In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 9 ( 2022-9-23), p. e0270545-
Abstract:
Voluntary medical male circumcision (VMMC) remains an effective biomedical intervention for HIV prevention in high HIV prevalence countries. In South Africa, United States Agency for International Development VMMC partners provide technical assistance to the Department of Health, at national and provincial levels in support of the establishment of VMMC sites as well as in providing direct VMMC services at site level since April 2012. We describe the outcomes of the Right to Care (RTC) VMMC program implemented in South Africa from 2012 to 2017. Methods This retrospective study was undertaken at RTC supported facilities across six provinces. Young males aged ≥10 years who presented at these facilities from 1 July 2012 to 31 September 2017 were included. Outcomes were VMMC uptake, HIV testing uptake and rate of adverse events (AEs). Using a de-identified observational database of these clients, summary statistics of the demographic characteristics and outcomes were calculated. Results There were a total 1,001,226 attendees of which 998,213 (99.7%) were offered VMMC and had a median age of 15 years (IQR = 12–23 years). Of those offered VMMC, 99.6% (994,293) consented, 96.7% (965,370) were circumcised and the majority (46.3%) were from Gauteng province. HIV testing uptake was 71% with a refusal rate of 15%. Of the newly diagnosed HIV positives, 64% (6,371 / 9,972) referrals were made. The rate of AEs, defined as bleeding, infection, and insufficient skin removal) declined from 3.26% in 2012 to 1.17% in 2017. There was a reduction in infection-related AEs from 2,448 of the 2,602 adverse events (94.08%) in 2012 to 129 of the 2,069 adverse events (6.23%) in 2017. Conclusion There was a high VMMC uptake with a decline in AEs over time. Adolescent men contributed the most to the circumcised population, an indication that the young population accesses medical circumcision more. VMMC programs need to implement innovative demand creation strategies to encourage older males (20–34 years) at higher risk of HIV acquisition to get circumcised for immediate impact in reduction of HIV incidence. HIV prevalence in the total population increased with increasing age, notably in clients above 25 years.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0270545
DOI:
10.1371/journal.pone.0270545.g001
DOI:
10.1371/journal.pone.0270545.g002
DOI:
10.1371/journal.pone.0270545.g003
DOI:
10.1371/journal.pone.0270545.t001
DOI:
10.1371/journal.pone.0270545.t002
DOI:
10.1371/journal.pone.0270545.t003
DOI:
10.1371/journal.pone.0270545.t004
DOI:
10.1371/journal.pone.0270545.s001
DOI:
10.1371/journal.pone.0270545.s002
DOI:
10.1371/journal.pone.0270545.s003
DOI:
10.1371/journal.pone.0270545.s004
DOI:
10.1371/journal.pone.0270545.s005
DOI:
10.1371/journal.pone.0270545.s006
DOI:
10.1371/journal.pone.0270545.s007
DOI:
10.1371/journal.pone.0270545.r001
DOI:
10.1371/journal.pone.0270545.r002
DOI:
10.1371/journal.pone.0270545.r003
DOI:
10.1371/journal.pone.0270545.r004
DOI:
10.1371/journal.pone.0270545.r005
DOI:
10.1371/journal.pone.0270545.r006
DOI:
10.1371/journal.pone.0270545.r007
DOI:
10.1371/journal.pone.0270545.r008
DOI:
10.1371/journal.pone.0270545.r009
DOI:
10.1371/journal.pone.0270545.r010
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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