Voluntary medical male circumcision: Safety and satisfacion at Migori County Hospital

Abstract

Background: The World Health Organization (WHO) recommended Voluntary Medical Male Circumcision (VMMC) as an HIV prevention option for men based on evidence showing a reduction in HIV acquisition of 50% to 60%. Based in this evidence, the rapid expansion of VMMC in sub Saharan Africa has raised concerns on the capacity of VMMC programs to provide sustainable high quality and safe VMMC services.

Objective: To determine the rates and correlates of adverse events following VMMC among clients attending Migori County Hospital.

Design: Descriptive cross sectional study Setting: Migori County Referral Hospital, Kenya.

Subjects: Between November and December 2015, 138 men receiving VMMC services at Migori County hospital were interviewed during their follow up visits within 7 days following the procedure. We systematically sampled every third participant attending their follow up visit. Face to face interviews were conducted to obtain data on demographics and levels of satisfaction, and physical examination to determine any adverse events after circumcision. Fishers exact was used to test for correlates of adverse events among participants.

Results: The mean age of participants was 22 years, Standard Deviation (SD) ±5) .About two-thirds (63.8%) had reached secondary level education, 26(18.8%) tertiary level, 23(16.7%) primary level and only 1(0.7%) had no education. The majority 100(72.5%) reported being aware of possible adverse events following male circumcision and almost all 135 (97.8%) participants reported having adhered to wound care instructions. The rate of mild and moderate adverse events was 58.7% and 2.9%, respectively. There was no severe adverse event reported. Bathing and not changing underpants was associated with adverse events. The Majority 137 (99.3%) of participants were highly satisfied with the circumcision procedure and the post-operative care services they received.

Conclusion: These results imply that VMMC in this setting can be delivered safely and effectively with high client satisfaction.