The fight against HIV/AIDS takes a multiprong approach for both prevention and treatment. Voluntary medical male circumcision (VMMC) is one of the biomedical HIV prevention interventions that are being emphasized. Uganda is among the 15 priority countries in which WHO/UNAIDS recommended VMMC. According to Uganda AIDS Commission report for 2020, 516,000 eligible males were circumcised.

Although strides have been made to reach males with VMMC, there is an age band disparity especially in getting males that are 30+ years to access VMMC. Boroboro Health Centre III, a UPMB-LSDA supported facility is among the sites where VMMC services are being provided in Lango sub region. Despite efforts to mobilize the 30+ years males for circumcision, turn up for services remained low. A root cause analysis conducted at the facility revealed that; the 30+ years males think that VMMC is for young boys. They also felt that their privacy was being violated during the VMMC camps when older men were mixed with young boys. The timing of the VMMC activity was also not favourable for them since it happens during working hours.

The facility team sought for solutions that could help them reach the 30+ years target group. The use of satisfied VMMC clients as “champions” to mobilize their peers and flexing working hours to accommodate the working class were selected as solutions to fix the problem. At the time of assessment, the facility had only managed to reach 30 males of 30+ years in a space of three months. This number was small compared to the monthly target of about 52 clients 30+ years.

“We realized that most of the males 30+ years preferred to come to the facility beyond 5 o’clock given their working schedules and also not wanting to be mixed with the other age categories consequently we had to adjust the working hours to accommodate this category and avail them the services”, says the VMMC Focal Person at the facility.

The satisfied client strategy was very instrumental in mobilizing and driving the client numbers high at Boroboro HC III. These satisfied clients are VMMC beneficiaries who are enlisted from within the Health Centers catchment area. They are briefly trained by the health information officers and are given a modest facilitation of transport refund and airtime. This facilitation is performance based and they have to meet certain targets in the month before being refunded, says the lead VMMC champion for mobilization.

In a space of six months, Boroboro HC III had managed to reach 80% of the expected target of male 30+ years. The efforts and strategies used enabled them to tap into an age band that is seemingly hard to reach with VMMC services. The facility continues to engage the satisfied clients with whom they hold regular planning meetings.
“VMMC services for this age band needs to be tailored to the needs of the clients other than operating in a business-as-usual mode of VMMC camps where these categories will not show up”, says the VMMC FP of Boroboro.

The UPMB regional team in the North have picked up lessons from the use of these strategies. They plan to scale them up to sites that have similar challenges like that of Boroboro to reach out to males 30+ years with HIV prevention services.