March 2023

Stepping Up for Male Circumcision to Reduce HIV Risk

“I first heard about [circumcision] from my boda-boda* peer, who had undergone the procedure and encouraged us to undertake it, too,” says Charles Okumu, a 25-year-old from Homabay, Kenya.

“Today I have taken a bold step to being a man: I have taken the cut,” Charles continues. “I am preparing to get married, and I want my woman to see me as a real man. We have been told circumcision helps reduce the chances of HIV infection and transmission and that’s why I came here today.

“I am happy I got the service here for free. I am a bit anxious about the wound pain, but the process went very well and I am grateful to the team.”

Victor Ober, after undergoing VMMC as the Ober Level 4 hospital. Photo: EGPAF 2023

Voluntary Medical Male Circumcision (VMMC) has been recommended by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) as part of a broader package of interventions designed to reduce HIV incidence among men in a generalized epidemic. It reduces female-to-male transmission of HIV by about 60%. VMMC is considered safe and cost-effective and creates an opportunity to increase HIV status awareness and access to integrated health services for both men and boys.

The HIV prevalence in Nyanza region has been traditionally high with Homabay County currently standing at 19.6%.2

VMMC is also proposed as beneficial to female sexual partners, with research showing a correlation between male circumcision and reduced risk of cervical cancer, cervical dysplasia, herpes, chlamydia, and syphilis.

Traditionally, the western Kenya region, predominantly occupied by the Luo ethnic community, is non-circumcising. In Homabay County, along the shore of Lake Victoria, the uptake of VMMC as an HIV prevention intervention had been particularly low.

VMMC Surgeon Dr. Lavenda Otieno and her assistant preparing a patient for the procedure at the Ober Level 4 hospital. Photo: EGPAF 2023

“I think times are changing and men in the region are taking up VMMC more,” says Dr. Lavenda Otieno, a VMMC surgeon. “This can be attributed to the efforts around sensitizing communities on its benefit and using lessons learned to inform approaches and strategies for community engagement and mobilization.

“We use a comprehensive model that is client-centered, where VMMC is integrated with health talks, HIV counseling and testing, and community outreaches to create awareness and increase the demand.”

“We have seen a lot of improvement in the uptake of VMMC and other integrated HIV services,” says Jacob Yahuma, VMMC senior technical advisor for the Vukisha 95 project, which is administered through LVCT Health, the Kenya Ministry of Health, and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). “We strive to offer high-quality services, through an integrated approach that includes, pain management, HIV counseling and testing, and follow-up.

“The partnership with Vukisha 95 project has helped us create demand for VMMC services, through training of health care workers to help them offer the services and demand creation through outreaches and working with community health volunteers to reach out to the communities,” says Dancan Aloo, the Ministry of Health VMMC focal person for Homabay County.

*Boda-boda refers to the motorcycle taxi drivers who provide vital transportation services.

Part of the LVCT Vukisha 95 project team. Photo: EGPAF 2023

Vukisha 95, is a five-year program funded by the U.S. Centers for Disease Control and Prevention (CDC) to support the sustainable implementation of comprehensive high-quality HIV prevention, care, and treatment interventions in Homa Bay and Kisii Counties. The program is among projects implemented collaboratively with the Ministry of Health and the LVCT Health, and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) consortium as the prime- and sub-recipient, respectively. The goal of the project is to achieve HIV epidemic control by going beyond the 95-95-953 targets in the programs target counties. The project is implemented in Homabay and Kisii Counties.

Created by:

Charity Mureithi

Country:

Kenya

Topics:

Male Involvement