Background
Voluntary medical male
circumcision (VMMC) is a critical HIV prevention tool. Since 2007, sub-Saharan
African countries with the highest prevalence of HIV have been mobilizing
resources to make VMMC available. While implementers initially targeted adult
men, demand has been highest for boys under age 18. It is important to
understand how male adolescents can best be served by quality VMMC services.
Methods and Findings
A systematic literature
review was performed to synthesize the evidence on best practices in adolescent
health service delivery specific to males in sub-Saharan Africa. PubMed,
Scopus, and JSTOR databases were searched for literature published between January
1990 and March 2014. The review revealed a general absence of health services
addressing the specific needs of male adolescents, resulting in knowledge gaps
that could diminish the benefits of VMMC programming for this population.
Articles focused specifically on VMMC contained little information on the
adolescent subgroup. The review revealed barriers to and gaps in sexual and
reproductive health and VMMC service provision to adolescents, including
structural factors, imposed feelings of shame, endorsement of traditional
gender roles, negative interactions with providers, violations of privacy, fear
of pain associated with the VMMC procedure, and a desire for elements of
traditional non-medical circumcision methods to be integrated into medical
procedures. Factors linked to effective adolescent-focused services included
the engagement of parents and the community, an adolescent-friendly service
environment, and VMMC counseling messages sufficiently understood by young
males.
Conclusions
VMMC presents an opportune
time for early involvement of male adolescents in HIV prevention and sexual and
reproductive health programming. However, more research is needed to determine
how to align VMMC services with the unique needs of this population.
Full article at: http://goo.gl/1p24IE
By:
1Johns Hopkins Center for Communication
Programs, Baltimore, Maryland, United States of America
2Population Services International (PSI),
Harare, Zimbabwe
3Johns Hopkins University School of
Medicine, Baltimore, Maryland, United States of America
4United Nations Children's Fund (UNICEF),
New York, New York, United States of America
5Ministry of Health, Dar es Salaam,
Tanzania
6Office of the U.S. Global AIDS
Coordinator, U.S. Department of State, Washington, DC, United States of America
7Ministry of Health and Child Welfare,
Harare, Zimbabwe
8World Health Organization (WHO), Geneva,
Switzerland
9National Department of Health, Pretoria,
South Africa
10United States Agency for International
Development (USAID) Washington/Global Health Bureau/Office of HIV/AIDS,
Washington, DC, United States of America
More at: https://twitter.com/hiv insight
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