“In HIV response in Tanzania no one should be left behind”: a Socio-Ecological analysis of civil society organizations’ possibilities to prevent HIV infection among vulnerable girls and women in Tanzania

Abstract: This study illuminates civil society organizations (CSOs)’ possibilities to prevent HIV among girls and women in Tanzania, reflecting on policy implications. A qualitative case study was conducted with a purposively selected CSO, Mtandao. Departing from a Socio-Ecological perspective, its staff was interviewed to find out (i) what signifies girls and women vulnerability to HIV infection (ii) how Mtandao addresses those vulnerabilities and (iii) what are the opportunities and constraints for its work. Gender inequalities, poverty, lack of education, the taboo around sex, harmful traditional beliefs and practices, poor access to condoms and health services, and discriminatory policies are key determinants to girls and women vulnerability to HIV infection. Mtandao addresses it by providing resources for their empowerment – condoms, education and economic opportunities. Also, Mtandao seeks to build an enabling environment to their health. The overall strategy is promoting structural cultural changes by engaging Tanzanian society and the government on Mtandao’s HIV prevention and health rights’ agenda. Mtandao’s shared background with vulnerable communities places it in a credible position to conduct those interventions. The Tanzanian government’s hostile position hinders it in providing policy frameworks to fulfill CSOs’ potential and effectively coordinate development partners, protecting CSOs autonomy in face of international donors.