A Sport-Based Intervention to Increase Uptake of Voluntary Medical Male Circumcision Among Adolescent Male Students: Results From the MCUTS 2 Cluster-Randomized Trial in Bulawayo, Zimbabwe

Kaufman, Zachary A.; DeCelles, Jeff; Bhauti, Kenneth; Hershow, Rebecca B.; Weiss, Helen A.; Chaibva, Cynthia; Moyo, Netsai; Mantula, Fennie; Hatzold, Karin; Ross, David A.

doi:10.1097/qai.0000000000001046

Cited by 29 publications

(69 citation statements)

References 12 publications

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“…Interventions were categorized into four major types: (i) financial incentives, (ii) counselling or education for prospective candidates, (iii) education and involvement of influencers, and (iv) novel information delivery, although some included more than one of these approaches. Most (n = 13) studies [13,[16][17][18][19][20][21]28,29,[31][32][33][34] presented data on the number of circumcisions completed at the end of the study period, while the remaining two studies [30,35] reported the prevalence of circumcision in the cohort. Table 2 shows the key findings from each study with both relative and absolute effects (where reported in the paper or calculated from raw data).…”

Section: Quantitative Resultsmentioning

confidence: 99%

“…Individual counselling is effective at increasing VMMC uptake when offered to men who had already taken the step of presenting to a VMMC facility . Group education or awareness raising interventions delivered in the community are also effective . Having time to process information between discussions allows for a natural decision‐making process; reviewing topics can reinforce benefits and alleviate new concerns .…”

Section: Discussionmentioning

confidence: 99%

“…The 18 papers included were published between 2014 and 2018 and presented data associated with 16 studies; five cluster randomised control trials (CRCTs) [13,14,16,[28][29][30], six RCTs [17,19,20,[31][32][33], two prospective interventional cohorts [34,35], two quasi-experimental [18,36] and one "non-experimental" study (amended from an RCT due to delays with VMMC service implementation) [21] (Table 1). Studies took place across seven countries in SSA.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Sgaier et al reviewed the impact evaluations from five randomized controlled trials (RCTs) and two quasi-experimental studies [13][14][15][16][17][18][19][20][21][22]. Three interventions, two offering financial incentives [19,20] and one novel football-based education sessions [16], reported significant impact, while qualitative components from others gave good insight into their implementational shortcomings [7]. Two further systematic reviews report the beneficial impact of financial incentives on VMMC uptake [23,24].…”

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confidence: 99%

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The effectiveness of demand creation interventions for voluntary male medical circumcision for HIV prevention in sub‐Saharan Africa: a mixed methods systematic review

et al. 2019

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Introduction UNAID S has recommended that in 14 countries across sub‐Saharan Africa ( SSA ), 90% of men aged 10 to 29 years should be circumcised by 2021 to help reduce transmission of HIV . To achieve this target demand creation programmes have been widely implemented to increase demand for Voluntary Medical Male Circumcision ( VMMC ). This review explores the effectiveness of demand creation interventions and factors affecting programme implementation. Methods We completed a mixed methods systematic review searching Medline, Embase, Global health, psyc INFO and CINAHL databases in August 2018 with no time restrictions. Demand creation interventions conducted in SSA were categorized and quantitative data about VMMC uptake was used to compare relative and absolute effectiveness of interventions. Qualitative data were summarized into themes relevant to the delivery and impact of programmes. Results and discussion Eighteen of the 904 titles were included in the review. Effective interventions were identified in each demand creation category: financial incentives, counselling or education, involvement of influencers and novel information delivery. Of the 11 randomized controlled trials ( RCT s), the greatest absolute impact on VMMC prevalence was seen with a complex intervention including VMMC promotion training for religious leaders (compared to control: 23% (95% CI 22.8 to 23.8) absolute increase; odds ratio ( OR ) 3.2 (1.4 to 7.3)). Financial incentives generally produced the largest relative effects with men up to seven‐times more likely to undergo VMMC in the intervention arm compared to control (adjusted OR 7.1 (95% CI 2.4 to 20.8), 7.1% (3.7 to 10.5) absolute increase). Qualitative findings suggest that interventions are more impactful when they are judged appropriate and acceptable by the target population; delivered by people with relevant personal experience; and addressing broader social and cultural influences through partnership with and education of community leaders. Conclusions A range of demand creation interventions can increase VMMC uptake. The most acceptable and effective interventions are financial incentives framed as fair compensation (relative effect) and programmes of education or counselling delivered by people who are influential in the community (absolute effect). Future research should include larger studies with longer follow‐up and a consistent definition of VMMC uptake.

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Section: Quantitative Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

mentioning

confidence: 99%

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The effectiveness of demand creation interventions for voluntary male medical circumcision for HIV prevention in sub‐Saharan Africa: a mixed methods systematic review

et al. 2019

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“…In that study we find low overall demand for male circumcision: only 3 percent are circumcised over a three month period. Several other studies have found similar results (significant but small impacts) using a wide range of programs for examples using soccer programs to educate and motivate young men in Zimbabwe(Kaufman et al 2014), and conditional food vouchers were evaluated inKenya (Thirumurthy et al 2014).…”

mentioning

confidence: 79%