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Service Delivery: Number of MC in OF since Jun ‘10
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Dr. Dirk Taljaard
ActivitiesActivities
Service deliveryTrainingTechnical AssistanceStart-up teamsResearch
Service Delivery:Number of MC in OF since Jun ‘10
Orange Farm (Linked Site)Zola, Soweto (Integrated Site)
New site in Pretoria (Linked Site)
Service Delivery:Sites
We have trained public and private sector
Training 4-5 Doctors/Nurses per week
60 Doctors 120 Nurses in KZN (Not the full course)
Capacitated NGOs or assisted them (PHRU, SFH, MatCH)
Training:
Clinical:Doctors
TheoryPracticals
Nurses – Professional – BlockingSuturing
Nurses – AuxiliarySurgery dutiesFollow-up PHC
Training:Courses
NDOHProvinces:
GautengMpumalangaFree StateNorthern Cape
UNAIDSWHO (MOVE Model)Neighboring countries
SwazilandNamibia
Technical Assistance:
Staff:Dr, Nurse, Aux Nurse, Counsellor, Manager
Assistance:SuppliesProcesses and systemsTraining Mentoring
Time lineAt most 1 month
Start-up Teams:
Survey 2010 in Orange FarmDemand creation studiesOther STI’s
HPVHSV2
MOVE Evaluation
Research:
What have we learnt?What have we learnt?Part 1Part 1
Minimum package of delivery crucialMisunderstanding about MC very challenging
Language issuesMisinformationRisk compensationRisk to women
Excellent opportunity to engage young men about safe sex, HIV in general
VCT / HCT uptake much higher than in general population (VCT 35% HCT 70%)
Individual conversation important to individualise information and discuss 6 week abstinence
What have we learnt?What have we learnt?Part 2Part 2
Information delivery has to be flexible and dynamicTest messaging outcomesObtain feedback from communityReact to research findings
Huge interest from parents about their childrenInformation delivery has to be culturally sensitive
Photos and drawingsWithout political backing and will MC will have
limited impact -> National campaigns
Uncircumcised Partially circumcised Circumcised
Self reported MC statusMen were asked “Are you circumcised?”After the interview a physical examination was done
to which they consented at the beginning of the interview
Physical examination was done by a male nurse45% of men who said they were circumcised had
intact foreskinPossible reasons:
Confusion between MC and InitiationConfusion with words used, vernacularLack of knowledge on what MC is
How does HIV compare in these groups?
HIV (%) and circumcision status
0
5
10
15
20
25
13
‘’Circumcised’’with foreskin
Uncircumcised
PRR=0.93 p=0.73
18.8%20.2%
HIV (%) and circumcision status
14
‘’Circumcised’’with foreskin
Uncircumcised0
5
10
15
20
25
PRR=0.48 p=0.002
18.8% 20.2%
9.5%
‘’Circumcised’’without foreskin
Thus, self reported MC status is a VERY unreliable indicator
Prof Bertran AuvertDr Dino RechProf David LewisProf Adrian PurenScott BillyCynthia NhlapoProf Mohamed HaffejeeGoliath GumedeVeerle Dermaux-MsimangPascale Lissouba
Acknowledgements
Bongiwe Klaas Tsietsi MbusoGaph Phatedi Bongani MazibukuAgenda GumbuDr ShilalukeDr ZuluDr GwalaDr Thabo MashigoDr Sean DoyleDr Josephine DarkoFrans RadebeVenessa Maseko
