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Characterizing the effect of the COVID-19 pandemic on PEPFAR-supported voluntary medical male circumcision services, 2020

Title
Characterizing the effect of the COVID-19 pandemic on PEPFAR-supported voluntary medical male circumcision services, 2020
Presenter
Megan Peck
Authors
M. Peck * (1), K. Ong (1), T. Lucas (1), V. Kiggundu (2), A. Thomas (3), S. Chandler (2), A. Yansaneh (2), A. Prainito (4), D.H. Watts (4), C. Toledo (1)
Institutions
(1) U.S. Centers for Disease Control and Prevention, Division of Global HIV & TB, Atlanta, United States, (2) U.S. Agency for International Development, Washington, D.C., United States, (3) U.S. Department of Defense, HIV/AIDS Prevention Program, San Diego, United States, (4) Office of the U.S. Global AIDS Coordinator, Washington, D.C., United States

BACKGROUND: The 2020 COVID-19 pandemic led to a significant disruption in the U.S. President''s Emergency Plan for AIDS Relief (PEPFAR) voluntary medical male circumcision (VMMC) program for HIV prevention in sub-Saharan Africa. VMMC programs are vulnerable to COVID-19 mitigation measures given that interventions aimed at curbing COVID-19 transmission such as suspension of elective medical interventions, and closure of healthcare facilities, directly impact VMMC services and health seeking behavior.
METHODS: PEPFAR Monitoring, Evaluation, and Reporting (MER) Data were analyzed to characterize VMMC service disruptions during the COVID-19 mitigation measures among the 15 sub-Saharan African countries prioritized for VMMC. VMMC annual and quarterly performance in U.S. Government fiscal year (FY) 2020 were compared to FYs 2017 to 2019 including the number of males circumcised and achievement of national targets.
RESULTS: Globally, 65% of the VMMC annual target was met in 2020 compared to 102% in 2019 and the majority, 12 of 15 countries, did not meet their annual national target. 2020 had the lowest achievement of annual target for the period of 2016 ' 2020 (Figure 1). Among all 15 countries combined, annual VMMC performance decreased 33% from 3,899,572 VMMCs performed in 2019 to 2,631,202 performed in 2020. Quarter 3 2020 was the most significantly impacted quarter (Figure 2), with 13 countries experiencing a reduction in services ranging from 18% to 100% compared to the same quarter in 2019.




CONCLUSIONS: Country-specific targets are established to maximize the benefits of VMMC; however, during the COVID-19 pandemic in 2020, most countries did not reach these targets.