Background : Every year in SA, thousands of young males participate in Customary Male - PowerPoint Presentation

1. Background : Every year in SA, thousands of young males participate in Customary Male Initiation (CMI); a significant part of the rite of passage from boy to manhood. Male Circumcision (MC) is part of the CMI activities of AmaXhosa males in the Eastern Cape (EC) Province.We assessed the effect of an integrated model of CMI support in five districts supported by RTC and PSI in EC in delivering high quality, safe MC services to 15-34 years old males also known as “age pivot”. Description: The integrated model of CMI support involved several components; community entry through stakeholder engagement; community advocacy campaigns on quality, safe MC, pre-screening of prospective initiates for chronic illnesses; MC procedure performed as per NDoH guidelines, Follow-up, and adverse events management. As per routine programmatic performance requirements, data of VMMC and HTS cascades from Financial Year (FY) 2016 to FY 2018-before implementation of integrated model of CMI support and FY 2019- after implementation of this model were collected using standardized NDoH tools and disaggregated into age groups. The data were captured and stored in a cloud data storage system called Data for Accountability Transparency Impact Monitoring (DATIM) and later analyzed using descriptive data analysis.An Integrated Approach To Customary Male Initiation Practices Improves Access to Male Circumcision Services In the Eastern Cape, South AfricaNelson Igaba1, Skye Grove1, Khumbulani Moyo1, Masingita Lambane2, Motshana Phohole1, Sizwe Hlongwane1, Stephen Khama2, Yayandry Govender2, Collen Bonnecwe31. Right to Care (RTC), Centurion, South Africa (SA), 2. Population Service International (PSI), Johannesburg, SA, 3. National Department of Health (NDoH), Pretoria, SAPRESENTED AT THE 23RD INTERNATIONAL AIDS CONFERENCE (AIDS 2020) | 6-10 JULY 2020Conclusions : This study found a large increase in circumcisions among males 15-34 years, also known as age pivot. The integrated model of CMI support presents an opportunity to reach sexually active males in this pivot age group for male circumcisions and allows for an immediate impact in reduction of HIV incidence in EC province.Acknowledgements: This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through Centers for Disease Control and Prevention (CDC) under the terms of Cooperate Agreement grant No. NU2GGH002137-03-00References:WHO/JHPIEGO Manual for Male Circumcision Under Local Anaesthesia and HIV Prevention Services for Adolescent Boys And Men, 2018.South Africa National Guidelines for Medical Male Circumcision, 2016Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren 4. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005.The integrated model of CMI support presents an opportunity to reach sexually active males in the pivot age group of 15-34 years for male circumcisions Fig. 1. Total number of male circumcisions performed between the two periodsFig. 2. Percentage of MCs performed among 15-34 years age groups between the two periodsLesson Learnt: In the period of this study, a cumulative number of 137,759 MCs were performed in the five EC districts with 95,828 (70%) MCs performed after implementation of the integrated model of CMI support (FY2019). Among 117,928 males aged 15-34 years circumcised in this period, only 30,403 (26%) were circumcised before implementation of this model (FY2016-FY2018) compared to 87,525 (74%) circumcised after implementation of this model (Chi2=11.706; Pvalue=0.003). We found a 188% increase in the total number of MCs performed among males aged of 15-34 years after implementation of this model. The increase in the population of 15-34 years male in these 5 EC districts was statistically insignificant over the period of this study (Chi = 0.1762, Pvalue=0.675)No. of MCsPercentage of MCs among 15-34 years malePercentage of MCs among 15-34 years maleDr Nelson Igaba: nelson.Igaba@righttocare.org / +27 74 048 5933