Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data
Objective This article provides an overview and interpretation of the performance of the US President’s Emergency Plan for AIDS Relief’s (PEPFAR’s) male circumcision programme which has supported the majority of voluntary medical male circumcisions (VMMCs) performed for HIV prevention, from its 2007...
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BMJ Publishing Group
2018-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/8/8/e021835.full |
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| author | Carlos Toledo Melissa Habel Stephanie M Davis Jonas Z Hines Jonathan M Grund Renee Ridzon Brittney Baack Jonathan Davitte Anne Thomas Valerian Kiggundu Naomi Bock Paran Pordell Caroline Cooney Irum Zaidi |
| author_facet | Carlos Toledo Melissa Habel Stephanie M Davis Jonas Z Hines Jonathan M Grund Renee Ridzon Brittney Baack Jonathan Davitte Anne Thomas Valerian Kiggundu Naomi Bock Paran Pordell Caroline Cooney Irum Zaidi |
| author_sort | Carlos Toledo |
| collection | DOAJ |
| description | Objective This article provides an overview and interpretation of the performance of the US President’s Emergency Plan for AIDS Relief’s (PEPFAR’s) male circumcision programme which has supported the majority of voluntary medical male circumcisions (VMMCs) performed for HIV prevention, from its 2007 inception to 2017, and client characteristics in 2017.Design Longitudinal collection of routine programme data and disaggregations.Setting 14 countries in sub-Saharan Africa with low baseline male circumcision coverage, high HIV prevalence and PEPFAR-supported VMMC programmes.Participants Clients of PEPFAR-supported VMMC programmes directed at males aged 10 years and above.Main outcome measures Numbers of circumcisions performed and disaggregations by age band, result of HIV test offer, procedure technique and follow-up visit attendance.Results PEPFAR supported a total of 15 269 720 circumcisions in 14 countries in Southern and Eastern Africa. In 2017, 45% of clients were under 15 years of age, 8% had unknown HIV status, 1% of those tested were HIV+ and 84% returned for a follow-up visit within 14 days of circumcision.Conclusions Over 15 million VMMCs have been supported by PEPFAR since 2007. VMMC continues to attract primarily young clients. The non-trivial proportion of clients not testing for HIV is expected, and may be reassuring that testing is not being presented as mandatory for access to circumcision, or in some cases reflect test kit stockouts or recent testing elsewhere. While VMMC is extremely safe, achieving the highest possible follow-up rates for early diagnosis and intervention on complications is crucial, and programmes continue to work to raise follow-up rates. The VMMC programme has achieved rapid scale-up but continues to face challenges, and new approaches may be needed to achieve the new Joint United Nations Programme on HIV/AIDS goal of 27 million additional circumcisions through 2020. |
| format | Article |
| id | doaj-art-35ef2fc77ce4480c994de3cf97795642 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2018-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-35ef2fc77ce4480c994de3cf977956422025-02-03T21:35:09ZengBMJ Publishing GroupBMJ Open2044-60552018-09-018810.1136/bmjopen-2018-021835Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme dataCarlos Toledo0Melissa Habel1Stephanie M Davis2Jonas Z Hines3Jonathan M Grund4Renee Ridzon5Brittney Baack6Jonathan Davitte7Anne Thomas8Valerian Kiggundu9Naomi Bock10Paran Pordell11Caroline Cooney12Irum Zaidi13Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA3 Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA3 Department of Neurology, University of Kentucky, Lexington, Kentucky, USA1 Division of Global HIV and TB, HIV Prevention Branch, Voluntary Medical Male Circumcision Team, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA1 Division of Global HIV and TB, HIV Prevention Branch, Voluntary Medical Male Circumcision Team, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA2 President’s Emergency Plan for AIDS Relief, Office of the U.S. Global AIDS Coordinator and Health Diplomacy, Washington, District of Columbia, USA3 Division of Global HIV and TB, Monitoring, Evaluation, and Data Analytics Branch, Clinical Monitoring and Evaluation Team, US Centers for Disease Control and Prevention, Atlanta, Georgia4 US Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USAUniversité de Lyon, Lyon, France5 United States Agency for International Development, Global Health Bureau, Office of HIV/AIDS, Prevention, Care and Treatment Division, Washington, District of Columbia, USA1 Division of Global HIV and TB, HIV Prevention Branch, Voluntary Medical Male Circumcision Team, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA3 Division of Global HIV and TB, Monitoring, Evaluation, and Data Analytics Branch, Clinical Monitoring and Evaluation Team, US Centers for Disease Control and Prevention, Atlanta, Georgia2 President’s Emergency Plan for AIDS Relief, Office of the U.S. Global AIDS Coordinator and Health Diplomacy, Washington, District of Columbia, USA2 President’s Emergency Plan for AIDS Relief, Office of the U.S. Global AIDS Coordinator and Health Diplomacy, Washington, District of Columbia, USAObjective This article provides an overview and interpretation of the performance of the US President’s Emergency Plan for AIDS Relief’s (PEPFAR’s) male circumcision programme which has supported the majority of voluntary medical male circumcisions (VMMCs) performed for HIV prevention, from its 2007 inception to 2017, and client characteristics in 2017.Design Longitudinal collection of routine programme data and disaggregations.Setting 14 countries in sub-Saharan Africa with low baseline male circumcision coverage, high HIV prevalence and PEPFAR-supported VMMC programmes.Participants Clients of PEPFAR-supported VMMC programmes directed at males aged 10 years and above.Main outcome measures Numbers of circumcisions performed and disaggregations by age band, result of HIV test offer, procedure technique and follow-up visit attendance.Results PEPFAR supported a total of 15 269 720 circumcisions in 14 countries in Southern and Eastern Africa. In 2017, 45% of clients were under 15 years of age, 8% had unknown HIV status, 1% of those tested were HIV+ and 84% returned for a follow-up visit within 14 days of circumcision.Conclusions Over 15 million VMMCs have been supported by PEPFAR since 2007. VMMC continues to attract primarily young clients. The non-trivial proportion of clients not testing for HIV is expected, and may be reassuring that testing is not being presented as mandatory for access to circumcision, or in some cases reflect test kit stockouts or recent testing elsewhere. While VMMC is extremely safe, achieving the highest possible follow-up rates for early diagnosis and intervention on complications is crucial, and programmes continue to work to raise follow-up rates. The VMMC programme has achieved rapid scale-up but continues to face challenges, and new approaches may be needed to achieve the new Joint United Nations Programme on HIV/AIDS goal of 27 million additional circumcisions through 2020.https://bmjopen.bmj.com/content/8/8/e021835.full |
| spellingShingle | Carlos Toledo Melissa Habel Stephanie M Davis Jonas Z Hines Jonathan M Grund Renee Ridzon Brittney Baack Jonathan Davitte Anne Thomas Valerian Kiggundu Naomi Bock Paran Pordell Caroline Cooney Irum Zaidi Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data BMJ Open |
| title | Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data |
| title_full | Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data |
| title_fullStr | Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data |
| title_full_unstemmed | Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data |
| title_short | Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data |
| title_sort | progress in voluntary medical male circumcision for hiv prevention supported by the us president s emergency plan for aids relief through 2017 longitudinal and recent cross sectional programme data |
| url | https://bmjopen.bmj.com/content/8/8/e021835.full |
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