Are Adolescent Male Circumcision Programs Making the Cut?

By Sandy Garçon, External Relations and Communications Manager, PSI

Voluntary medical male circumcision (VMMC) may be one of the first occasions when adolescent boys and young men in many African countries interact with their health system.

After the WHO and UNAIDS joint recommendation in 2007 to integrate VMMC as part of a comprehensive HIV prevention strategy, various countries in eastern and southern Africa have taken steps to implement VMMC scale-up activities. Since the inception of these programs, many boys between the ages of 10 and 18 have undergone the procedure.

Despite the tremendous popularity of VMMC programs among these boys and their parents, questions remain about whether they are being adequately served with age-appropriate counseling, since services were not originally designed with this younger age group in mind. Are boys getting appropriate and understandable messages about the procedure, how to care for their wounds and how VMMC fits into a larger picture of HIV prevention?

To address this critical evidence gap, PSI in collaboration with the USAID-funded Health Communication Capacity Collaborative (HC3) conducted a multi-country study in South Africa, Tanzania and Zimbabwe to understand boys’ experience when it comes to VMMC services.

The findings, detailed in the latest supplement of the Journal of Clinical Infectious Diseases, outline both gaps and best practices in addressing the needs of adolescent clients, including providing a satisfactory client experience that may also foster continued safe sex practices and interaction with the health system as they enter adulthood.

The studies reported in the supplement provide a qualitative and quantitative examination of VMMC services for adolescents from multiple levels, including:

  • Understanding client-level facilitators and barriers to seeking VMMC, including parents’ and peer perspectives;
  • Evaluation of perceived quality of VMMC counseling and services by beneficiaries;
  • Assessment of delivery of the minimum package of services, which includes HIV testing, safer sex education, STI screening and management and condom promotion and distribution;
  • Assessment of the provider’s perspective of working with adolescents;
  • Analysis of post-counseling changes in knowledge and behavioral outcomes.

We look forward to bringing these findings to life in all our VMMC programs and addressing shortcoming in our design. PSI is committed to more than just providing these services; we want to create positive experiences of health care that lead to a lifetime of healthy behaviors.

Please find below select studies from the supplement:

Age Differences in Perceptions of and Motivations for Voluntary Medical Male Circumcision Among Adolescents in South Africa, Tanzania, and Zimbabwe

Females’ Peer Influence and Support for Adolescent Males Receiving Voluntary Medical Male Circumcision Services

Parental Communication, Engagement, and Support During the Adolescent Voluntary Medical Male Circumcision Experience

Providers’ Perceptions and Training Needs for Counseling Adolescents Undergoing Voluntary Medical Male Circumcision

Adolescent Wound-Care Self-Efficacy and Practices After Voluntary Medical Male Circumcision—A Multicountry Assessment

For the full supplement on adolescent voluntary medical male circumcision, click here.

Banner Photo: © Population Services International / Photographer: Eric Gauss