Thousands of Zambian Men Reduce their Risk of HIV Infection by 60 Percent

{Photo credit: Todd Shapera}Photo credit: Todd Shapera

Word is spreading in Zambia: one simple procedure can reduce a man’s risk of HIV infection by a shocking 60 percent.

Young men have heard this news at school and older men at their workplaces. The nurses are talking about it during clinic appointments and community leaders at village gatherings.  One man says he had the procedure done and is now encouraging his friends to try it. 

This isn’t the old standbys of abstinence, condom use, and fidelity. This procedure has been around since ancient times and has been known to reduce HIV transmission risks for nearly a decade. Now, over 30 years after the world’s first HIV diagnosis, Zambians finally have access to this effective risk reduction strategy: male circumcision.

Although the World Health Organization supports circumcision for HIV prevention and multiple studies have confirmed its risk-reducing effect, convincing men to voluntarily undergo this surgery has been, understandably, challenging. Fortunately, the PEPFAR-funded, USAID project, Zambia Prevention Care and Treatment Partnership (ZPCT II), has been working for over three years to improve the uptake of male circumcision in Zambia. The project’s implementer, FHI360, with support from Management Sciences for Health (MSH), and other subcontractors, are working with the Government of Zambia to implement a broad range of interventions to promote, deliver, and sustain the benefits of male circumcision in Zambia. MSH’s role in the project involves supporting commodity management and facilitating access to instruments and supplies necessary for male circumcision.

[Number of men circumcised in Zambia, 2010 to 2012.]Number of men circumcised in Zambia, 2010 to 2012.In just three years, ZPCT II has seen the demand for male circumcision skyrocket throughout 45 districts in the six project-supported provinces. The number of men circumcised in ZPCT II-supported regions in 2012 was 16 times higher than the number of men circumcised in 2010. Equally impressive is the fact that ZPCT II’s trained health workers have already circumcised 16,851 men in the first two quarters of 2013, putting the project on track to surpass its annual targets once more.

When asked to discuss the source of this success, ZPCT II’s Senior Advisor for Pharmaceutical and Laboratory Services Management Gail Bryan-Mofya eagerly described the project’s outreach and clinical strategies.

“We reach men at health facilities and through mobile outreach clinics in all of the ZPCT II-supported districts. Boys and men learn the benefits of circumcision but also have a chance to ask questions about the procedure and their recovery. ZPCT II then tests them for HIV and provides circumcision services to those who test negative and counseling and support to those who test positive,” said Mrs. Bryan-Mofya.

In recent months, ZPCT II has also told chiefs and village leaders about the benefits of circumcision. Many of these leaders are now encouraging men in their communities to consider circumcision as a way to protect themselves and their partners from HIV.

“Community leaders are very influential: so if they tell their people that something is good and they should get it then they often do—just like that! Those who have been circumcised also share their stories and this helps encourage others and ease their concerns,” said Mrs. Bryan-Mofya.

ZPCT II provides direct support for male circumcision at 55 health facilities. The project’s outreach activities and mobile clinics have also allowed them to expand circumcision services to the majority of the project-supported areas in Zambia.