Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115137

Emmanuel O. Otolorin, MD, JHPIEGO Corporation, 1615 Thames St, Baltimore, MD 21231, 410-537-1800, eotolorin@jhpiego.net, Richard S. Hughes, MA, Zambia Country Office, JHPIEGO Corporation, 8 Ngumbo Road, Long Acres, PO Box 36873, Lusaka, Zambia, and Joseph Nikisi, MD, School of Health Systems and Public Health, University of Pretoria, PO Box 667, Pretoria, South Africa.

Issues: Over 40 observational studies worldwide have shown that the lack of male circumcision (MC) is associated with a high prevalence of HIV infection. While 3 randomized controlled trials are ongoing, recognition of MC as a potential public health intervention is growing. In Zambia, numerous constraints continue to limit access to MC services. This report describes the strengthening of 3 MC sites to meet client demands in Zambia.

Description: Three clinics were selected for strengthening based on existing demand for MC and the interest of health care providers. The sites were reorganized and equipped to provide MC and male reproductive health services (e.g., counseling on FP, HIV, STIs, etc.), staff were standardized in the provision of quality MC services under local anesthesia, and the provision of MC services was supported.

Lessons Learned: The removal of barriers to MC led to a 3 to 4-fold increase in services. 55% of clients were children under 15 years. Over 90% were Christians and had come to the service site through self or parental referral. 83.9% sought services for social or religious reasons while phimosis, paraphimosis and erectile pain were indications for 11.4%, 1.9% and 2.8% of clients respectively. Three tribes constituted two-thirds of the clientele: Bemba (25.1%), Nyanja (21.5%) and Luvale (21.5%).

Recommendations: There is an unmet need for MC in Zambia. Many Zambians prefer to utilize clinical MC services, provided the services are pain-free, safe and affordable. However, barriers to access must be addressed before MC services will be readily available.

Learning Objectives: Participants attending this session will be able to

• Describe the relationship between male circumcision (MC) and HIV infection
• Describe the status of MC in Zambia
• Identify constraints to MC services in Zambia
• Describe the MC standardization process in Zambia
• Identify key factors for a successful scale-up of MC and male RH services in Zambia

Keywords: Male Reproductive Health, HIV/AIDS

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation