Reducing the Spread of HIV through voluntary medical male circumcision: JSI’s experience in East Central Uganda

 

Men undergo voluntary male circumcision (VMC) procedures at an outreach clinic run by STAR-EC.
Men undergo voluntary medical male circumcision (VMMC) procedures at an outreach clinic run by STAR-EC.

About eight years ago three randomized controlled studies showed done in Uganda, Kenya and South Africa showed that male circumcision for sexually active men provides up to 60% protection against HIV infection. Increasingly with support from PEPFAR, voluntary medical male circumcision (VMMC) is being added to other HIV prevention interventions in high HIV prevalence and low male circumcision prevalence areas, particularly in sub-Saharan Africa.

In Uganda—a largely traditionally non-circumcising country—it is estimated that over the next three years, up to 4.4 million men aged 15 years and above need to be circumcised in order to achieve population-level impact for reduced HIV infection through this intervention. In East Central Uganda where JSI runs the Strengthening TB and HIV&AIDS Responses in East Central Uganda (STAR-EC) program (funded by USAID) an estimated 500,000 men need to be circumcised in the nine districts covered by STAR-EC.

Male circumcision for sexually active men can reduce the risk of HIV infection by up to 60%
Male circumcision for sexually active men can reduce the risk of HIV infection by up to 60%

Since 2010, STAR-EC has supported the circumcision of more than 150,000 men in the region through the use of static health facilities, outreach activities, and ‘circumcision camps.’ The uptake of VMMC has so far been impressive and the program and our district-level partners can now support high-quality circumcision services for up to 10,000 men monthly through the innovative methods such as the use of disposable circumcision kits; weekend ‘tent outreaches’ to bring services nearer to those who need them; and week-long ‘circumcision camps’ in hard-to-reach areas where HIV prevalence is high.

Voluntary medical male circumcision is now integrated into other health service delivery since STAR-EC’s approach is to strengthen the public health system to deliver combination HIV prevention interventions. Through this approach, other health services are provided concurrently including HIV counseling and testing (HTC), immunization for children, family planning, laboratory tests, condom promotion, antiretroviral therapy, etc. STAR-EC has ambitious targets and expects that by the end of 2015, half a million men over the age of 15 years will have received VMMC resulting in averting an estimated 26,000 new HIV infections in the region.

3 responses to “Reducing the Spread of HIV through voluntary medical male circumcision: JSI’s experience in East Central Uganda”

  1. High quality VMMC of up to 10,000 men monthly-Quite impressive result in eastern and central Uganda .Attempt to carry out VMMC services to the rural folk here in middle north Uganda has not been as successful due to circulating myths on the program, despite the region being second highest in HIV prevalence in the country. the population apparently requires massive mobilization program for proper uptake of these very importance strategy to avert HIV spread

  2. Congratulations Dr. Samson and the entire STAR EC team. It’s a huge undertaking which requires a lot of effort and resources to get all those men to voluntarily get circumcised. There is no doubt that project targets will be met. Going beyond VMMC, one would be interested to know the follow up mechanism for the all the young men who unde went VMMC. Have their changed their risk behaviors? Are there post test clubs for them? Considering gender perceptions, do girls and women feel that having protected sex with circumcised boys and men safer? If pressure for having men circumcise came from their sexual partners, the VMMC would be sustained beyond the project. How this can be done is now the next strategy. Good SBCC messages can enhance the VMMC interventions.

  3. Congratulations to STAR EC. We definitely need concerted effort and multiple actors to enable us reach our national target over the next 5 years.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.