, aimed at mineworkers, female bar/guest house workers, and the communities surrounding the mines targets the mine site, the community and district health facilities. Key objectives of the programme have been to:
- promote healthy behaviour with respect to HIV, STIs and malaria among the mine workforce through awareness workshops and the
peer health educator (PHE) scheme;
- facilitate community participation in the prevention of HIV, STI, TB and malaria transmission as well as care of those already infected through training and supporting
community health educators (CHE);
- implement focused interventions targeting female bar/guest house workers by promoting safe sex and treating STIs;
- manage a sustainable voluntary counselling and testing (VCT) service for mineworkers, their families and the community;
- support district health facilities in the provision of services; and
- measure the impact, and assess the effectiveness of this intervention
In 2002, with funds provided by Geita, AMREF opened the HIV Information Centre at the former Geita bus station. The Geita HIV Information Centre, offering sexual and reproductive health services, and VCT, is one of the first stand-alone VCT centres in Tanzania. In 2004 some 5,185
clients presented at the centre, of whom 2,128 requested HIV testing and 1,889 were treated for STIs. The
VCT centre, with six full-time staff, three part-time staff and volunteer staff,
works in partnership with the Geita district municipality.
A progress survey was conducted in 2004 to determine changes in the prevalence of HIV, STI and malaria and in high-risk behaviour patterns, since the baseline survey of 2001. Results showed an improvement in sexual health knowledge among mineworkers and community members. Condom use had increased and HIV prevalence had not risen significantly. HIV prevalence amongst both female community members and bar/guest house workers had decreased, though not significantly. STI incidence had decreased as had the number of men and women paying for sex.
Putting the project in context: facts about Geita and HIV/AIDS
Geita town has an estimated population of 120,000 people. Geita gold mine was - until the
business combination of the two companies in April 2004 - jointly managed by AngloGold and Ashanti Goldfields Company.
Construction began at Geita in 1999 and production in 2000, so this is a relatively new operation. Open pit gold mining operation is conducted with 648 employees (594 local and 54 expatriate) and 1390 contractor employees.
AMREF completed a baseline STI/HIV/AIDS survey in Geita town and on the mine in January 2001. The survey confirmed a pre-existing local HIV epidemic, and specifically that:
- 16% of men and 18% of women in the local community were HIV positive; and
- 42% of local commercial sex workers were HIV positive.
Geita collaborated with and contracted AMREF to run various components of its HIV programme for three years (2001 -
2004). A notable feature of this programme is that the mine-based interventions are integra-ted with parallel interventions in the com-munity, which are partially sponsored by the mine.
The programme is continuing.
History of project
Recently the MHP collaboration has In 1989 the African Medical and Research Foundation (AMREF), the London School of Hygiene and Tropical Medicine (LSHTM) and the Tanzania National Institute for Medical Research (NIMR) collaborated on the development and evaluation of interventions for HIV and STI prevention in the Lake Victoria zone. The AMREF Mine Health Project (MHP) was established in 2000 to minimise the potential health risks posed to new mine recruits and members of the surrounding communities.
Roll out of ART advanced at Geita, thanks to intervention5>
Recently the MHP collaboration has brought forward the introduction of anti-retroviral therapy (ART) at Geita, after a concern that Geita may be excluded from the national ART roll-out until the 3rd year in 2006. Since the VCT programme has alerted people to their status, Geita was considered by all parties (GGM, AMREF and Geita District) to be a high priority site for ART.
Following a plea by these parties to the Tanzanian Commission for AIDS (TACAIDS), Geita has now been advanced to the first year of national ART roll-out. Provision has been made for 300 patients in the first year in compliance with government treatment regimes and the first patient treatment began in November 2004.