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Note to Self on World AIDS Day: Preventive Care Takes Work


Getting men and boys to line up for circumcision is no easy feat. But in Tanzania, mobile phone reminders help.


This morning I went to the dentist for a checkup and cleaning. Last week I received two confirmation emails for this appointment. Yesterday I received an additional reminder email. And today, after the appointment, I received an email regarding my next bi-annual appointment. 

I can’t help but appreciate that I have a dentist who believes in preventive procedures. Despite the fact that routine cleanings could take away income he might get from filling cavities down the line, my dentist has chosen to invest in technology to help me make it to my appointments and receive preventive services. That is something to be truly grateful for.

IntraHealth International’s Tanzania HIV Prevention Project (THPP) works closely with the Tanzanian Ministry of Health and Social Welfare to provide a comprehensive package of male circumcision services, a preventive procedure identified by PEPFAR as a key priority for reducing HIV transmission. Male circumcision reduces transmission of HIV to men by 60%. 

Now men in Tanzania are clamoring to get circumcised. 

Now men in Tanzania are clamoring to get circumcised. And over 165,000 have gone through the procedure since THPP began offering services in November 2010. 

I suspect there are also many men in Tanzania who are interested in circumcision but who forget their appointments or need help remembering to coordinate transportation, childcare, job coverage, and so on. It takes a lot of support to pursue medical prevention. Research shows that most people do not consider themselves to be at risk for disease, and that once they learn they are eligible for services, they need reminders.

Fortunately, that’s where IntraHealth and the Tanzania Youth Alliance come in. The Tanzania Youth Alliance is a local nongovernmental organization that empowers youth to create and engage in a life free from poverty and disease. It uses information and communications technology as a tool to build capacity in life and entrepreneurial skills, behavioral change, and disease prevention in Tanzania. 

Through THPP, IntraHealth and the Tanzania Youth Alliance launched an intensive social mobilization initiative that uses mobile telephone SMS (or text messaging) to increase demand and awareness of voluntary medical male circumcision services. The Tanzania Youth Alliance enlists their network of 6,000 popular opinion leaders—a collection of magnetic personalities who have all been nominated as role models by their peers—in drumming up demand.

There are few formal requirements for the position and the opinion leaders do not receive male circumcision education or training. Instead, their role is to reach out to their communities and engage their peer groups in signing up for SMS services. They explain that clients will receive preferential appointments and text message reminders for circumcision appointments, follow-up information, wound care, and sexual health information after their surgeries. 

Thanks to this partnership, men and boys in Tanzania are benefitting from the same kind of reminders and support structures for preventive medical care that my dentist provides here in the US. The services empower them on their path to lives that are free from HIV.