HIVDR-Prevent: Design and evaluation of interventions for preventing HIV drug resistance in Dar es Salaam urban cohort study (DUCS) area in Tanzania, using a transdisciplinary human centered approach.

HIV Drug Resistance (HIVDR) is rising and antiretroviral treatment (ART) is getting less effective, so people living with HIV (PLHIV) suffer more as they are restricted in their daily abilities. This induces several sustainability threats, touching several SDGs, not only health, but several other SDGs such as education, poverty, gender equality, among others. Root causes need to be determined in order to design leverage points to counteract HIVDR at community level. During a VLIR-UOS-SI, a transdisciplinary methodology was co-developed involving semi-structured interviews and co-creation workshops with the local communities, stakeholders and researchers. A systems map was built representing the “last mile” at the point of care delivery on ART and HIVDR in the Dar es Salaam area. Key performance indicators (KPIs) have been designed during a VLIR-UOS-JOINT project and are being measured. This TEAM project will capitalize on these efforts, through further rolling out the trans-disciplinary methodology to support the qualitative and quantitative HIVDR systems model design and improvement which started during the SI and JOINT projects. During this TEAM project, intervention models will be co-designed, and interventions will be tested and evaluated to improve the last mile based on identified leverage points. The experience so far has been an eye opener for all parties, and the local community is already taking action based on what the project has revealed, for example through local social enterprises. The project will empower researchers, the local community, stakeholders and policy makers to collaborate and improve the last mile in HIV treatment, thereby preventing HIVDR from rising further in the study area. Interventions, transferable to other settings and contexts are envisioned. At the same time, the project will enable both Tanzanian and Belgian partners to further develop their skills on trans-disciplinary research and education.