More than 100,000 men in the Shinyanga Region of Tanzania are now less likely to contract the HIV virus thanks to the benefits of voluntary medical male circumcision and IntraHealth International’s Tanzania HIV Prevention Project.

IntraHealth has been working with the government of Tanzania to offer male circumcision services in Shinyanga Region since November 2010. The project is funded through PEPFAR by the US Centers for Disease Control and Prevention. As of April 28, 2013, some 110,760 men in the region had opted for the procedure.

Three randomized controlled trials conducted in 2005 and 2006 demonstrated that medical male circumcision may reduce heterosexual transmission of the HIV virus by as much as 60%ⁱ. Other studies since then have suggested the protective factor may be even higher.

Increasing the availability and use of male circumcision services could drastically diminish the spread of HIV in Tanzania. The national HIV prevalence rate in Tanzania stands at 5.1% and the national rate of male circumcision is 72%. Shinyanga Region—where male circumcision is less common (32.1%) and HIV prevalence is high (7.4%)—is one of eight regions or districts that the government of Tanzania prioritized for male circumcision services.

Voluntary medical male circumcision services include: male circumcision counseling; HIV testing and counseling; screening and treatment for sexually transmitted infections; the male circumcision surgical procedure; post-operation follow-up; promotion of safer sex practices; and linkages with other HIV prevention, treatment, care, and support services.

Making high-quality services accessible requires facilities, trained health workers, and equipment and supplies, but also cultural changes in attitudes and beliefs around male circumcision.

IntraHealth is using a variety of approaches to bring male circumcision services to men who could benefit from them. The services are available free of charge at health centers and at mobile clinics, and we are training more health workers in the procedure. We are engaging regional, district, and community leaders, conducting outreach services, and implementing mass social marketing campaigns to spread information about medical circumcision and to build demand for services. And it’s working.

“We are happy that the community has accepted [these male circumcision] services, the demand for services is high, and more people can be reached… Our focus now is to reach rural areas and to focus on adults,” said Shinyanga Region AIDS Control Coordinator, Dr. Amri Salehe Mawazo.

Much of the project’s success is built on collaborations. “We really appreciate the strong collaboration with the regional, district, and village authorities,” said IntraHealth’s Dr. Lucy Mphuru, project director for the Tanzania HIV Prevention Project. “Everyone has been at the forefront to make this program so successful. Kudos to all the Shinyanga leaders at different levels, as well as to the [male circumcision] providers who are working tirelessly to make sure every client in need of [these] services receives services on time despite the critical shortages of health care workers.”

The project will continue its existing work, train additional providers, and focus on bringing male circumcision services to health facilities in hard-to-reach areas. The project’s goal is to reach 135,000 clients by September 2013.

[i] Auvert B et al. 2006. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 Trial. PLoS Medicine. 2005 Nov;2(11):e298. Erratum in: PLoS Med. 2006 May;3(5):e298.

Bailey RC et al. 2007. Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. Lancet. 369(9562):643-56.

Gray RH et al. 2007. Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial. Lancet 369:657-666.