Prevalence of Voluntary Medical Male Circumcision for HIV Infection Prevention - Chókwè District, Mozambique, 2014-2019

Abstract

Male circumcision is an important preventive strategy that confers lifelong partial protection (approximately 60% reduced risk) against heterosexually acquired HIV infection among males (1). In Mozambique, the prevalence of male circumcision was 51% when the voluntary medical male circumcision (VMMC) program began in 2009. The Mozambique Ministry of Health set a goal of 80% circumcision prevalence among males aged 10-49 years by 2019 (2). CDC analyzed data from five cross-sectional surveys of the Chókwè Health and Demographic Surveillance System (CHDSS) to evaluate progress toward the goal and guide ongoing needs for VMMC in Mozambique. During 2014-2019, circumcision prevalence among males aged 15-59 years increased 42%, from 50.1% to 73.5% (adjusted prevalence ratio [aPR] = 1.42). By 2019, circumcision prevalence among males aged 15-24 years was 90.2%, exceeding the national goal (2). However, circumcision prevalence among males in older age groups remained below 80%; prevalence was 62.7%, 54.5%, and 55.7% among males aged 25-34, 35-44, and 45-59 years, respectively. A multifaceted strategy addressing concerns about the safety of the procedure, cultural norms, and competing priorities that lead to lack of time could help overcome barriers to circumcision among males aged ≥25 years.

FIGURE

HIV prevalence among males aged 15–59 years, by circumcision status and survey round^, — Chókwè Health Demographic Surveillance System, Chókwè District, Mozambique, 2014–2019 Abbreviations: aPR = age-adjusted prevalence ratio; CI = confidence interval; R = round. * R1: April 2014–April 2015; R2: May 2015–January 2016; R3: March–December 2016; R4: March–November 2017; R5: April 2018–March 2019. † aPRs (95% CIs) were calculated by survey round: R1 = 0.67 (0.51–0.89); R2 = 0.55 (0.40–0.76); R3 = 0.62 (0.46–0.83); R4 = 0.65 (0.49–0.88); and R5 = 0.81 (0.60–1.11).