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.