By the end of 2014, nearly 85,000 men received VMMC as part of comprehensive HIV prevention services, with 56% of this number also tested for HIV.23 However, a review conducted in 2013 found that a high percentage were lost to follow-up.
This is because: In 2010, UNAIDS emphasised the need to reach older men in order to achieve the 80% coverage target and to maximise the population-wide prevention benefits of VMMC.12 The circumcision of newborn babies has also been put forward as a longer-term strategy to combat the HIV epidemic.13 Since 2009, over 10 million men have received VMMC services in the priority sub-Saharan African countries.14 In 2014, there was a rapid scale up of VMMC services with 3 million circumcisions performed that year alone.15 Despite this progress, it is unlikely that the ambitious target of 20.8 million circumcisions by 2016 will be reached.
Progress also varies significantly across priority countries.
For example, Ethiopia and Kenya have exceeded their 80% VMMC coverage targets and in July 2015, Tanzania was in reach of this target.
By comparison, Lesotho, Malawi, Namibia, Rwanda and Zimbabwe still have very low coverage – ranging from 6% to 26%.16 The Central African Republic and South Sudan have also been identified as high priority countries in need of VMMC programmes.17 The new UNAIDS Fast-Track strategy demands that an additional 27 million men are circumcised by 2020 on 2014 levels18 A few of the most high profile VMMC programmes are detailed below. It aimed to conduct 860,000 circumcisions by July 2013 (80% coverage).
Between 20, the number of annual operations conducted increased dramatically from 8,000 to 190,000.19 The country fell just short of its target, reaching 800,000 men (71%) but achieved its coverage goal in the Nyanza region where most of the implementation took place.20 The next phase of Kenya’s VMMC strategy aims to see 95% of men aged 15 to 49 years circumcised by 2019.
Other key areas of focus include offering age-appropriate services for young infants aged 0 to 60 days and adolescents (10 to 14 years).
The country also aims to encourage safer surgical practices among traditionally circumcising communities.21 In 2009, the Lesotho Demographic and Health Survey found that only 37% of men, compared to 66% of women, had ever been tested for HIV.
With one of the world's biggest generalised HIV epidemics, VMMC was viewed primarily as another means of increasing HIV testing uptake among men.22 Launched in March 2012, Lesotho’s VMMC programme now performs circumcisions in 18 hospitals and private clinics as well as outreach sites at over 100 health centres.
In the mid-2000s, male circumcision was found to reduce the female-to-male sexual transmission of HIV by 60%.1 Since 2007, the World Health Organization (WHO) and UNAIDS have recommended voluntary medical male circumcision (VMMC) as a key component of HIV prevention in countries with a high HIV prevalence and low levels of male circumcision.