HIV burden and the global fast-track targets progress among pregnant women in Tanzania calls for intensified case finding: Analysis of 2020 antenatal clinics HIV sentinel site surveillance

Background For successful HIV response, updated information on the burden and progress towards elimination targets are required to guide programmatic interventions. We used data from the 2020 HIV sentinel surveillance to update on the burden, HIV status awareness, ART coverage, and factors associated with HIV infection among pregnant women in Tanzania mainland. Methodology We conducted the ANC surveillance in 159 ANC sites from all 26 regions of Tanzania’s mainland from September to December 2020. This cross-sectional study included all pregnant women (≥15 years) on their first ANC visit in the current pregnancy during the survey period. Routine HIV counseling and testing were done at the facility. Multivariable logistic regression model was used to examine factors associated with HIV infections. Results A total of 38,783 pregnant women were enrolled (median age (IQR) =25 (21–30) years). HIV prevalence was 5.9% (95%CI: 5.3% - 6.6%), ranging from 1.9% in Manyara region to 16.4% in Njombe region. Older age, lower and no education, not being in marital union, and living in urban or semi-urban areas was associated with higher odds of HIV infection. HIV status awareness among women who tested positive was 70.9% (95% CI: 67.5%- 74.0%). ART coverage among those aware of their status was 91.6% (86.5%- 94.9%). Overall, 66.6% (95% CI: 62.4%- 70.6%) of all pregnant women tested positive for HIV knew their HIV status and were on ART. Conclusion HIV is increasingly prevalent among pregnant women in Tanzania especially among older, those with lower or no formal education, those outside marital union and pregnant women living in urban and semi-urban areas. Behind the global fast-target to end HIV/ AIDS, about a third of pregnant women living with HIV initiating ANC were not on ART. Interventions to increase HIV testing and linkage to care among women of reproductive age should be intensified.