Western Cape (South Africa) to Adopt PrePex into its Healthcare Programs
In the Western Cape Province of South Africa, the Department of Health has restructured and reinvigorated its VMMC program by focusing it around the use of PrePex in its DOH facilities.
PrePex will be used as the primary tool to reach Male Circumcision targets which, until now, have not been met. According to the HAST (HIV/AIDS/STIs/TB) directorate, PrePex offers a comprehensive solution to the difficulties faced in the Western Cape in providing expansive circumcision services to the communities. These challenges are primarily due to a lack of human and general resources — in addition to the withdrawal of some PEPFAR partners from certain districts, earlier than expected. With the help of PEPFAR partners and the National Department of Health, the Western Cape Department of Health has moved swiftly with a coordinated training schedule and procurement strategy, in addition to various marketing initiatives, aimed at reaching incremental growth and expansion in its VMMC program (which is to be led by use of PrePex).
PrePex Availability in South Africa to Increase Demand for VMMC
To address community needs and improve uptake of VMMC services, it is important to properly identify the actual barriers within the local community. A telephonic survey was conducted by CareWorks among South African men who had declined VMMC services to determine the reason for their refusal - and to assess whether the introduction of a non-surgical VMMC method (using PrePex™) could potentially overcome these barriers.
Eligible participants were men aged 15-49 years, with a valid contact number, who had declined VMMC offered by CareWorks mobilisers in the Limpopo, North West, Gauteng, or Mpumalanga provinces from the period January 1 through May 31, 2015. To participate in the survey, these men were required to be conversant in English, Zulu, Xhosa, or Sotho.
In total, 108 men aged 15 to 47 years (mean age 22 years) were included in the analysis. Surveys were conducted from September through October, 2015.
The results were stunning ……..
One-hundred decliners (93%) reported barriers related to time off and/or surgery-related fears — attributes that may be considered as not being associated with PrePex VMMC. However, 95% of these respondents had never heard of the PrePex device. After informing them of the benefits of PrePex, the majority of participants (97%) responded that if this were available to them, they would access VMMC. In fact, 88% wanted to schedule PrePex VMMC during the survey.
Results of this study demonstrated that the characteristics of PrePex appeal to men who refuse surgical VMMC — however, only 5% of the men surveyed, who previously had declined VMMC, knew of PrePex.
According to the study: "PrePex characteristics should be used as part of demand-generating strategies, while education should be provided to eligible men to inform them of the benefits, advantages and availability of PrePex — and to assuage their concerns of VMMC in general, and teach them about new options available to them. There is clearly an imminent need to increase the availability of PrePex in South Africa, since it has the potential to significantly increase the uptake of VMMC. "
Providers in South Africa find Using PrePex to be Easy, Faster, and Bloodless
A cross-sectional, open-ended questionnaire was presented to healthcare workers from nine MMC programs in South Africa, providing either PrePex and surgical circumcision (mixed sites) or surgical circumcision only (surgery-only sites). A total of 77 healthcare workers (37 at mixed sites and 40 at surgery-only sites) with median ages of 29 years (range 27-37) and 34 years (range 29-42), respectively, were recruited into the study.
The benefits of PrePex perceived by the healthcare workers were: device simplicity, convenience, bloodless, and ease-of-use. Healthcare Providers perceived the PrePex device to be simple and adaptable for existing medical male circumcision programs. Click here to read the full article.
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The PrePex Team