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Review
. 2022 Dec;28(13):S262-S269.
doi: 10.3201/eid2813.212455.

Effects of COVID-19 Pandemic on Voluntary Medical Male Circumcision Services for HIV Prevention, Sub-Saharan Africa, 2020

Megan E Peck, Katherine S Ong, Todd Lucas, Amber Prainito, Anne G Thomas, Alex Brun, Valerian Kiggundu, Aisha Yansaneh, Lesego Busang, Kabelo Kgongwana, David Kelaphile, Khumo Seipone, Mpho H Letebele, Panganai F Makadzange, Amon Marwiro, Mirriam Sesinyi, Tyrone Lapidos, Njabuliso Lukhele, Vusi Maziya, Mandzisi Mkhontfo, Teruwork Gultie, Dejene Mulatu, Mesfin Shimelis, Tiruneh Zegeye, Tesfaye Teka, Marc Bulterys, John N Njenga, Elijah Odoyo-June, Ambrose W Juma, Leonard Soo, Norah Talam, Malerato Brown, Tafadzwa Chakare, Nyane Nonyana, Mpho A Khoabane, Andrew F Auld, Alice Maida, Wezi Msungama, Martin Kapito, Rose Nyirenda, Faustin Matchere, James Odek, Marcos Canda, Inácio Malimane, Jotamo Come, Nuno Gaspar, Antonio Langa, Mekondjo A Aupokolo, Kaauma C Vejorerako, Lawrence Kahindi, Denis Mali, Abeje Zegeye, Derek Mangoya, Brigitte L Zemburuka, Jackson Bamwesigye, Ida Kankindi, Eugenie Kayirangwa, Samuel S Malamba, Thierry Roels, Lenny Kayonde, Eugene Zimulinda, Emah Ndengo, Sabin Nsanzimana, Eric Remera, Gallican N Rwibasira, Beata Sangwayire, Muhammed Semakula, Eugene Rugira, Eugene Rugwizangoga, Emmanuel Tubane, Emmanuel Yoboka, Joseph Lawrence, Dayanund Loykissoonlal, Nandi Maphothi, Victoria Achut, Sudhir Bunga, Monday Moi, Mbaraka Amuri, Kokuhumbya Kazaura, Daimon Simbeye, Neway Fida, Alick A Kayange, Mohamed Seleman, Juliet Akao, Stella T Alamo, Geoffrey Kabuye, Sheila Kyobutungi, Fredrick E Makumbi, Peter Mudiope, Barbara Nantez, Omega Chituwo, Lingenda Godfrey, Brian Muyunda, Royd Kamboyi, Joseph Masiye, Eda Lifuka, John Mandisarisa, Mutsa Mhangara, Sinokuthemba Xaba, Carlos Toledo
Review

Effects of COVID-19 Pandemic on Voluntary Medical Male Circumcision Services for HIV Prevention, Sub-Saharan Africa, 2020

Megan E Peck et al. Emerg Infect Dis. 2022 Dec.

Abstract

Beginning in March 2020, to reduce COVID-19 transmission, the US President's Emergency Plan for AIDS Relief supporting voluntary medical male circumcision (VMMC) services was delayed in 15 sub-Saharan African countries. We reviewed performance indicators to compare the number of VMMCs performed in 2020 with those performed in previous years. In all countries, the annual number of VMMCs performed decreased 32.5% (from 3,898,960 in 2019 to 2,631,951 in 2020). That reduction is largely attributed to national and local COVID-19 mitigation measures instituted by ministries of health. Overall, 66.7% of the VMMC global annual target was met in 2020, compared with 102.0% in 2019. Countries were not uniformly affected; South Africa achieved only 30.7% of its annual target in 2020, but Rwanda achieved 123.0%. Continued disruption to the VMMC program may lead to reduced circumcision coverage and potentially increased HIV-susceptible populations. Strategies for modifying VMMC services provide lessons for adapting healthcare systems during a global pandemic.

Keywords: 2019 novel coronavirus disease; COVID-19; HIV prevention; HIV/AIDS; SARS-CoV-2; coronavirus disease; impacts of COVID-19; respiratory infections; severe acute respiratory syndrome coronavirus 2; sub-Saharan Africa; viruses; voluntary medical male circumcision; zoonoses.

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Figures

Figure 1
Figure 1
US President’s Emergency Plan for AIDS Relief–supported VMMCs performed in 15 countries in sub-Saharan Africa, by quarter and fiscal year (October 1–September 20), 2016–2020. VMMC, voluntary medical male circumcision.
Figure 2
Figure 2
Mean number of male clients circumcised per US President’s Emergency Plan for AIDS Relief (PEPFAR)–supported nonmilitary VMMC site and mean number of PEPFAR VMMC sites, 14 countries in eastern and southern Africa prioritized for VMMC, by quarter, PEPFAR fiscal year 2020. Scales for the y-axes differ substantially to underscore patterns but do not permit direct comparisons. Q, quarter; VMMC, voluntary medical male circumcision.
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