||Voluntary Male Circumcision: Assessing Impacts, Barriers and Facilitators
Oral Poster Discussion Session : Track C
||21.07.2014, 13:00 - 14:00
Getrude Ncube, Zimbabwe
|Are “cold-spots” of male circumcision driving the spatial distribution of HIV infection in Tanzania?|
D. Cuadros1,2, A. Branscum3, S. Awad1, L. Abu-Raddad1,2
1Weill Cornell Medical College in Qatar, Infectious Disease Epidemiology Group, Doha, Qatar, 2Weill Cornell Medical College, Department of Healthcare Policy and Research, New York, United States, 3Oregon State University, College of Public Health and Human Sciences, Corvallis, United States
|Piloting early infant male circumcision using two devices in Zimbabwe: a randomized trial|
W. Mavhu1,2, G. Ncube3, K. Hatzold4, H. Weiss5, O. Mugurungi3, J. Mufuka1, C. Samkange6, J. Sherman7, N. Madidi4, F. Cowan1,2, I. Ticklay6, G. Gwinji3
1Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe, 2University College London, Research Department of Infection & Population Health, London, United Kingdom, 3Ministry of Health & Child Care, Harare, Zimbabwe, 4Population Services International, Harare, Zimbabwe, 5London School of Hygiene & Tropical Medicine, London, United Kingdom, 6University of Zimbabwe, Harare, Zimbabwe, 7Unicef, Harare, Zimbabwe
|Male circumcision and the incidence of syphilis acquisition among male and female partners of HIV-1 serodiscordant heterosexual African couples: a prospective study|
J. Pintye1, J. Baeten1, L. Manhart1, C. Celum1, A. Ronald2,3, N. Mugo1,4, A. Mujugira1, C. Cohen4,5, E. Were6, E. Bukusi4,5, J. Kiarie1,7, R. Heffron1
1University of Washington, Department of Global Health, Seattle, United States, 2University of Manitoba, Winnipeg, Canada, 3Makerere University, Kampala, Uganda, 4Kenya Medical Research Institute, Nairobi, Kenya, 5University of California-San Francisco, San Francisco, United States, 6Moi University, Eldoret, Kenya, 7University of Nairobi, Nairobi, Kenya
|The effect of conditional economic compensation on uptake of voluntary medical male circumcision: a randomized controlled trial of a demand creation intervention for male circumcision in Kenya|
H. Thirumurthy1, E. Evens2, S. Rao3, M. Lanham4, E. Omanga3, K. Agot3
1University of North Carolina at Chapel Hill, Department of Health Policy and Management, Chapel Hill, United States, 2FHI 360, Durham, United States, 3Impact Research and Development Organization, Kisumu, Kenya, 4FHI 360, NC, United States
|Assessing risk compensation post-male circumcision in Zambia's national program|
P.C. Hewett1, P. Todd2, N. Grau2, K. Dzekedzeke3, E. Soler-Hampesjek4, N. Shiliya5, B.S. Mensch6
1Population Council, Lusaka Zambia, Zambia, 2University of Pennsylvania, Philadelphia, United States, 3Dzekedzeke, Inc., Lusaka, Zambia, 4Population Council, Poverty, Gender, and Youth, New York, United States, 5Society for Family Health, Lusaka, Zambia, 6Population Council, New York, United States
|A sport-based intervention to increase uptake of voluntary medical male circumcision among adult male football players: results from a cluster-randomised trial in Bulawayo, Zimbabwe|
Z.A. Kaufman1, J. DeCelles2, K. Bhauti3, H.A. Weiss1, K. Hatzold4, C. Chaibva5, D.A. Ross1
1London School of Hygiene and Tropical Medicine, Epidemiology and Population Health, London, United Kingdom, 2Grassroot Soccer, Curriculum and Innovation, Cape Town, South Africa, 3Grassroot Soccer Zimbabwe, Bulawayo, Zimbabwe, 4Population Services International Zimbabwe, Harare, Zimbabwe, 5National University of Science and Technology, Bulawayo, Zimbabwe
|Piloting early infant male circumcision using two devices in Zimbabwe: a randomized trial - Webster Mavhu|
|Male circumcision and the incidence of syphilis acquisition among male and female partners of HIV-1 serodiscordant heterosexual African couples: a prospective study - Jillian Pintye|
|The effect of conditional economic compensation on uptake of voluntary medical male circumcision: a randomized controlled trial of a demand creation intervention for male circumcision in Kenya - Kawango Agot|
|Assessing risk compensation post-male circumcision in Zambia's national program - Erica Soler-Hampesjek|
|A sport-based intervention to increase uptake of voluntary medical male circumcision among adult male football players: results from a cluster-randomised trial in Bulawayo, Zimbabwe - Jeff De Celles|
Track C report by Ruthanne Marcus
The session covered a range of projects and research related to voluntary medical male circumcision (VMMC):
1) D. Cuadros used national data to conduct
geospatial analyses and successfully correlated where high coverage of VMMC existed, HIV prevalence in Tanzania was reduced. They performed a cluster analysis and found that VMMC inside and outside of the ‘cold spots’ were able to predict HIV incidence, despite controlling for geographical cultural differences. Geospatial studies can help guide HIV prevention efforts.
2) W. Mavhu compared outcomes using a RCT of two devices (AccuCirc and Mogen) used for infant VMMC. External validity was low since only 13% of 1151 parents of potentially eligible infants agreed to any VMMC. For those agreeing, patient satisfaction was high and complications low.
3) J. Pintye examined the impact of VMMC on syphilis incidence on men and their female partners over 2.7 years for those enrolled in the Partners PrEP study (N=4716). VMMC resulted in significant reductions in syphilis for both men and their female partners, especially for HIV+ but not for HIV- men. Having a male partner who was circumcised reduced risk for incident syphilis infection for both HIV+ and HIV- women. Importantly, this study confirms that VMMC extends the benefit beyond HIV prevention to now include syphilis prevention.
4) K. Agot conducted an elegant RCT of 1504 men using various levels of economic compensation on uptake of VMMC in Kenya. Compared to no compensation, increasing levels of food voucher economic compensation (no compensation, US $2.50, US $8.75, US $15.00) resulted in higher levels of VMMC uptake. Despite the statistically significant increases in uptake, uptake was profoundly low (1.6% VMMC in the control group, 1.9%, 6.6%, 9% in each of the arms, respectively), perhaps suggesting that the level of compensation to achieve higher levels should be increased.
5) E. Soler-Hampesjek examined risk compensation among ~2000 young men (15-29 years) in Zambia post-VMMC, using time-dependent rounds (N=4) to control for temporal trends. There did not appear to be any risk compensation when measuring: 1) sex with 2+ partners in the past year; 2) unprotected sex; 3) sex after alcohol use; 4) experience of STI symptoms in the past year; and 5) paying for sex in the past year. Acknowledged limitations were the potential for bias introduced due to inability to control for unmeasured variables.
6) J. DeCelles reported on the "Make the Cut" intervention, introduced to determine if soccer (futbol) professionals could improve VMMC in Zimbabwe. Using a “cluster randomized trial” of 3 arms (an intervention delivered by soccer pros, non-soccer pros, and no intervention) found that VMMC update after 3 months were 9.8-fold higher in the two intervention groups (they combined both intervention groups in analysis due to a small sample size) compared to the control group.