Forging Pathways to an AIDS-Free Generation

Young People and VMMC 11th November 2014

Young People and HIV

8% of the world’s adolescents (10-19 yrs.) living with HIV are in Tanzania (UNAIDS 2012)

Approximately 1% of the 15-19 yr. old boys in Tanzania are HIV+ (UNAIDS - GAP)

About 79% of the 15-19 yr. old men in Tanzania never tested for HIV (THMIS 2012)

VMMC for HIV Prevention

Jhpiego has received USAID funding for VMMC since late 2009.

The program launched in September 2009 with a pilot site in Iringa region and has now scaled up in three regions – Iringa, Njombe and Tabora

Focus on men aged 10–34 years

Why VMMC for Young People

VMMC is a key priority HIV prevention intervention for adolescents in settings with high HIV prevalence and low circumcision rates (UNICEF, 2013)

Adolescence as a period of transition: most either about to become sexually active or just began

• Age of sexual debut for men in Tanzania is 18.7 yrs. • In Tanzania, 7% and 44% of men reported to have

engaged in sex by age 15 and age 18 respectively (THIMS 2012)

Opportunity for adolescent men to access sexual and reproductive health services

VMMC service data

Campaigns mostly reaching adolescents

HIV Testing

Source: HTC in VMMC study

Sexual Behavior and HIV Testing

Self reports of sexual intercourse engagement indicate: 0.09% of 10-14 yrs. old 9% of 15-19 yrs. Old

0.4% of circumcised adolescent were HIV+ compared to 1% of all VMMC clients

Benefits Beyond 60% Decrease in HIV Acquisition

0.45% of 33,017 boys aged 15-19 were diagnosed and treated for STI symptoms (excluding HIV)

Counseling and condom use demonstration likely to improve future use

Challenges in Age Appropriate Counseling

Currently condom promotion and safer sex counseling is designed for sexually active individuals

Providers offer separate group education, ensuring risk reduction counseling is age appropriate

About 68% of 18-19 yrs. olds reported to be less satisfied with counseling compared to the 52% of 15-17 boys or 42% of the 20+ yrs. men (Source: HTC in VMMC

study)

Turning the Tide Against AIDS

Requires concentrated focus on young people (UNICEF)

VMMC provides only partial protection Adolescents needs continual access to

other services:-• HIV counseling and testing • Condoms and other prevention technology• HIV education in schools• Treatment and prevention of other STI• Care and treatment services

Collaboration with a local NGO in Makete to reach adolescents

UNICEF/Jhpiego/SUMASESU (“Support Makete to Self Support”)

Demand creation in advance by SUMASESU (funded by UNICEF) as they have local intelligence and can better engage local leaders and the community to seek VMMC services, focusing on youths

VMMC services offered in the targeted communities using trained VMMC providers supported by Jhpiego

Conducted 3 VMMC outreaches reaching 2,080 clients since Feb 2014. Majority (more than ¾) are adolescents

Results of the collaboration

Number of outreaches 3

Total VMMCs 2,080

Adolescents 1,587 (76.3%)

HIV testing 2,070 (99.5%)

Positive 35 (1.6%)Total number of facilities involved 20

SUMASESU OUTREACHES

Asante Sana!