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Forging Pathways to an AIDS-Free Generation
Young People and VMMC 11th November 2014
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Young People and HIV
8% of the world’s adolescents (10-19 yrs.) living with HIV are in Tanzania (UNAIDS 2012)
Approximately 1% of the 15-19 yr. old boys in Tanzania are HIV+ (UNAIDS - GAP)
About 79% of the 15-19 yr. old men in Tanzania never tested for HIV (THMIS 2012)
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VMMC for HIV Prevention
Jhpiego has received USAID funding for VMMC since late 2009.
The program launched in September 2009 with a pilot site in Iringa region and has now scaled up in three regions – Iringa, Njombe and Tabora
Focus on men aged 10–34 years
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Why VMMC for Young People
VMMC is a key priority HIV prevention intervention for adolescents in settings with high HIV prevalence and low circumcision rates (UNICEF, 2013)
Adolescence as a period of transition: most either about to become sexually active or just began
• Age of sexual debut for men in Tanzania is 18.7 yrs. • In Tanzania, 7% and 44% of men reported to have
engaged in sex by age 15 and age 18 respectively (THIMS 2012)
Opportunity for adolescent men to access sexual and reproductive health services
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VMMC service data
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Campaigns mostly reaching adolescents
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HIV Testing
Source: HTC in VMMC study
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Sexual Behavior and HIV Testing
Self reports of sexual intercourse engagement indicate: 0.09% of 10-14 yrs. old 9% of 15-19 yrs. Old
0.4% of circumcised adolescent were HIV+ compared to 1% of all VMMC clients
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Benefits Beyond 60% Decrease in HIV Acquisition
0.45% of 33,017 boys aged 15-19 were diagnosed and treated for STI symptoms (excluding HIV)
Counseling and condom use demonstration likely to improve future use
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Challenges in Age Appropriate Counseling
Currently condom promotion and safer sex counseling is designed for sexually active individuals
Providers offer separate group education, ensuring risk reduction counseling is age appropriate
About 68% of 18-19 yrs. olds reported to be less satisfied with counseling compared to the 52% of 15-17 boys or 42% of the 20+ yrs. men (Source: HTC in VMMC
study)
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Turning the Tide Against AIDS
Requires concentrated focus on young people (UNICEF)
VMMC provides only partial protection Adolescents needs continual access to
other services:-• HIV counseling and testing • Condoms and other prevention technology• HIV education in schools• Treatment and prevention of other STI• Care and treatment services
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Collaboration with a local NGO in Makete to reach adolescents
UNICEF/Jhpiego/SUMASESU (“Support Makete to Self Support”)
Demand creation in advance by SUMASESU (funded by UNICEF) as they have local intelligence and can better engage local leaders and the community to seek VMMC services, focusing on youths
VMMC services offered in the targeted communities using trained VMMC providers supported by Jhpiego
Conducted 3 VMMC outreaches reaching 2,080 clients since Feb 2014. Majority (more than ¾) are adolescents
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Results of the collaboration
Number of outreaches 3
Total VMMCs 2,080
Adolescents 1,587 (76.3%)
HIV testing 2,070 (99.5%)
Positive 35 (1.6%)Total number of facilities involved 20
SUMASESU OUTREACHES
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Asante Sana!