{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:02:48Z","timestamp":1787896968028,"version":"build-2784847793"},"reference-count":71,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["Framework Partnership Agreement 2013-0039"],"award-info":[{"award-number":["Framework Partnership Agreement 2013-0039"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The 2016\u20132017 Tanzania HIV Impact Survey (THIS) reported the accomplishments towards the 90-90-90 global HIV targets at 61-94-87, affirming the need to focus on the first 90 (i.e., getting 90% of people living with HIV (PLHIV) tested). We conducted a patient-pathway analysis to understand the gap observed, by assessing the alignment between where PLHIV seek healthcare and where HIV services are available in the Shinyanga region, Tanzania. We used existing and publicly available data from the National AIDS Control program, national surveys, registries, and relevant national reports. Region-wide, the majority (n = 458\/722, 64%) of THIS respondents accessed their last HIV test at public sector facilities. There were 65.9%, 45.1%, and 74.1% who could also access antiretroviral therapy (ART), CD4 testing, and HIV viral load testing at the location of their last HIV test, respectively. In 2019, the viral suppression rate estimated among PLHIV on ART in the Shinyanga region was 91.5%. PLHIV access HIV testing mostly in public health facilities; our research shows that synergies can be achieved to improve access to services further down the cascade in this sector. Furthermore, effective engagement with the private sector (not-for-profit and for-profit) will help to achieve the last mile toward ending the HIV epidemic.<\/jats:p>","DOI":"10.3390\/ijerph18168418","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T21:41:46Z","timestamp":1628545306000},"page":"8418","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Shinyanga Patient: A Patient\u2019s Journey through HIV Treatment Cascade in Rural Tanzania"],"prefix":"10.3390","volume":"18","author":[{"given":"Nwanneka E","family":"Okere","sequence":"first","affiliation":[{"name":"Department of Global Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Global Health and Development, 1105 BP Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veryeh","family":"Sambu","sequence":"additional","affiliation":[{"name":"National AIDS Control Programme, Dodoma 41110, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudas","family":"Ndungile","sequence":"additional","affiliation":[{"name":"Regional Health Management Team, Shinyanga 37103, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"van Praag","sequence":"additional","affiliation":[{"name":"Amsterdam Institute for Global Health and Development, 1105 BP Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Global Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Global Health and Development, 1105 BP Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Naniche","sequence":"additional","affiliation":[{"name":"ISGlobal-Barcelona Institute for Global Health, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias F Rinke","family":"de Wit","sequence":"additional","affiliation":[{"name":"Department of Global Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Global Health and Development, 1105 BP Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Maokola","sequence":"additional","affiliation":[{"name":"National AIDS Control Programme, Dodoma 41110, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela B","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,9]]},"reference":[{"key":"ref_1","unstructured":"UNAIDS (Joint United Nations Programme on HIV\/AIDS) (2014). 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