Theme: Social Science & Policy Research Year: 2025
Background:
Women who use drugs (WWUD) in Tanzania face significant psychological distress, including depression, anxiety, and trauma, which can hinder their engagement with HIV prevention strategies such as pre-exposure prophylaxis (PrEP). This study examined the mental health challenges WWUD experience and how these affect PrEP engagement.
Methods:
In-depth interviews with 30 WWUD and five focus group discussions with WWUD, mental health providers, and outreach workers were conducted in Dar es Salaam (March–June 2024). Thematic analysis identified key insights on mental health burdens and barriers to PrEP engagement.
Results:
Economic hardship, stigma, housing instability, and violence significantly impacted WWUD’s mental health and HIV prevention behaviors. Many experienced heightened emotional distress, particularly mothers struggling with parenting challenges and guilt. Stigma was reported as leading to social isolation and self-worth loss, while drug cravings exacerbate stress and risky behaviors. Although some WWUD knew about PrEP, many learned about it during the study, indicating limited outreach. Providers highlighted fragmented services that focus on medications for opioid use disorder but lack sustained psychosocial support. Outreach workers stressed the need for tailored interventions, particularly for WWUD experiencing housing instability. While all groups recognized PrEP’s importance, stigma and unstable lifestyles hinder engagement. Providers emphasized improving accessibility and integrating mental health with HIV prevention efforts.
Conclusion:
Addressing mental health burdens is critical to improving PrEP engagement among WWUD. Community-based interventions that integrate mental health services with PrEP delivery can enhance engagement by addressing both structural barriers and lived realities. Tailored strategies offering sustained psychosocial support and flexible, accessible PrEP services are essential to overcoming stigma and mental distress.
Disclosure of Interest Statement:
The authors have not conflicts of interest to disclose.
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