Effects of COVID-19 Pandemic on Voluntary Medical Male Circumcision Services for HIV Prevention, Sub-Saharan Africa, 2020

Peck, Megan E; Ong, Katherine; Lucas, Todd; Prainito, Amber; Thomas, Anne; Brun, Alex; Kiggundu, Valerian; Yansaneh, Aisha; Busang, Lesego; Kgongwana, Kabelo; Kelaphile, David; Seipone, Khumo; Letebele, Mpho; Makadzange, Panganai; Marwiro, Amon; Sesinyi, Mirriam; Lapidos, Tyrone; Lukhele, Njabuliso; Maziya, Vusi; Mkhontfo, Mandzisi; Gultie, Teruwork; Mulatu, Dejene; Shimelis, Mesfin; Zegeye, Tiruneh; Teka, Tesfaye; Bulterys, Marc; Njenga, John N; Odoyo-June, Elijah; Juma, Ambrose; Soo, Leonard; Talam, Norah; Brown, Malerato Cecilia; Chakare, Tafadzwa; Nonyana, Nyane; Khoabane, Mpho A; Auld, Andrew F; Maida, Alice; Msungama, Wezi; Kapito, Martin; Nyirenda, Rose; Matchere, Faustin; Odek, James; Canda, Marcos; Malimane, Inácio; Come, Jotamo; Gaspar, Nuno; Langa, António; Aupokolo, Mekondjo; Vejorerako, Kaauma C; Kahindi, Lawrence; Mali, Denis; Zegeye, Abeje; Mangoya, Derek; Zemburuka, Brigitte; Bamwesigye, Jackson; Kankindi, Ida; Kayirangwa, Eugenie; Malamba, Samuel; Roels, Thierry H.; Kayonde, Lenny; Zimulinda, Eugene; Ndengo, Emah; Nsanzimana, Sabin; Remera, Eric; Rwibasira, Gallican Nshogoza; Sangwayire, Beata; Semakula, Muhammed; Rugira, Eugene; Rugwizangoga, Eugene; Tubane, Emmanuel; Yoboka, Emmanuel; Lawrence, J. Joseph; Loykissoonlal, Dayanund; Maphothi, Nandi; Achut, Victoria; Bunga, Sudhir; Moi, Monday; Amuri, Mbaraka; Kazaura, Kokuhumbya; Simbeye, Daimon; Fida, Neway; Kayange, Alick A; Seleman, Mohamed; Akao, Juliet; Alamo, Stella; Kabuye, Geoffrey; Kyobutungi, Sheila; Makumbi, Fredrick; Mudiope, Peter; Nantez, Barbara; Chituwo, Omega; Godfrey, Lingenda; Muyunda, Brian; Kamboyi, Royd; Masiye, Joseph; Lifuka, Eda; Maa, John; Mhangara, Mutsa; Xaba, Sinokuthemba; Toledo, Carlos

doi:10.3201/eid2813.212455

Cited by 8 publications

(6 citation statements)

References 20 publications

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“…Generally, the current study attributes the decline in VMMC in Gauteng province to the indirect disruptive effect of COVID-19 that involved mitigation strategies like lockdowns which involved movement restrictions and the reallocation of health resources to the pandemic which adversely impacted a wide range of routine health services including HIV/AIDS and VMMC as reported in earlier studies (9,12,13,16,17). For example, the 33.8% overall decline in VMMC in Gauteng province in 2020, due to the indirect effect of COVID-19 in the present study is consistent with a similar 31.8% decline in another study that involved 13 Eastern and Southern African countries in 2020 compared to the baseline period of 2019 ( 16).…”

Section: Discussionmentioning

confidence: 82%

The impact of the COVID-19 pandemic on Voluntary Medical Male Circumcision in Gauteng Province, South Africa

Fonka

2024

Preprint

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Objective: Voluntary Medical Male Circumcision (VMMC) has a 60% effectiveness and is cost-effective in preventing HIV/AIDS transmission in Sub-Saharan Africa. However, there is a lack of evidence of the COVID-19 pandemic's potential impact on VMMC in Gauteng province, South Africa. This study aimed to assess the impact of the COVID-19 pandemic on VMMC in Gauteng Province. Method: This was a longitudinal study design. VMMC data was obtained from all public and private hospitals in Gauteng province from the District Health Information System and all medical schemes respectively. The datasets were merged with the years 2019 and 2020 as the before and during COVID-19 periods respectively. Percentage change in VMMC was calculated to demonstrate the effect of the pandemic on VMMC. Results: Provincially, VMMC declined in 2020 by an overall of 33.8% for ≥10 years, 32.4% for 10-14 years, and 35.8% for ≥15 years. All five districts in Gauteng province were affected differently. Exceptionally, the Tshwane Metropolitan district recorded an increase of 21.8% in ≥10 years and 36.0% in 10-14 years. While the other four districts saw a percentage decline in the three age groups, the worst performance was experienced in the West Rand district. Conclusion: The COVID-19 pandemic had an adverse indirect impact on VMMC in the Gauteng province of South Africa, except in one district. Considering the biomedical evidence and cost-effectiveness of VMMC in reducing HIV/AIDS transmission, there is an urgency to return VMMC post-COVID-19 to its pre-pandemic levels.

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Section: Discussionmentioning

confidence: 82%

The impact of the COVID-19 pandemic on Voluntary Medical Male Circumcision in Gauteng Province, South Africa

Fonka

2024

Preprint

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“…Estimates presented here end in 2019 due to data availability for this analysis. The COVID-19 pandemic created substantial short-term disruption to VMMC provision in South Africa 42 and temporary suspension of traditional male initiation ceremonies in several provinces 43 . Nationally, the reported number of VMMCs conducted declined from 464,000 in 2019 to 144,000 in 2020 and 388,000 in 2021.…”

Section: Discussionmentioning

confidence: 99%

Substantial but spatially heterogeneous progress in male circumcision for HIV prevention in South Africa

Thomas,

Zuma,

Loykissoonlal

et al. 2024

Commun Med

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Background Voluntary medical male circumcision (VMMC) reduces the risk of male HIV acquisition by 60%. Programmes to provide VMMCs for HIV prevention have been introduced in sub-Saharan African countries with high HIV burden. Traditional circumcision is also a long-standing male coming-of-age ritual, but practices vary considerably across populations. Accurate estimates of circumcision coverage by age, type, and time at subnational levels are required for planning and delivering VMMCs to meet targets and evaluating their impacts on HIV incidence. Methods We developed a Bayesian competing risks time-to-event model to produce region-age-time-type specific probabilities and coverage of male circumcision with probabilistic uncertainty. The model jointly synthesises data from household surveys and health system data on the number of VMMCs conducted. We demonstrated the model using data from five household surveys and VMMC programme data to produce estimates of circumcision coverage for 52 districts in South Africa between 2008 and 2019. Results Nationally, in 2008, 24.1% (95% CI: 23.4–24.8%) of men aged 15–49 were traditionally circumcised and 19.4% (18.9–20.0%) were medically circumcised. Between 2010 and 2019, 4.25 million VMMCs were conducted. Circumcision coverage among men aged 15–49 increased to 64.0% (63.2–64.9%) and medical circumcision coverage to 42% (41.3–43.0%). Circumcision coverage varied widely across districts, ranging from 13.4 to 86.3%. The average age of traditional circumcision ranged between 13 and 19 years, depending on local cultural practices. Conclusion South Africa has made substantial, but heterogeneous, progress towards increasing medical circumcision coverage. Detailed subnational information on coverage and practices can guide programmes to identify unmet need to achieve national and international targets.

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“…The unprecedented nature of the pandemic necessitated innovative strategies to sustain HIV prevention and treatment, particularly for key demographics and voluntary medical male circumcision (VMMC) services in the 15 sub-Saharan African nations prioritized by the US President's Emergency Plan for AIDS Relief ( 35 ). A key response was the expanded and diversified application of telehealth, a transformation catalyzed by the pandemic, which enhanced delivery of healthcare accessibility, flexibility, and efficiency ( 36 ).…”

Section: Leveraging Telehealth For Hiv Prevention Care and Support In...mentioning

confidence: 99%

Unlocking the potential of telehealth in Africa for HIV: opportunities, challenges, and pathways to equitable healthcare delivery

Cuadros,

Huang,

Mathenjwa

et al. 2024

Front. Digit. Health

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Effects of COVID-19 Pandemic on Voluntary Medical Male Circumcision Services for HIV Prevention, Sub-Saharan Africa, 2020

Cited by 8 publications

References 20 publications

The impact of the COVID-19 pandemic on Voluntary Medical Male Circumcision in Gauteng Province, South Africa

The impact of the COVID-19 pandemic on Voluntary Medical Male Circumcision in Gauteng Province, South Africa

Substantial but spatially heterogeneous progress in male circumcision for HIV prevention in South Africa

Unlocking the potential of telehealth in Africa for HIV: opportunities, challenges, and pathways to equitable healthcare delivery

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