VMMC Programmatic Successes and Challenges: Western Kenya Case Study

Agot, Kawango; Onyango, Jacob; Ochillo, Marylyn; Odoyo-June, Elijah

doi:10.1007/s11904-022-00644-8

Cited by 4 publications

(3 citation statements)

References 45 publications

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“…The study area includes traditionally non-circumcising communities, 50 which since 2008, have been targeted by Kenya's National HIV Program for aggressive programmatic scale-up of VMMC to reduce HIV transmission risk among heterosexual men. [51][52][53] The protective effects of male circumcision may be partially offset by increased sexual risk behaviour as a result of lower perception of HIV infection risk after circumcision. 54 The literature on risk compensation is mixed, with earlier studies finding evidence of sexual risk compensation after male circumcision [55][56][57][58] and more recent studies finding contrary [59][60][61][61][62][63][64][65] or inconclusive 56,66,67 evidence.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of sexually transmitted infections in the setting of a generalized HIV epidemic—a population-based study, western Kenya

Awuoche,

Joseph,

Magut

et al. 2024

Int J STD AIDS

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Background Sexually transmitted infections (STIs) cause adverse health outcomes, including increasing HIV acquisition/transmission risk. We analyzed data from an HIV biomarker and behavioral survey to estimate STI prevalence, and explore associated factors in the setting of a generalized HIV epidemic in Siaya County, western Kenya. Methods Data were collected in March–September 2022 through face-to-face interviews using structured questionnaires; records from 9643 sexually active participants aged 13+ years were included in the analysis. We calculated weighted self-reported STI prevalence, by sex, age, and HIV status and explored associated factors using multivariable logistic regression. Results Median age was 37 years and 59.9% were female; HIV prevalence was 18.0%. Overall STI prevalence was 1.8%; 1.5-fold higher among males vs. females, and 2.6-fold higher among participants living with HIV vs. those without. HIV status and multiple sexual partners were independently associated with STI in both sexes. Mind-altering substance use and being circumcised were associated with STI among males. Conclusions This study estimates STI prevalence in the setting of high HIV prevalence. Findings underscore the importance of: effective STI screening in HIV clinics and HIV testing and counseling in STI clinics; screening and counseling on substance use, and HIV pre-exposure prophylaxis; and intensive sexual health counseling in male circumcision programmes.

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Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of sexually transmitted infections in the setting of a generalized HIV epidemic—a population-based study, western Kenya

Awuoche,

Joseph,

Magut

et al. 2024

Int J STD AIDS

Self Cite

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“…To improve VMMC, it is important to understand the factors hindering access to the intervention. Besides movement restriction and the reallocation of health resources to mitigate the spread of COVID-19 (9,12), evidence from Kenya suggests that the lack of policies and support for early infant circumcision, service integration at facilities, community ownership of VMMC programs, domestic funding, and household nancial constraints undermine VMMC (20). Moreover, some studies have highlighted counter perceptions acting as cognitive barriers to VMMC like perceived reduced sexual pleasure, sexual dysfunction, infertility and health workers' misconceptions amongst other factors (21,22).…”

Section: Barriers To Vmmcmentioning

confidence: 99%

“…Fourthly, policy reviews address barriers hindering access to VMMC for adolescent boys and men (7). In countries like South Africa and Malawi where traditional and cultural practices play a crucial role in circumcision (20), both the biomedical and traditional stakeholders should collaborate and integrate.…”

Section: Demand Creation Strategies For Vmmcmentioning

confidence: 99%

The impact of the COVID-19 pandemic on Voluntary Medical Male Circumcision in Gauteng Province, South Africa

Fonka

2024

Preprint

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Objective: Voluntary Medical Male Circumcision (VMMC) has a 60% effectiveness and is cost-effective in preventing HIV/AIDS transmission in Sub-Saharan Africa. However, there is a lack of evidence of the COVID-19 pandemic's potential impact on VMMC in Gauteng province, South Africa. This study aimed to assess the impact of the COVID-19 pandemic on VMMC in Gauteng Province. Method: This was a longitudinal study design. VMMC data was obtained from all public and private hospitals in Gauteng province from the District Health Information System and all medical schemes respectively. The datasets were merged with the years 2019 and 2020 as the before and during COVID-19 periods respectively. Percentage change in VMMC was calculated to demonstrate the effect of the pandemic on VMMC. Results: Provincially, VMMC declined in 2020 by an overall of 33.8% for ≥10 years, 32.4% for 10-14 years, and 35.8% for ≥15 years. All five districts in Gauteng province were affected differently. Exceptionally, the Tshwane Metropolitan district recorded an increase of 21.8% in ≥10 years and 36.0% in 10-14 years. While the other four districts saw a percentage decline in the three age groups, the worst performance was experienced in the West Rand district. Conclusion: The COVID-19 pandemic had an adverse indirect impact on VMMC in the Gauteng province of South Africa, except in one district. Considering the biomedical evidence and cost-effectiveness of VMMC in reducing HIV/AIDS transmission, there is an urgency to return VMMC post-COVID-19 to its pre-pandemic levels.

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Voluntary Medical Male Circumcision to Reduce HIV Acquisition and Transmission

Vermund

2022

Curr HIV/AIDS Rep

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VMMC Programmatic Successes and Challenges: Western Kenya Case Study

Cited by 4 publications

References 45 publications

Prevalence and risk factors of sexually transmitted infections in the setting of a generalized HIV epidemic—a population-based study, western Kenya

Prevalence and risk factors of sexually transmitted infections in the setting of a generalized HIV epidemic—a population-based study, western Kenya

The impact of the COVID-19 pandemic on Voluntary Medical Male Circumcision in Gauteng Province, South Africa

Voluntary Medical Male Circumcision to Reduce HIV Acquisition and Transmission

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