Division of Global HIV/AIDS, Kenya

Results and Service Delivery Trends in Kenya’s Voluntary Medical Male

Circumcision Scale up from 2008-2011

Z. Mwandi1, A Ochieng2, J Grund3, S Mwalili1, D Kimanga2,

K Chesang1, N Bock3, N Knight1, “et al”4

1. Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Nairobi, Kenya 2. National AIDS and STI Control Program, Ministry of Health, Kenya 3. Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Atlanta, USA4. CDC Implementing Partners – IRDO, NRHS, FACES,EDARP

Abstract no. MOPDE0104

Presented at AIDS 2012Washington D.C.

July 23, 2012

Results: Age and Cadre of Provider

2008 2009 2010 20110

20000

40000

60000

80000

100000

120000

140000

160000

17,770.026,272.0

14,898.0

25,383.0

64,997.0

111,960.0

5,854.0

15,874.0

22,672.0

<1-14 years 15-24 years

25+ years

Nu

mb

er

of

MC

s d

on

e (

tho

us

an

ds

)

MCs by Age 2008 - 2011

6,323

171,793

129,653

Medical officer

Clinical officer

Nurse

MCs by Cadre of provider

Clinical officers and Nurses performed 56% and 42% of Circumcisions respectively

Results: HTC and Adverse Events in VMMC

2008 2009 2010 201150.0%

55.0%

60.0%

65.0%

70.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

63.3%63.8%

73.1%

85.2%

Prop

ortio

n of

MC

Clie

nts

Rece

ivin

g H

TC

Proportion of VMMC clients counseled and tested for HIV, 2008-2011 (n=241,408)

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

1.41.2

0.4

0.8

2.3

1.5

0.0

1.3

0.9

0.0

0.7 0.7

2008

2009

2010

2011

Cadre of the Provider

Pro

port

ion o

f P

ost-

surg

ery

A

dvers

e

Events

Proportion of Adverse Events by Cadre of provider among VMMC clients follow ups, 2008-2011 (n=102,372)

Time in Years

Coverage against 4 year targets,

2008-2011

2008 2009 2010 2011 -

10,000

20,000

30,000

40,000

50,000

60,000

- - 3,917

13,272

Western

17,189/57,000 (Coverage: 30.2% of 4-year, 50% of Dec. 2011)

2008 2009 2010 2011 -

20,000

40,000

60,000

80,000

100,000

120,000

5,356

30,936

67,421

101,678

Nyanza

205,391/426,500 (Coverage: 48.2% of 4-year, 86% of Dec. 2011)

2008 2009 2010 2011 -

10,000

20,000

30,000

40,000

50,000

60,000

- - 301 2,969

Rift Valley

3,270/188,500

(Coverage: 1.7% of 4-year, 3% of Dec. 2011 )

2008 2009 2010 2011 -

10,000

20,000

30,000

40,000

50,000

60,000

- 301

9,232 16,274

Nairobi

25,807/129,500 (Coverage: 19.9% of 4-year, 37% of Dec. 2011)

This is a result of

1. increases in circumcisions conducted by nurses,

2. increased HIV testing of clients and their partners, and

3. decreases in AEs among VMMC clients.

The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of CDC.

Division of Global HIV/AIDS, Kenya

Acknowledgements

VMMC task force members of Ministry of Health

PEPFAR VMMC TWG

VMMC clients

VMMC Implementing partners

PEPFAR