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Increasing voluntary medical male circumcision uptake among adult men in Tanzania

OBJECTIVE: We evaluated a demand-creation intervention to increase voluntary medical male circumcision (VMMC) uptake among men aged 20–34 years in Tanzania, to maximise short-term impact on HIV incidence. METHODS: A cluster randomized controlled trial stratified by region was conducted in 20 outreac...

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Autores principales: Wambura, Mwita, Mahler, Hally, Grund, Jonathan M., Larke, Natasha, Mshana, Gerry, Kuringe, Evodius, Plotkin, Marya, Lija, Gissenge, Makokha, Maende, Terris-Prestholt, Fern, Hayes, Richard J., Changalucha, John, Weiss, Helen A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378002/
https://www.ncbi.nlm.nih.gov/pubmed/28350578
http://dx.doi.org/10.1097/QAD.0000000000001440
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author Wambura, Mwita
Mahler, Hally
Grund, Jonathan M.
Larke, Natasha
Mshana, Gerry
Kuringe, Evodius
Plotkin, Marya
Lija, Gissenge
Makokha, Maende
Terris-Prestholt, Fern
Hayes, Richard J.
Changalucha, John
Weiss, Helen A.
author_facet Wambura, Mwita
Mahler, Hally
Grund, Jonathan M.
Larke, Natasha
Mshana, Gerry
Kuringe, Evodius
Plotkin, Marya
Lija, Gissenge
Makokha, Maende
Terris-Prestholt, Fern
Hayes, Richard J.
Changalucha, John
Weiss, Helen A.
author_sort Wambura, Mwita
collection PubMed
description OBJECTIVE: We evaluated a demand-creation intervention to increase voluntary medical male circumcision (VMMC) uptake among men aged 20–34 years in Tanzania, to maximise short-term impact on HIV incidence. METHODS: A cluster randomized controlled trial stratified by region was conducted in 20 outreach sites in Njombe and Tabora regions. The sites were randomized 1 : 1 to receive either a demand-creation intervention package in addition to standard VMMC outreach, or standard VMMC outreach alone. The intervention package included enhanced public address messages, peer promotion by recently circumcised men, facility setup to increase privacy, and engagement of female partners in demand creation. The primary outcome was the proportion of VMMC clients aged 20–34 years. FINDINGS: Overall, 6251 and 3968 VMMC clients were enrolled in intervention and control clusters, respectively. The proportion of clients aged 20–34 years was slightly greater in the intervention than control arm [17.7 vs. 13.0%; prevalence ratio = 1.36; 95% confidence intervals (CI):0.9–2.0]. In Njombe region, the proportion of clients aged 20–34 years was similar between arms but a significant two-fold difference was seen in Tabora region (P value for effect modification = 0.006). The mean number of men aged 20–34 years (mean difference per cluster = 97; 95% CI:40–154), and of all ages (mean difference per cluster = 227, 95% CI:33–420) were greater in the intervention than control arm. CONCLUSION: The intervention was associated with a significant increase in the proportion of clients aged 20–34 years in Tabora but not in Njombe. The intervention may be sensitive to regional factors in VMMC programme scale-up, including saturation.
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spelling pubmed-53780022017-04-07 Increasing voluntary medical male circumcision uptake among adult men in Tanzania Wambura, Mwita Mahler, Hally Grund, Jonathan M. Larke, Natasha Mshana, Gerry Kuringe, Evodius Plotkin, Marya Lija, Gissenge Makokha, Maende Terris-Prestholt, Fern Hayes, Richard J. Changalucha, John Weiss, Helen A. AIDS Epidemiology and Social OBJECTIVE: We evaluated a demand-creation intervention to increase voluntary medical male circumcision (VMMC) uptake among men aged 20–34 years in Tanzania, to maximise short-term impact on HIV incidence. METHODS: A cluster randomized controlled trial stratified by region was conducted in 20 outreach sites in Njombe and Tabora regions. The sites were randomized 1 : 1 to receive either a demand-creation intervention package in addition to standard VMMC outreach, or standard VMMC outreach alone. The intervention package included enhanced public address messages, peer promotion by recently circumcised men, facility setup to increase privacy, and engagement of female partners in demand creation. The primary outcome was the proportion of VMMC clients aged 20–34 years. FINDINGS: Overall, 6251 and 3968 VMMC clients were enrolled in intervention and control clusters, respectively. The proportion of clients aged 20–34 years was slightly greater in the intervention than control arm [17.7 vs. 13.0%; prevalence ratio = 1.36; 95% confidence intervals (CI):0.9–2.0]. In Njombe region, the proportion of clients aged 20–34 years was similar between arms but a significant two-fold difference was seen in Tabora region (P value for effect modification = 0.006). The mean number of men aged 20–34 years (mean difference per cluster = 97; 95% CI:40–154), and of all ages (mean difference per cluster = 227, 95% CI:33–420) were greater in the intervention than control arm. CONCLUSION: The intervention was associated with a significant increase in the proportion of clients aged 20–34 years in Tabora but not in Njombe. The intervention may be sensitive to regional factors in VMMC programme scale-up, including saturation. Lippincott Williams & Wilkins 2017-04-24 2017-04-03 /pmc/articles/PMC5378002/ /pubmed/28350578 http://dx.doi.org/10.1097/QAD.0000000000001440 Text en Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Epidemiology and Social
Wambura, Mwita
Mahler, Hally
Grund, Jonathan M.
Larke, Natasha
Mshana, Gerry
Kuringe, Evodius
Plotkin, Marya
Lija, Gissenge
Makokha, Maende
Terris-Prestholt, Fern
Hayes, Richard J.
Changalucha, John
Weiss, Helen A.
Increasing voluntary medical male circumcision uptake among adult men in Tanzania
title Increasing voluntary medical male circumcision uptake among adult men in Tanzania
title_full Increasing voluntary medical male circumcision uptake among adult men in Tanzania
title_fullStr Increasing voluntary medical male circumcision uptake among adult men in Tanzania
title_full_unstemmed Increasing voluntary medical male circumcision uptake among adult men in Tanzania
title_short Increasing voluntary medical male circumcision uptake among adult men in Tanzania
title_sort increasing voluntary medical male circumcision uptake among adult men in tanzania
topic Epidemiology and Social
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378002/
https://www.ncbi.nlm.nih.gov/pubmed/28350578
http://dx.doi.org/10.1097/QAD.0000000000001440
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