Medical Male Circumcision as an anti-HIV/STIs strategy: Lessons from Community-based Well-men efforts in Uganda 2010-2012
INTRODUCTION: Uganda is targeting to circumcise
4.2 million men by 2015. Circumcision reduces female to male heterosexual HIV
transmission by 60%, is associated with reduction in risk of Herpes simplex
virus 2 (HSV2) and syphilis. Benefits from circumcision are provided as part of
comprehensive HIV prevention including community-mobilisation, providing accessible
safe male circumcision sites, surgery camps and enrolling support of men-only clubs.
Meaningful population protection will be achieved if men play inclusive roles.
METHODOLOGY: MARPS In Uganda in partnership with 15
safe male circumcision referral centers scattered in Kampala provided health
education. The entry points were the leisure board games which attracted many young
and adult men. Formalizing and planned team building skills for cohesion and
consolidation, enabled reaching informal sector categories of men aged 17 years
to 65 years such as: Board-game clubs, Artisanry, furniture marts, repair
workshops; skilled/unskilled labour, construction, retail and small scale
businesses.
OUTCOMES: Male-only groups can be a motivation to
improving on numbers of males understanding benefits services such as circumcision.
This combined with proximity to safe male circumcision centers has enabled
1,700 male candidates express need for circumcision. 40 key leaders aged 17-55 years, 400 males
aged 22-50 years, 30 male sex-workers, 300 mobile men with money (Market-based
traders, board-game players, quick food-vendors, foot-ball clubs, entertainment
industry, FBOs, rural-based societies/clubs), 10 reformed former in-mates and 20
substance users have since been circumcised. On follow up 800 had actually circumcised
and 900 had been lost to follow-up.
CONCLUSION: Peer adult male to male mobilisation in
familiar cohesive spaces can influence decisions for uptake of circumcision by
men.
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