Session Voluntary Medical Male Circumcision VMMC Office of
- Slides: 10
Session: Voluntary Medical Male Circumcision (VMMC) Office of Global Health and HIV (OGHH) Office of Overseas Programming & Training Support (OPATS)
Session Learning Objectives § After this session, participants determine how to work with current mobilization and education activities to support community efforts for VMMC.
What is VMMC § Male circumcision is the removal of the foreskin of the penis. § Voluntary medical male circumcision is the voluntary act of having the foreskin removed by a trained medical professional. § VMMC for HIV prevention programs target men (1549) in 14 countries in Southern and Eastern Africa.
VMMC program goals § UNAIDS, WHO, and PEPFAR have set a target to reach 80% of men in 14 countries by 2015. § Modeling estimated that this would eliminate 20% of all new infections in the region by 2025. § VMMC programs target adult men to get immediate prevention effect. Neonatal circumcision is more straightforward (i. e. , not minor surgery) but doesn’t have an immediate impact on HIV.
Evidence of VMMC’s Effectiveness § Early observational studies noted lower HIV prevalence rates where rates of male circumcision are high. § Randomized controlled trials in Kenya, Uganda, and South Africa demonstrated that circumcision reduces men’s risk of being infected by upwards of 60% during vaginal intercourse (female to male transmission).
VMMC and HIV Prevention § How does circumcision prevent HIV transmission? Theories about physiological change – Uncircumcised men seem to be more likely to have small tears and lesions that allow the virus to enter the body. – There is a high concentration of HIV target cells in the inner foreskin. – Circumcision also demonstrated a reduction in risk for other sexually transmitted infections, which can increase the chance of being infected with HIV.
Package of VMMC Services § HIV testing and counseling § Screening and treatment for STIs § Provision of male and female condoms and promotion of their correct and consistent use § Promotion of safer sex practices and risk reduction counseling § MC or surgical removal of the foreskin § Active linkage of HIV-positive client to care and treatment § Also require post operative review (generally seven days later). Bandage can be removed after two days. Must avoid erections for a certain period and abstain from sex for six weeks
Limitations of VMMC § Only partial protection – up to 60%. Still have to use condoms. § Does not provide HIV prevention benefit for HIV-positive men. § Only protects insertive partner during heterosexual vaginal sex.
National VMMC Strategy § Post adaptation – Include current coverage rates – Include actors, implementers – Review cultural norms around circumcision
PCV Support to VMMC Efforts § Conduct information sessions on VMMC. § Support promotion of VMMC, particularly among adult men. Encourage women to support men in going for VMMC. § Provide referrals to local VMMC facilities. § Work with local partners to recruit, train, and select VMMC clients as community advocates. § Educate community on appropriate post-surgical care and appropriate follow up.
