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HIV infection is very high among the Islands of Lake Victoria of Tanzania. It was revealed that Lukuba Islanders were aware of the presence of HIV/ STIs infections, and aware of condoms use as one of the protection ways from HIV infections. Condoms availability, accessibility and affordability were not a problem on the Island. Nevertheless, condom use realized to be very low and inconsistent among the Island dwellers; alcoholism, cleansing culture, irresponsible sexual behaviors, men dominance in sex decision making and low income among women blamed to fuel the emergence of new STIs infections including HIV. In view of these, there is a need for regular voluntary testing,counseling and treatment for STIs and provision of ARVs to people living with HIV, and rethink of designing messages promoting condom use that reflects the contextual hindrances to condom use in these communities. In these regards, there is a need of enhancing HIV/AIDS and STIs outreach preventions interventions using water-boat mobile clinics. This should go hand in hand with empowering women in order for them to have negotiation capabilities in sex relations and take legal action in case they are sexually abused