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

Abstract

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.